MUS Workers' Compensation Program

Step 1 - Employee and Supervisor

Complete the First Report of Injury form  Click here to begin

Injured Employee and Supervisor may complete the form together.  

Employee provides all Worker Information.  The "next" button automatically emails instructions to the Supervisor.  

Supervisor completes requested information, prints the form for the Employee to sign and date, and then hits the "next" button to continue routing. 

Step 2 - Employee

Employee must:

  1. send signed and dated form to Mike Panisko, 34D Phyiscal Plant; and, 
  2. call the third party administrator, Intermountain Claims, 866-722-4421, if Employee has or is seeking any medical treatment. (If an emergency, Supervisor can call Mike Panisko at 243-2842 when appropriate.)

Questions?

Contact Mike Panisko, 406-243-2842 or 406-544-6121, with any questions or concerns.