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Workers' Compensation

Injuries on school premises are covered under Worker’s Compensation. Injuries must be reported to the school nurse or campus contact as soon as they occur and a First Report of Injury must be completed. To file a First Report of Injury (FROI) go to www.tasbrmf.org
Worker’s Compensation is covered by a different insurance company than the district’s health insurance plan.

 

If an employee is going to be treated for their injury they must go to a clinic in the Alliance.

 

Benefits Coordinator: 
Kimberly Kempken
kkempken@fisdk12.net
Phone: 281-482- 1267
Fax: 281-996- 2606

 

FORMS:

 Verification of Employment
Send with employee to clinic

 Optum Prescription Card
Send with employee to clinic

• Election of Leave Benefits
• Election of Leave Benefits (Spanish)
Return to Benefits Coordinator

• Employee Acknowledgement of Alliance
• Employee Acknowledgement of Alliance (Spanish)
Return to Benefits Coordinator

• Employee Notice of Alliance
Give a copy to the injured employee

• Notice of Injured Employee Rights
• Notice of Injured Employee Rights (Spanish)
Give a copy to the injured employee