Workers’ Compensation

Our Workers’ Compensation Department understands the importance of you and your employee’s safety. Please complete the following form and someone will get back with you as soon as possible.

Work Comp Request Form

Phone

This field is for validation purposes and should be left unchanged.

Patient Name

First and Last

Patient Date of Birth

How Can We Reach You?

Contact Name (If different than patient)

First Last

Your Email Address

Email Address Confirm Email Address

Your Phone

So that we can best assist you, please complete the information below.

Date of Injury

Body part

Employer Name

Employer Contact

Contact Number

Work Comp Insurance

Name of Adjuster

Nurse Case Manager

Claim #

List any prior treatment for this injury

Is there litigation involved?

Yes

Any other information you'd like to share?

Nearly 3 million American workers are injured on the job every year, and if you or one of your employees is one of them, you know how important it is to get proper and timely treatment for the injury. Tri-State Orthopaedics provides a wide variety of orthopaedic care for injuries involving the spine, hands, feet, and ankles, in addition to physical medicine and rehabilitation, physical and occupational therapy, and surgery. Our same-day Orthopaedic Urgent Care clinic allows injured workers to be seen immediately, without an appointment.

Tri-State Orthopaedics Workers’ Compensation understands the Indiana Workers’ Compensation Program and can help those with job-related injuries get back to work quickly and safely.

Our Work-Related Injury Program features:

Board-certified orthopaedic surgeons with specialties in hand surgery, foot & ankle surgery, spine care, and physiatry
Certified hand therapists
Evaluation, diagnosis, and treatment of on-the-job orthopaedic injuries
Onsite medical imaging – X-ray, MRI, Diagnostic Ultrasound, EMG, and nerve testing
Physical medicine and rehabilitation
Orthopaedic surgery
Physical therapy
Occupational therapy
Work hardening
Prompt verbal and written professional communications for Worker’s Compensation

For Workers’ Compensation care, call our office today – 812-471-6683.