Workers' Compensation-HR @ Carnegie Mellon University - Carnegie Mellon University

Workers' Compensation

The Pennsylvania Workers' Compensation Act provides medical benefits and payment for lost wages to employees who sustain a work-related injury or illness through the course of employment. Your follow-up care must be obtained by approved physicians/facilities in order to be eligible for Workers' Compensation benefits.

All employees should review the Workers' Compensation Injury/Illness Forms Packet [pdf], which contains the following:

  • Injury/Illness Report: Work with your manager to complete the form - sign and return it to Human Resources' Benefits Department if you sustain a work-related injury or illness
  • Acknowledgement of Employee Rights and Duties: Sign and return to Human Resources Benefits Department
  • Information Form: Sign and return to Human Resources Benefits Department
  • Workers' Compensation Medical Panel: A list of approved Workers' Compensation medical providers

When you sustain a work-related injury or illness...

You must follow this procedure in order to be awarded workers' compensation. 

Important: Worker's Compensation forms must be submitted immediately to the Benefits Department via fax (412-268-7472) or email (Jan Provenzano, Leaves Manager at with or without signatures. Do not submit forms via Campus Mail or U.S. Mail.

  1. Seek medical attention.
    • If your injury occurred on-campus and is severe, call University Police (412-268-2323) for immediate assistance. If the injury occurred off-campus, call 911 for immediate transportation to an emergency room for treatment.
    • If your injury is not an emergency, go to Concentra Medical Center at 120 Lytton Avenue for walk-in treatment or call Concentra Medical Center at 412-621-5430 to inquire about scheduling an appointment.
  2. Inform your manager and complete paperwork.
    • Inform your manager of your injury immediately (within 8 hours) so that you and s/he can complete an Injury/Illness Report and the Acknowledgement of Employee Rights and Duties forms. Completed forms must be submitted to the Benefits Department via fax or email immediately.
      Note: If your manager is not available, a department representative with knowledge of the situation and departmental authority may submit the forms without manager signatures. The Benefits Department will follow-up to obtain the necessary signatures.
    • If your injury does not appear to require medical attention, still complete the forms to record the injury, in case medical attention should become necessary later.
    • Note: Environmental Health & Safety (EH&S) has developed an Incident Response Flowchart [pdf] to assist with this process. For more information about this process and reporting, visit EH&S's Accident Prevention and Reporting site.
  3. Obtain necessary follow-up care.
    • Your follow-up care must be provided for the next 90 days by a Panel Physician [pdf]. Concentra Medical Center is recommended.
    • If you do not choose to have your follow-up treatment provided by a Panel Physician, you will be required to pay all expenses yourself.
    • After 90 days, if additional treatment is required, you can choose your own physician after notifying the Benefits Department within five days.


Through Workers' Compensation, you can receive the following benefits:

  • Payment of Medical Expenses: Reasonable and necessary medical expenses are paid for work-related injuries or illnesses even if the employee does not miss any days away from work. Medical expenses are paid for as long as the employee requires treatment for the work related injury or illness.
  • Replacement of Lost Wages: An employee is paid a portion of his/her salary if the employee is unable to work due to a work-related injury or illness, up to a maximum amount per week as provided by law. Payment begins after seven calendar days. This is known as the "waiting period." If an employee is unable to work for more than 14 calendar days, then benefits begin retroactively as of the date of injury or illness.
  • Specific Loss Benefit: Benefits are payable, in specified amounts as defined by law, for the loss of vision, hearing, and/or the use of a limb, including fingers and toes.
  • Disfigurement Benefits: Benefits are payable for serious, permanent disfigurement of the head, face or neck.
  • Death Benefits: An employee's dependents may claim benefits if an employee dies due to a work-related injury or illness.


Concentra Medical Center
University Center
120 Lytton Avenue
Suite 275
Pittsburgh, PA 15213