In the event of an employee incident, complete the following First Report of Incident within 24 hours of your (or other managers) notification of incident. Have the employee sign the First Report of Incident. If the employee refuses to sign or is unable to sign, please note this on the report. Do not hold this report for the employee to sign, MB Advisors can get the employee signature at a later date.
If available, please fax any medical notes from the treating physician or hospital to MB Advisors Risk Management Department at 1.888.894.4622 or email it to wcinjuryreport@MBAdvisors.com.
Print and sign the Medical Authorization form and give it to the employee, along with one Chain of Custody form (Except for California).
A Drug Test is REQUIRED (Except for California) on ALL Reported Incidents Whether Medical Treatment is Needed or Not.
For weekday work related injuries:
Send the injured employee to the nearest identified medical facility from the approved provider list with a signed Medical Authorization form and Chain of Custody form (except for California). Then complete the following First Report of Incident.
For weekend, after hours, or holiday work related injuries:
Send the injured employee to the nearest identified medical facility from the approved provider list with a signed Medical Authorization form and Chain of Custody (except for California). Then complete the following First Report of Incident.
On the next regular business day, follow up with MB Advisors’ Risk Management Department at 1.888.622.6460.
For any EMERGENCY or SERIOUS work related injuries:
Call 911 for immediate treatment of the employee's condition. Please be sure to provide the emergency medical technicians a signed Medical Authorization form.
Call MB Advisors’ Risk Management Department at 1.888.622.6460 and complete the following First Report of Incident.
If you need additional help or information, please contact MB Advisors Risk Management Department at
1.888.622.6460