Work-related incidents, injuries, and illnesses must be reported and investigated promptly and accurately.  All work related incidents must be reported, including “near misses.”

Work Related Incident/Injury/Illness Absences

If an employee misses 4 or more days of work as a result of the work related incident/injury/illness, contact the Workers’ Compensation Department at occupationalhealth@luxotticaretail.com or (513) 765-3987.  A Workers’ Compensation Leave of Absence will then be reported to HR and the associate will be made “Inactive” in SAP, until notification is received of their return to work.

In the event of a work-related incident/injury/illness, you must take the following actions as listed in the Workers’ Compensation timeline.

Immediate Action:

  • If this is a life threatening condition, please call 911. Otherwise, please administer first aid (if injury/illness occurs as a result of the incident).
  • If care beyond basic first aid is needed, have the employee call the 24/7 Nurse Line at 1-866-350-9088
  • Refer to timeline for your respective state above to ensure that all required paperwork is completed and returned.

Within 24 hours (U.S. and Canada):

The employee, his/her manager, and a witness (if applicable) must complete and fax the following forms to the Workers’ Compensation Department at 513-492-6965.

Associate Report of Occupational Incident, Injury or Illness
Supervisor Report of Occupational Incident, Injury or Illness
Witness Report of Occupational Incident, Injury or Illness

Copies of all forms can also be found on the HR Solutions site.

CA Stores only: Employee must complete a DWC 1 Form (Employee’s Claim for Workers’ Compensation Benefits) in addition to the Associate Report of Occupational Incident/Injury/Illness and fax it to the Workers’ Compensation Department. 

Retention: Stores that retain personnel files on site should retain original forms in the employee’s personnel file.

Workers’ Compensation Required Postings

Workers’ Compensation Coverage Poster:
The Proof of Workers’ Compensation Coverage posting is distributed to stores by our insurance broker, Willis Towers Watson. This poster must be posted in an area of your store that all employees are able to access.

Medical Panel Poster:
Some states determine which facilities can provide an employee with medical care by providing an approved Medical Panel list.  In these states, employees may only obtain medical care from one of the facilities/healthcare providers listed on the medical panel. The Medical Panel poster must be posted in an area of your store that all employees are able to access.

*Note: the following states/regions do not require medical panels:  Nevada, Ohio, Oregon, Washington, Puerto Rico, Canada, Guam, Virgin Islands

If your location is missing either of these required postings, contact the Workers’ Compensation Department at occupationalhealth@luxotticaretail.com or (513) 765-3987.

Canada – Workers’ Compensation process:

Complete the above incident reports and fax them to (513) 492-6965 within 24 hours of the work injury.

Canadian Workers’ Compensation Boards (WCB) are provincially and territorially regulated throughout the Country and provide insurance for workplace injuries and illnesses. Once incident reports are received, the Workers’ Compensation Manager will determine whether a claim needs to be reported to the respective Workers’ Compensation Board.

Note:  Sedgwick does not manage Canada Workers’ Compensation claims.

Frequently Asked Questions

Q: What should I do if my store receives an Occupational Injury/Illness Survey?
A: Email the survey to retailsafety@luxotticaretail.com.

Q: My employee claims that he sustained an injury at work a few weeks ago, but did not report or complain of it at the time he allegedly sustained the injury.  What should I do?
A: Contact the Workers’ Compensation Department at occupationalhealth@luxotticaretail.com or 214-973-4396 for further instruction.

Q: My employee does not want to obtain treatment from a facility on the state Medical Panel list. What should I do?
A: Advise the employee that if he/she refuses to obtain treatment with a provider listed on the medical panel, he/she may be personally liable for payment of medical treatment expenses.

Q: When does a claim need to be reported to Sedgwick?
A: If the employee receives outside medical treatment (other than first aid) at an urgent care, doctor’s office, hospital, etc., then a claim will need to be reported to Sedgwick by calling (866) 350-9088.

Q: My question is not addressed here/I need further assistance – who should I contact?
A: Contact the Workers’ Compensation Department at occupationalhealth@luxotticaretail.com or 214-973-4396.