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Mississippi

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

  1. Complete First Report of Injury or Illness as soon as you have been notified of a work-related injury.
  2. The injured employee has the right to choose their medical provider for treatment. The Notice of Physician Choice and Medical Authorization Form must be completed by the injured worker, if medical care is requested and submitted with the First Report of Injury.
  3. Complete the Wage Statement form, providing 52 weeks of payroll information. If the injured worker has not been employed for 52 weeks prior to the date of accident, provide the payroll information for the weeks of employment.
  4. 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.
  5. Please forward the return-to-work/disability slip from the doctor to Benchmark Administrators as soon as possible.
  6. 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 with any insurance-related information the medical provider may require.
  7. If there is a serious injury, notify Benchmark Administrators immediately by telephone.

Please submit any correspondence and medical bills to:

Benchmark Administrators
P.O. Box 940097
Maitland, FL 32794
Telephone: (321) 594-7222
Toll Free: (800) 362-5198
Fax: (352) 240-1203

24-HOUR CLAIM REPORTING HOTLINE: 1-866-337-0891
Customer Service Representatives are on staff 24 hours per day to assist you with reporting a claim. Please have the injured worker’s information available as well as the accident description.