WORKERS COMPENSATION

A University of Houston employee who sustains an injury or occupational disease in the course and scope of employment is entitled to receive compensation under the State Workers’ Compensation System. The following people are not considered employees for the purposes of workers’ compensation:

  • Independent contractors
  • Volunteers, except during a Governor-declared State of Emergency
  • Members of the state military forces, except while on active duty
  • Persons covered by federal workers’ compensation
  • Offenders
  • Consumers or patients of a state institution or agency
  • Non-employed students receiving a scholarship stipend

In most cases it is easy to determine if an on-the-job injury has occurred. Some cases, however, may require further investigation. It is not the Claims Coordinator/Claims Analyst’s or the Supervisor’s responsibility to make this determination. If the injured employee feels that the injury or illness is work-related, then it should be reported. The determination of compensability is made by the State Office of Risk Management, who administers the university’s workers’ compensation program. Please review the Workers Compensation Manual for detailed information. Additional references may found in the University of Houston's Manual of Administrative Policies and Procedures for Workers Compensation and Return to Work.


Filing a Workers' Compensation Claim

Employee Forms:

Employee's Report of Injury (SORM-29) [English] [Spanish] – The employee must complete this form immediately after sustaining a work-related injury. The form should be submitted to the Claims Coordinator who forward a copy to the State Office of Risk Management (SORM)

Authorization for Release of Information (SORM-16) [English] [Spanish] - The employee must complete this form immediately after sustaining a work-related injury and submit to the Claims Coordinator who will forward a copy to SORM.

Employee Election Form (SORM-80) [English] [Spanish] - employee must complete this form immediately after sustaining a work-related injury and submit to the Claims Coordinator who will forward a copy to SORM.

Workers Compensation Network Acknowledgement Form:  [English] [Spanish] - The employee must complete this form immediately after sustaining a work-related injury. The form should be submitted to the Claims Coordinator who will forward a copy to the State Office of Risk Management (SORM).

Employee Network Notification Packet: [English] [Spanish] - The employee network notification packet provides employees with information on how to get health care under workers’ compensation insurance. Please read the packet before signing the Workers’ Compensation Network Acknowledgement form which can be found directly above or in the employee notification packet. Additional information along with a brief video for employees can be found on SORM’s CompKey+ Employee page.


Supervisor Forms:

Supervisor’s First Report of Injury or Illness [English] – This form shall be completed by the injured employee’s supervisor or their designated representative and submitted to the Claims Coordinator within 24 hours in order to meet state stipulated deadlines. Failure to submit the necessary forms on a timely basis may delay medical and income benefits to the injured employee and may result in administrative fines to the University.

Witness Statement (SORM-74) [English] [Spanish] - The form must be completed by each witness to the accident. The injured employee's supervisor or designee should forwarded the statements to the Claims Coordinator.

 


 



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Related Links
Workers' Compensation Brochure
Workers' Compensation Contact Information
TXComp - Division of Workers' Compensation
State Office of Risk Management
CompKey+ Health Care Network
Find a Health Care Network provider here