Workers Compensation

When a workers’ compensation injury occurs the injured employee’s supervisor or other person designated by the employer should make sure that the claim forms are filled out and faxed to the Office of Human Resources at 501-450-5088.   Send original to Wingo Hall, Suite 106, Attn:  Ruby Burroughs.

Employer’s First Report of Injury or Illness (Completed by supervisor)

Employee’s Report of Accident (Form PECD 1) (Completed by employee)

Employer’s Report of Accident (Form PECD 2) (Completed by supervisor)

Employee’s Notice of Injury (Form N) (Completed by employee)

Supplemental Report (Form S) (Completed by supervisor)

Incident Report

Mileage Form

Health Care Notice for Employees Under Managed Care (Form H)

Worker’s Compensation Instructions to Employers and Employees (Form P)

The Company Nurse Injury Hotline



The Office of Human Resources is providing this information as a service to the campus community.  This is a service that is continually under development.  We will make every effort to keep this site current and to correct errors brought to our attention.

Workers’ Compensation Information – Worker’s Compensation for state employees is handled by the Public Employee Claim Division of the Arkansas Insurance Department.

Q.    If I have sustained an injury on the job, what do I do?

A.    If it is an emergency situation, seek medical care immediately. Also, immediately advise your supervisor that you need to report an injury.  If the injury is not an emergency, you will be asked by your employer to fill out and sign:

                        Forms AR-N ( and

                        PECD-1 (

Your employer will complete:

                        Forms I-A1 ( and

                        PECD-2   (

All of these forms will be forwarded to the Public Employee Claims Division of the Arkansas Insurance Department where a Claims Determination Manager will decide whether medical and/or indemnity benefits are payable on your claim.

**Important: In a non-emergency situation, failure to report an injury BEFORE seeking treatment may result in a denial of medical benefits until such time as you notify your employer of the accident.

Q.    Can I report to my usual physician for medical care?

A.     Actually, your employer has the right to select a physician from its MCO network to treat your workers’ compensation injury in most non-emergency situations. If your usual physician is within the network, it may be possible, but not guaranteed.

Q.     What if it’s an emergency situation? Does it matter where I seek medical care?

A.    In emergency situations, you will most likely be directed or taken to the nearest emergency room for immediate care.

Q.    What if I’m not satisfied with the physician selected for me by my employer?

Can I choose another physician?

A.    Your employer should have a directory of MCO member physicians and hospitals. You do have the right to petition the Arkansas Workers’ Compensation Commission for a one-time change of physician. However, you must choose a new physician who is listed in the MCO directory.

Q.    Is there another way I can have access to the directory of available physicians?

A.    Yes. The directory can also be accessed on-line by going to the Arkansas Insurance Department’s website at and under “Divisions” selecting “Public Employee Claims.” This will proved you with a list of menus options that include the “PECD Preferred Provider List.”

Q.    How or where do I obtain prescription medication?

A.    You may fill prescription medication at your local pharmacy.

Q.    Do I need to get a particular brand of medication?

A.    Yes. Arkansas Workers’ Compensation Commission rules require that generic brands should be used unless the treating physician provides sufficient justification for requiring brand name medication.

Q.    Will I get paid for my time off work?  If so, when will I start receiving payments?

A.    In general, there are two types of workers’ compensation claims:

        (1)   “Medical Only” claims, which do not involve more than seven days of disability for which only medical benefits are required and

        (2)   “Lost Time” claims for which either temporary total or temporary partial disability benefits are payable.  A claim is not considered a “lost time” claim until after you have missed seven (7) days of work; if you are disabled for two (2) weeks or more, your compensation benefits become retroactive to the first date of your disability.

If you have to miss work because of a work-related injury or illness, you may be eligible to receive some cash benefits (indemnity benefits).

The waiting period for these benefits is seven (7) calendar days and must be at the direction of your approved doctor. These payments can help you through the period of time you are disabled from your workplace injury or illness. Your coverage begins on the eighth day of partial or total disability.

You will be paid for the first seven (7) days only if you are disabled for more than fourteen (14) days. These days do not have to be continuous calendar days.

Q.    Will I get my full salary while I’m off work with a job-related injury?

A.    No. In most cases you will receive bi-weekly compensation payments in the amount of 66-2/3% of your average weekly wage, subject to the state maximum average weekly wage as determined by the Arkansas Workers’ Compensation Commission.

Q.    Can I use my sick leave or vacation leave to make up the difference?

A.    Yes, you have the option of using your sick leave to make up the difference between what your salary was and what you are receiving from worker’s compensation.  Only the difference between 8 hours per day and the hours per day paid by Workers’ Comp will be charged against your sick leave.

Q.    How long can I expect to receive Workers’ Comp. Benefits?

A.    In general, you will receive medical, and in appropriate cases, temporary disability benefits as long as you remain in you healing period and are either partially or totally disabled from working due to work injury.

Q.    Who determines when I am ready to return to work?

A.    In most cases, your physician will determine when your healing period has ended, also referred to as “maximum medical improvement,” and whether you have sustained any anatomical impairment warranting a period of additional compensation for any permanent disability. However, your employer may have a light duty program that will allow you to return to work in modified duty even during your healing period.

Q.     What if I am required to be on medication after my “healing period” has ended and my physician has approved for me to return to work? Will Workers’ Comp. pay for that medicine?

A.    Even after your healing period and permanent benefits (if any) have ended, you may be entitled to maintenance medication and/or medical devices as determined by your physician.

Q.    How do I contact the Arkansas Insurance Department Public Employee  Claims Division?

A.    Address: 1200 West Third Street, Suite 201

Little Rock, AR 72201

Phone:   (501) 371-2700- Little Rock, or (866) 278-8066 Toll Free