KHPA Home - Workers Compensation (SSIF)

State Self Insurance Fund

For a list of people to contact in the State Self Insurance Fund click here Contacts

Mission: To provide high quality medical care, prompt disability and death benefits, return to work options and customer service to state employees covered under the Kansas Workers Compensation Act.

Philosophy: We are committed to providing workers compensation services that meet The Kansas Division of Workers Compensation Rules and Regulations.  We will strive for professional competency, responsiveness, fairness, cost effectiveness, consistency, accuracy and the highest ethical standards of conduct in all our operations.  We are focused on activities and processes that are geared to getting the injured employee back to work.

What should an employee who is injured at work do?

• Report any injury/accident to supervisor
• Agency staff must complete the Employer's Report of Accident form WORD version and email to wc1101a@khpa.ks.gov
• Obtain authorization for medical treatment if necessary from SSIF (use CorVel in network providers - click here). All email containing Protected Health Information (PHI) such as, the Employer’s Report of Injury, physician’s notes, medical reports, etc. must be sent securely. If you do not have a secure email delivery mechanism, you may use KHPA’s ‘Tumbleweed’ secure email delivery server to send encrypted email to KHPA.
• Communicate with agency/department and SSIF (phone: 785-296-2364)
• Frequently Asked Questions
• A Mileage Form PDF version is available for your use in keeping track of your miles and may be submitted periodically, usually monthly, as you drive
• A Guideline for the Repair or Replacement of Eyeglasses, WC-00-A PDF version, explains the process for obtaining benefits.  A Prescription Eyeglasses Replacement Form, WC-00 PDF version, needs to be filled out and returned to SSIF should your prescription eyeglasses be damaged during the course of your work.

What are the responsibilities of the agency when an employee is injured at work?

• Obtain authorization for medical care, if necessary from SSIF. Get the employee to the closest medical provider if it is a life or a limb threatening emergency.
• If a medical provider contacts you for authorization of medical care, refer the provider to the State Self Insurance Fund at 785-296-2364.
• Complete the Employer's Report of Accident PDF version form; Form 1101-A and send it as soon as possible to the State Self Insurance Fund. You may either mail it to: SSIF, 900 SW Jackson, Room 900-N, Landon State Office Building, Topeka, KS 66612 or fax it to: 785-296-6995.
• Submission of the Employers Report of Accident does not mean that the employee has been approved for Workers Compensation. The SSIF will investigate the claim once they have received the Employers Report of Accident and determine compensability.
• Refer the employee to this website for information they need to know about Workers Compensation. If they don’t have ready access to the website, please print out Frequently Asked Questions and Information for Employees  PDF version and give it to them. You may also refer them to call the SSIF at 785-296-2364.
• If the employee receives medical care and is given work restrictions by the medical provider, the agency must determine if those restrictions can be accommodated. If an employee is missing work due to a work-related injury and you haven’t received any information from the medical provider, contact the employee and obtain a copy of the work release or restrictions.
• It is important to keep the SSIF informed about any changes in the status of an injured worker. This includes changes in work restrictions, if they begin missing work or return to work.
• When the employee is eligible to receive Workers Compensation disability benefits, they may want to supplement it with vacation or sick leave. Please contact the SSIF if you have questions about the SHARP adjustments.
• Employees who receive Workers Compensation are not eligible for Shared Leave for the same medical condition. If you have questions about Workers Compensation and how it interacts with the Family Medical and Leave Act, you may contact the SSIF.
• Please contact the SSIF whenever you have questions about any aspect of handling a work-related injury. The phone number is 785-296-2364 and the fax is 785-296-6995. If you know who the adjuster is for a particular claim, you may contact them directly.

What are the Human Resource / Supervisor’s Role in the deployment of the CorCareRX prescription drug program?

The prescription program is for all New Claims as of October 12, 2009. The program is initiated as soon as the employee reports the injury and wants to go to the doctor for treatment:

• First, complete an Employer’s Report of Injury (Form K-WC 1101a, 02/06) and send it to the State Self Insurance Fund promptly within 24 hours of notification. The injury report may be sent by secure email to: wc1101a@KHPA.KS.Gov, or by fax to: (785)296-6995, or by mail to: The State Self Insurance Fund, 900 SW Jackson, Suite 900North, Topeka, Kansas 66612. All email containing Protected Health Information (PHI) such as, the Employer’s Report of Injury, physician’s notes, medical reports, etc. must be sent securely. If you do not have a secure email delivery mechanism, you may use KHPA’s ‘Tumbleweed’ secure email delivery server to send encrypted email to KHPA. Please refer to Appendix A for instructions on using the Tumbleweed system. If you would like to get your account set up in the Tumbleweed server please call the State Self Insurance Fund at 785-296-2364.
• Next, enter the Injured Worker’s Name, Social Security number and Date of Injury in the First Fill Letter.
• Print off a copy of the completed First Fill Letter and give it to the employee.
• Participating pharmacies are listed on the First Fill letter (including Walmart, Walgreens and CVS). You can also select a participating pharmacy from the Corvel website. Remember to search under the “CorCareRX” heading in the drop-down selection for a pharmacy in your area. (This drop-down is where you also search for a physician under the “workers compensation” heading). The link to the Corvel site is on the State Self Insurance Fund webpage.
• Inform the employee to give the First Fill Letter along with the prescription to the participating pharmacy if the doctor prescribes medication to treat the injury.
• Inform the employee that the First Fill letter is only good for 24 hours after receipt and only for their first prescription(s) following the injury.
• The letter can only be used for prescription medications related to this injury and cannot be used for obtaining unrelated medications.
• Payment for the prescription may be denied within 5 days if the State Self Insurance Fund does not receive the Employer’s Report of Injury (Form K-WC 1101a, 02/06).
• As soon as the State Self Insurance Fund receives the Employer’s Report of Injury (Form K-WC 1101a, 02/06) compensability will be determined.
• If the claim is accepted, the prescription will be approved and the injured employee will receive a CorCare RX prescription drug card in 3 to 4 days. The employee should use the CorCare RX Prescription Drug Card for any medication related to the injury that is prescribed by the treating physician.
• If the claim is not compensable, the employee will receive a statement in the mail indicating that it has been denied and that the employee will need to submit any bills related to the denied claim to their health plan provider.
• The employee’s CorCareRX Prescription Drug Card will remain valid for up to six months or as soon as the doctor releases the employee from care. If medical treatment extends beyond a six month period, the employee’s prescriptions may be transferred to a long term program. State Self Insurance Fund staff will handle this transfer.
• A CorCareRX Prescription Drug Card has to be issued for each new date of injury. Employees with two injury dates requiring medications will be issued two CorCareRX cards.
• For assistance please contact the State Self Insurance Fund at 785-296-2364 or Corvel at 800-683-1185.

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