1. Notify Supervisor and Program Nurse of injury immediately.

    2. Fill out Employee Report of Injury and HIPPA form. 

    3. If you wish to seek medical attention, inform your Supervisor or Program Nurse. They will contact Kelly Kmetty in the Business Office.  An authorization for treatment will be sent to Ingalls prior to your arrival.

    4. Submit all completed paperwork to your Supervisor or Program Nurse (per Supervisor direction). DO NOT TURN THESE FORMS INTO INGALLS. 

    5. Follow up with your Supervisor regarding injury treatment and ability to return to work.

    6. Supervisor will complete a Supervisor Report and ask for Witness Statements, if witnesses are indicated on the employee's injury report. 

    7. Supervisor or Program Nurse (per Supervisor direction) will submit all paperwork to the Business Office for processing. 


    If you have any questions or concerns regarding Worker's Compensation, please contact Kelly Kmetty at 708-342-5350 or kkmetty@swcccase.org. 


  • If a form or link is not working properly on this page, please notify Kelly Kmetty at kkmetty@swcccase.org.