Insurance info: EMPLOYEES (Employee Assistance, Departmental Forms)
ALL insurance forms (completed & signed) are to be submitted to the Select Board's Office
ARE YOU A TOWN EMPLOYEE INJURED ON THE JOB?
Sorry to hear it - we want you well!
Our default stance for injuries occurring on the job?
When in doubt, report!
Submit paperwork ASAP
- Complete the appropriate form (including the injured employee's social security number)
- Obtain sign-off from your manager (managers, please provide your full contact information on the form where indicated)
- Submit the paperwork to the Select Board Office immediately at selectmen@townofberlin.com, deliver it to Room 206, or drop all paperwork in the Select Board 2nd floor mailbox.
Click here to find the necessary forms to report employee on-the-job injuries (both public safety and non-public safety employees):
- Non-public safety employees -----> complete a Workers' Compensation (WC) report form
- Police and Fire officials -----> complete the 111F injured on duty (IOD) report form
- Was ambulance transport needed for your on-the-job injury? Only if transported by Berlin EMS, the Berlin EMS ambulance fee may be waived for Berlin employees injured on the job (per Berlin Select Board)
- Senior and Veteran Work-Off workers are not Town Employees under the Workers' Compensation policy. Instead, Work Off employees injured on the job may file a 3rd party property/liability claim with the Select Board Office).
ARE YOU AN EMPLOYEE IN NEED OF ASSISTANCE?
The MIIA Employee Assistance Program (EAP) is the Town-paid confidential counseling and referral service for its employees. It is here for you! 24 hours a day ... 7 days a week.
Call 800‐451‐1834
You receive 3 confidential in‐person or phone counseling sessions:
- Manage Anxiety/Depression
- Adjust to Demands of Work
- Resolve Relationship Conflict
- Talk About a Loved One’s Drinking
- Address Parenting and Family Issues
- Assess Your Level of Stress
- Become a Better Communicator
You receive legal assistance of one free 30-minute office or telephone consultation per legal matter (this offering does not include job‐related legal issues).
- Divorce
- Child Custody
- Car Accidents
- Real Estate / Landlord / Tenant Issues
You receive financial counseling with one free 30-minute telephone consultation per financial issue.
- Financial Planning
- Credit Card Debt
- Tax Advice
- College Planning
- Retirement Consultation