Workers' Compensation

The District's integrated Workers' Compensation Program will provide workers' compensation benefits in accordance with Florida Statutes (Chapter 440) to employees injured in an accident arising out of and in the course and scope of employment.

Reporting an Injury/Illness

It is the responsibility of every employee to report a work-related injury/illness as soon as it happens. The employee must notify his/her supervisor and work-site worker's compensation contact immediately and complete a Comprehensive Accident Report. The work-site worker's compensation contact will complete the First Report of Injury/illness, etc. and will offer medical attention, if needed, with an approved workers' compensation medical management treatment facility. An Employee Acknowledgement Form must be reviewed and signed by the employee and a Medical Authorization for Treatment Form will be completed by the workers' compensation contact/supervisor if medical care is necessary. IMPORTANT: Do not email any document with a full social security number; use only the last four (4) digits.  For example: XXX-XX-1212.

Workers' Compensation Forms

WC Packet - WITH MEDICAL WC PACKET - WITHOUT MEDICAL First Report of Injury Comprehensive Accident Report Injured Worker Brochure Injured Worker Brochure (Spanish) Authorization for Release of Medical Information Fraud Statement

Employee Acknowledgment of Declined WC Benefits Employee Acknowledgment of Declined WC Benefit (Spanish) MyMatrixx Prescription Card Authorized Treatment Facilities Employee Acknowledgement Medical Authorization for Treatment What to do In Case of a Work Related Injury Optional Supplement to Leave Form

Contact Information 

Michelle Gallas
Analyst, Workers' Compensation
Phone Number: 386.734.7190 ext. 20225
Email: mlgallas@volusia.k12.fl.us

USIS: 1.800.444.9098