Report A Workers’ Comp Claim


 WORKERS’ COMPENSATION
CLAIMS REPORTING AND EMERGENCY REPORTING PROCEDURE

Report Claims Within 24 Hours of Injury

Report ALL workers’ compensation claims requiring medical treatment as soon as possible by calling your dedicated

Qual-Lynx Hotline

1-888-342-3839

Do not delay in reporting the claim even if you do not have all necessary information. After the First Report of Injury is taken, the First Report representative will ask the caller if they need to speak to the nurse on call.

If so, the First Report representative will ask the caller for a number where they can be reached and will page the nurse. The nurse will call the First Report representative and obtain all pertinent information and call you back to review the process for assigning a nurse case manager and how we will obtain follow up for the injured worker. The nurse will also answer any questions you may have.

For EMERGENCIES, ask for the 24-hour nurse on call. As part of the After Hours services, there is a nurse on call 24 hours a day, 7 days a week. A nurse is available to speak to the caller in the event of a catastrophic injury. A nurse will be paged and you will receive a return phone call. Have a contact name and phone number available.


 

When placing the above phone call, you will need the following information:

  • Date, place and time of injury
  • How the injury occurred and how it is work related
  • Type of injury
  • Social Security Number
  • Names of witnesses

For Questions or Issues Regarding a Filed Claim:

Qual-Lynx Client Services Manager
Christine Gallagher

Telephone #: 609-365-4016
Email: Christine.gallagher@Qual-Lynx.com

Qual-Lynx Nurse Case Manager
Ms. Stephanie Dionisio

Office:  609-388-9404
Fax:  609-365-4000
Email: stephanie.dionisio@Qual-Lynx.com 

Qual-Lynx 
100 Decadon Drive
Egg Harbor Township, NJ 08234

Click Here for the Qual-Lynx Account Service Team Contact List

These forms are now PDF fillable forms to make things easier for all of you to navigate, complete and save an electronic copy for any future use.

CLAIM FORMS:
(To download the below instructions in a printable Adobe PDF format, click here)

  1. Complete or have completed:
  2. Forward copies to Qual-Lynx with the  Workers’ Compensation Transmittal Form 
    Qual-Lynx
    100 Decadon Drive
    Egg Harbor Township, NJ 08234
  3. Send a copy of the Supervisor’s Report to your Business Administrator and/or Safety Committee Coordinator

Get a sample Instructions Guide for Employees Reporting Injuries Sustained on the Job
Click Here for a PDF Version 
Click Here for a Word Version 


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