Claims Contacts for Cornerstone Comp Members
- Monument Administrators Cornerstone Comp Administrators
- Athens Administrators Claim Administrators for Cornerstone Comp
- Division of Workers’ Compensation Headquarters
- DMIG Workers’ Compensation Claims Advocate
Procedures for Cornerstone Comp Members
- Cornerstone Comp Time of Injury Checklist What to do when an injury occurs.
- Summary of Documents Checklist of required postings and distributions as outlined and linked on this page.
- OSHA Reporting Requirements and Instructions Outline of instances in which you must report an injury to OSHA, and instructions for reporting.
- Athens Administrators Online Reporting Procedure
- Claim Authorization Form Provides authorization for Cornerstone Comp to release loss runs to your designated staff members. Must be completed by an officer of the company and returned to Monument.
- Select a Medical Provider Click “Monument MPN” on the top right of the page to access the Monument MPN and select the Industrial Medical Provider that will provide care to your injured employees. If you would like assistance with your selection, please contact us.
Posting Notices – Must be posted in a location for all employees to view
- DWC-7 in English and Spanish
- MPN Notification (posted with the DWC-7). The MPN provider search may be accessed at www.monumentllc.com Click the red Monument MPN tab in the upper right-hand corner of the page.
New Hire Documents
- Time of Hire Pamphlet English, Time of Hire Pamphlet Spanish Included with new hire information. Includes list of DWC Information and Assistance Offices
- MPN Acknowledgement Form New Hire must sign form. A copy is given to the new employee. The signed original is to be placed in personnel file.
- MPN Notification
Time of Injury Documents
- Cornerstone Comp 5020 Employers Report of Occupational Injury or Illness. Must be completed at the time of injury and emailed/faxed to Athens.
- DWC-1 Workers’ Compensation Claim Form & Notice of Potential Eligibility. Must be provided to injured worker within 24 hours of reporting the injury.
- MPN Notification Copy given to injured employee at the time of injury.
- MPN Acknowledgement Form Injured employee must sign the form. Copy to employee, and signed copy is provided to Athens.
- Employers Approval for Medical Attention Send with injured employee to treating physician
- Cypress Care First Fill Letter Provide to injured worker to receive their first fill of medications paid without out-of-pocket expense.
- First Aid Definitions Guideline for determining if an injury can be treated as first aid.