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WORKERS' COMPENSATION
Medical Providers |
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| Medical Provider Forms: | Authorization from Eagle River Water & Sanitation District: |
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Work Restriction Form: |
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Employees |
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| Workers' Compensation Employee Forms: | CTSI (County Technical Services Inc.) Workers' Compensation Contacts: |
| CTSI Workers' Compensation Claim Forms Checklist | Toll-Free Number: (888) 559.6829 |
Main Number: (303) 861.0507 |
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| Employer's First Report of Injury: | Fax Number: (303) 861.1022 or (303) 861.2832 |
Norma Stimmler, Claims Manager, Extension 118, nstimmler@ctsi.org |
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| Employee's Written Notice of Injury to Employer: | |
Jeanette Bryant, Claims Adjuster, Extension 119, jbryant@ctsi.org |
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| Sundee Hahn, Senior Claims Adjuster, Extension 120, shahn@ctsi.org | |
| ERW&SD's Incident and Near Miss Report: | Cecilia (Sid) M. Hust, Senior Claims Adjuster, Extension 121, shust@ctsi.org |
Leslie Cavanaugh, Claims Adjuster, Extension 129, lcavanaugh@ctsi.org |
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| HIPAA-Compliant Authorization for Release of Medical Information: | Dee Martinez, Nurse Case Manager, Extension 126, dmartinez@ctsi.org |
| Colorado Mountain Medical Authorization (Initial Visit): | |
| Lost Time Claims: | |
| Wage Statement: | |
| Colorado Workers' Compensation Supplemental Report of Return to Work: | |
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This Website was last updated on July 31, 2007.
