State Employee Health Benefits

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 which meet or exceed the expectations of our customers.  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 which add value to services.

Customer Survey:  The State Self Insurance Fund, Division of Personnel Services, processes and manages Workers Compensation claims for employees of the State of Kansas.  Our goal is to provide these services in the most efficient and satisfactory manner possible.   

What should an employee who is injured at work do?

• Report any injury/accident to supervisor
• Complete incident reports per agency policy
• Agency staff must complete the Employer's Report of Accident form [PDF version]  [Word version] and email to wc1101a@khpa.ks.gov
• Seek medical treatment if necessary (use managed care contracted facilities). This does not mean a claim will be approved.
• Communicate with agency/department and SSIF (phone: 785-296-2364)
• Complete WC-9 (SSIF) [PDF version] [Word version] and submit written claim (within 200 days of accident)
• Frequently Asked Questions
• See Information for Employees [PDF version] [Word version] for additional information
• 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] [Word version], explains the process for obtaining benefits.  A Prescription Eyeglasses Replacement Form, WC-00 [PDF version] [Word 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?

• Direct the employee to receive medical care, if necessary. Refer them to a managed care facility if there is one in the area (see list below). Otherwise, the employee may go to their PCP or to the emergency room at the local hospital.
• It is important to understand that directing the employee to seek medical care does not mean their Workers Compensation claim is approved. The SSIF adjuster will determine compensability of the claim.
• 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 920-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 or the Division of Workers Compensation at 1-800-332-0353.
• 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.

Managed Care Facilities

The State Self Insurance Fund has designated medical care providers in certain areas. To receive authorized medical treatment, injured employees must be seen at these facilities (if within their area). In locations that do not have managed care facilities the employee should be seen by their primary care physician.

Topeka:
St. Francis Hospital & Medical Center
1700 SW 7th Street
Topeka, KS 66606
(785) 295-8000

Kansas City:
University of Kansas Hospital Authority
3901 Rainbow Blvd.
Kansas City, KS 66160
(913) 588-5000

Kansas City:
KU Med West
7405 Renner Road
Shawnee, KS 66217
(913) 588-8400

Lawrence:
Lawrence Memorial Hospital
325 Maine Street
Lawrence, KS 66044
(785) 749-6100

Manhattan:
Mercy West
315 Seth Child
Manhattan, KS 66502
(785) 776-2813

Wichita:
Wichita Clinic
Occupational Health Building
3311 E. Murdock
Wichita, KS 67208
(316) 261-6183