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Worker's Compensation - Notification of Designated Providers

  1. General Procedure
    Employee(s) who suffer a work-related illness or injury should immediately report the injury to the supervisor.

    1. Supervisors are to immediately call an ambulance (9-1-1) if the injury is a critical emergency. The employee will be sent to the nearest emergency medical facility. However, one of the medical providers designated below must provide all of the follow-up care. If a non-life threatening injury occurs after hours and immediate medical attention is required, the employee should seek treatment at the following after-hours urgent care facility: AfterOurs - Thornton, 3212 E. 104th Ave., Thornton, CO 80233. Hours of operation are 8:00 am - 11:00 pm, 7 days a week.

    2. When the injury is not critical, the supervisor or employee is to complete the Employee’s First Report of Injury Form. This must be completed within 24 hours of the occurrence of the injury and delivered to the HR Department. Do not wait for medical reports before filling out the First Report of Injury Form. The supervisor will direct or arrange for the employee to get to one of the designated authorized medical facilities. The employee may choose which of the four designated providers listed below they wish to see.
  2. The authorized medical providers designated by the Town of Frederick:
  3. US Healthworks (Concentra)
    1860 Industrial Cir., Ste. D
    Longmont, CO 80501
    M-F 8:00 am to 5:00 pm
  4. Advanced Urgent Care & Occupational Medicine
    112 S. Denver Ave.
    Fort Lupton, CO 805621
    M-F 8:00am to 5:00pm
    2801 Purcell Street
    Brighton, CO 80601
    Open 7 Days a Week, 8:00am - 8:00pm
  5. WorkWell Occupational Medicine
    205 S. Main St., Ste. C
    Longmont, CO 80501
    M-F 8:00 am to 5:00 pm
  6. SCL - Larkridge Family and
    Occupational Medicine
    16570 Washington St.
    Thornton, CO 80023
    M W F 8:00am to 5:00pm
    T TH 7:00 am to 5:00 pm
    Saturday 8:30 am - 12:30 pm
  7. If an unauthorized medical provider treats an employee, the employee will be responsible for the payment.
  8. 3. The employee must provide copies of any reports given to him/her by the treating physician to the HR Department. An employee capable of performing the essential functions of his/her job will be returned to work. An employee requesting reasonable accommodation to assist in performing his/her job will also be returned to work upon accommodation. Accommodation requests should be communicated to the HR Department and to the employee’s supervisor. When an employee is able to fully return to work, written clearance from the authorized treating physician MUST be provided to the HR department prior to the employee’s return to full duty.
  9. Acknowledgement
    I have read and have access to a copy of this policy. I am fully aware of the Town’s policy regarding medical treatment for work-related injuries and illnesses. I further understand that I must immediately report any work-related injury to my supervisor. I understand that work-related illnesses and injuries must be treated by one of the designated facilities listed above, and that if I choose to see an unauthorized medical provider to treat my work-related illness or injury, I will be solely responsible for payment to that medical provider, and any future benefits to which I may be entitled may be reduced or denied.
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