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When an employee is injured on the job, proceed with the following:

  1. Complete Form WC 1 – First Report of Injury providing detailed information about the accident and injury.
  2. Complete Wage Chart providing payroll information for 52 weeks immediately preceding the date of accident.
  3. If you are a drug free work place, post-accident drug testing must be requested according to your policy requirements.
  4. Should the injured worker request medical care, present them with a list of four (4) Urgent Care/ Walk-In Clinics located in your area for them to select designated medical provider. Once the injured worker has selected their physician, circled said physician and signed the document selecting the physician, you will need to contact the selected physician by telephone prior to sending the injured worker for medical care. This document will need to be provided to Benchmark Administrators at the time the claim is reported. If you need assistance finding providers for your designated medical provider listing, please contact Benchmark Administrators for assistance.
  5. Inform the medical provider that you have an injured worker coming and that Benchmark Administrators is the claims administrator.
  6. Advise the injured worker they must return to your office or job site after receiving medical care and provide the doctor’s signed return to work slip or documentation of medical disability.
  7. Please forward the return to work/disability slip from the doctor to Benchmark Administrators as soon as possible.
  8. If a worker is seriously injured and needs immediate care or is transported by ambulance, the employer should have a co-worker or supervisor go with the injured worker to assist the injured worker with any insurance related information that the medical provider may require.

Required State Forms

Colorado - First Report of Injury

Medical Provider Options:

Advanced Urgent Care & Occupational Medicine

AFC Urgent Care

Centura Centers for Occupational Medicine

NextCare Urgent Care

UC Health Walk-in and Urgent Care Centers

Correspondence & Prescription Billing

Benchmark Administrators
PO Box 46350
Las Vegas, NV 89114
Telephone: (866) 221-3110
Toll Free: (800) 362-5198
Fax: (801) 623-6035

Medical Billing

Medical Bills Can Be Mailed To:

P.O. Box 14365
Lexington, KY 40512

Process medical bills online by signing up with E-Billing Benefits

Western Integrated Care, on behalf of Benchmark Administrators, Payer ID is LV191.


Customer Service Representatives are on call 24 hours per day to assist you. Please have the injured worker's information available as well as the accident description.