Workers' Compensation Insurance

Worker’s Compensation coverage provides financial compensation to employees* when they are injured on the job due to a work related injury that arises out of  and due to the employees employment responsibilities. Compensation is in the form of loss wages and medical costs. Rose-Hulman obtains Worker’s Compensation insurance coverage from an insurance carrier. An injury "arises out of the employment" when there is a relationship between the injury sustained and the duties or services performed by the employee. Ind. Code §22-3-6-1(e). 

*For Worker’s Compensation purposes; an employee is an individual classified by Rose-Hulman as a FT/PT employee and obtains a monthly or bi-weekly wage/payroll statement and W2 from Rose-Hulman.  

W/C Packets-Site Coordinators

Site Coordinators are trained on how to file a First Report of Injury in the event of a work related injury. Employees can receive their Work Comp packet and instructions from the Site Coordinator or their immediate supervisor.  The Site Coordinator and the immediate supervisor are first contacts in the event of a work related injury. Employees are only permitted to seek initial treatment from the medical providers or locations listed within the packet. Any referrals to another physician or location (unless life threatening) must be pre-approved by the workers compensation carrier. Unapproved referrals for a work related injury will not be covered by Worker’s Compensation or by the Rose-Hulman group health insurance. Please follow the process as outlined to avoid any personal financial hardship.

If an employee is traveling, they should seek initial treatment at the closest emergency care or emergency room and notify their immediate supervisor or site coordinator of their situation immediately.

How to Report an Injury

Step by Step Claim Procedures:

  1. Immediately notify your immediate supervisor or Site-Coordinator of the injury.
  2. Complete First Report of Injury form.
  3. The immediate supervisor or Site-Coordinator must email (preferred method) or hand deliver a completed First Report of Injury form to Susan Butts within 24 hours of the date of the injury. 
  • A delay in reporting the work comp incident to RM will delay the approval and acceptance time of the Work Comp carrier-please submit all injury reports ASAP
  1. READ the information provided within the “Employee Care Packet” received from your immediate supervisor or Site-Coordinator.
  2. Obtain medical treatment at one of the “Initial Care Physicians” listed within the “Employee Care Packet” for treatment due to your W/C injury. Injured employees are not authorized to receive medical treatment from any locations other than those listed on the “Initial Care Physician” form without prior approval from our Worker’s Compensation carrier, unless for a life threatening injury.
  3. Employee will be subject to a drug and alcohol screening at time of medical treatment/s. 
  4. During the initial visit, provide the medical care provider with the Medical Provider Report that is located within the Employee Packet.
  5. Return to work and provide your supervisor or Site-Coordinator, as well as Risk Management, with the Medical Release or Return-To-Work form that you receive from the medical care provider.

NOTE:  If your injury requires any work restrictions or time off from work, please notify your immediate supervisor and Risk Management as soon as possible.   

You are not permitted to seek medical treatment or be referred to another medical care provider (unless life threatening) without the approval of the insurance carrier.

Additional Information

Prescription Coverage

Prescription coverage is provided by our Workers Compensation carrier when the employee’s injury requires medication.  Employees are not permitted to use their RHIT prescription card for prescriptions related to their worker’s compensation injury.  A temporary prescription card is located within each Site-Coordinator/Work Comp packet. Once the claim has been assigned to an insurance adjuster, additional information related to prescriptions will be provided to the employee by the insurance carrier.

Return to Work Program (RTW)

In the event an employee suffers an injury which was caused by and due to their job responsibilities, and such injury requires work restrictions, Rose-Hulman will work with the immediate supervisor to determine if the restrictions will prohibit the employee from performing their normal job functions. 

If the injury prohibits the employee from performing their normal job functions, we will look for other work available within the employee’s immediate department. If there is no work available within the employee’s immediate department, the Institute will temporarily place the injured employee in an alternative department on or off campus.  The employee will remain in the alternative department until the light duty work is no longer available or until the employee’s work restrictions are changed by the physician. While working within the alternate department, that department’s supervisor will oversee the supervision of the temporarily placed employee. Any time away from work (medical appointments, vacation, sick time and etc...) will be coordinated through the temporary department supervisor as well as Risk Management. The work hours while on light duty (restricted work) may be different than the employees normally scheduled hours or shift.                              

If there is no light duty or alternative work available, the employee will remain off work until their work restrictions are changed by the work comp physician, until light duty becomes available or until the employee is released to return to work, whichever comes first.          

Rose-Hulman will provide, when available, light duty work for a maximum period of no longer than 180 days, per injury.  After 180 days, or when such restrictions cannot be accommodated, the employee will be released from the RHIT RTW program and will remain off work until they are released from Work Comp, or no longer have work restrictions. After the waiting period has been satisfied and all work comp requirements have been met, the employee will be paid a salary through the work comp carrier at a rate of 66 2/3% of the employees “average weekly wage.”               

Timely Claim Reporting

All injuries must be reported to the Site Coordinator or immediate supervisor within 24 hours of the time of the injury. Please do not delay the reporting of your claim; even if you are not seeking medical treatment, a claim form must be submitted in the with the 24 hour timeline! If neither the Site Coordinator nor immediate supervisor can be reached, the employee can notify the Manager of Insurance and Risk Management, Moench Hall room A101, and complete the required forms.

The Site Coordinator or immediate supervisor will immediately email the First Report of Injury to the Manager of Insurance and Risk Management (RM). RM will provide all documentation to the Work Comp carrier for handling of the injury. A delay in reporting work comp incidents to RM will delay the approval and acceptance time of the Work Comp carrier-please submit all injury reports ASAP

Job Assessments

Job Assessments have been performed on all high incident positions such as grounds, housekeeping, custodial services, maintenance and etc. These assessments evaluate the requirements of the position and safety measures which are to be taken into account when performing the required job functions.

Accident Investigation

Worker’s Compensation injuries requiring medical treatment or time off from work are investigated by the office of Environmental Health and Safety. Accident investigations are a way for OEHS and Risk Management to determine if workplace programs and safety measures in place are adequate or if changes should be implemented in order to provide a safe working environment for all employees, students, and guests. All completed Investigative Reports are submitted to the Manager of Insurance and Risk Management for further review.


Training should be provided to all new employees before the operation of any machinery or equipment. Documentation of such training should be recorded and maintained in the employees file. The employee and the immediate supervisor should both sign off on the appropriate form in order to verify that training was completed and the process was completely understood. Safety training, other than basic departmental training, is conducted by the Office of Environment Health and Safety on an annual basis.

Retraining after an injury (When applicable)

When an employee is injured during the operation of or process involving equipment or machinery, retraining will be required.  Once retrained, the employee, the immediate supervisor, and EH & S (when applicable) will sign off on the required form stating that such training has been performed and that the employee understands the functions required of the job.  This form should be retained in the employees file. 

Enforcement of Safety

Rose-Hulman takes the safety of our employees seriously and has created safety policies, procedures and training programs in order to educate and protect our employees. Failure to follow safety will not be tolerated and is a violation of Rose-Hulman’s safety program; such violationscould result in a written citation and/or disciplinary actions as deemed appropriate by the Institute.           

Contact Numbers

After an injury had been reported to Risk Management, the claim will be reported to the Rose-Hulman work comp carrier for handling. The adjuster assigned to Rose-Hulman claims is Kathi Willitzer at JWF Specialty. If an employee has a question about their claim, they can contact Kathi directly at 800-359-6659 X9565 or 317-706-9565.


If an employee has any questions or concerns involving the ergonomic correctness of their workstation, they should contact the Manager of EH&S and request an ergonomic inspection of their work area or workstation.