Workers' Compensation Toolkit

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This kit is provided to new workers' compensation policyholders and their agents, as well as to all current policyholders when their policies renew. It contains important claims department contact information, instructions, and forms.


Georgia Contact Information:

Nationwide Insurance - East Office
One Nationwide Gateway, Dept. 5570
Des Moines, IA 50391-5570
(800) 889-9872
Fax: (800) 363-8904

Harleysville Insurance
PO Box 244
Harleysville, PA 19438-0244
(888) 595-9876
Fax: (800) 441-4118

Agribusiness Mailing Address for Claims Related Mail
1100 Locust St., Dept 3010
Des Moines, IA, 50391-3010
Phone: (800) 228-6700
Fax: (800) 842-1482

 

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Georgia Compliance Information

Posting Requirements

Reporting Of Claim By Employer

Penalties for Late Reporting

Physician Selection


Posters and Publications

OFFICIAL NOTICE Panel of Physicians (Must be printed and posted on legal size (8.5 x 14) paper) Required


OFFICIAL NOTICE Panel of Physicians (Must be printed and posted on legal size (8.5 x 14) paper (Spanish) Required

OFFICIAL NOTICE WC/MCO Panel Must be printed and posted on legal size (8.5 x 14) paper Required

OFFICIAL NOTICE WC/MCO Panel Must be printed and posted on legal size (8.5 x 14) paper (Spanish) Required

POSTER - Bill of Rights (Must be printed and posted on legal size (8.5 x 14) paper) Required

POSTER - Bill of Rights Spanish (Must be printed and posted on legal size (8.5 x 14) paper) Required

POSTER - Stop Workers Compensation Fraud Poster Required

POSTER - Stop Workers Compensation Fraud Poster (Spanish) Required

BROCHURE - Best Practices for Proper Claim Reporting

BROCHURE - Best Practices for Role of the Employer

BROCHURE - Best Practices for Selecting Physicians for Your Panel

BROCHURE - Best Practices for Early Return to Work

BROCHURE - Best Practices for Communication with Workers Compensation System


Forms

Employer's First Report of Injury


Wage Statement






Please Note: The information on this site is maintained by a third-party, Nationwide does NOT warrant or represent that the information will be error-free. Your use of the site is on an as-is basis, at your sole discretion and risk. The site is for informational purposes, and nothing included in the site shall replace the need for qualified legal counsel. We recommend that you consult with legal counsel, agents, or risk managers regarding workers' compensation obligations.

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