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THE HADESTOWN HUB
WORKPLACE INJURY REPORT FORMS & INFO
INJURY REPORT FORM
Submit this form to Stage Management to inform them of an injury. Should you seek medical treatment, please let Company Management know.
Workplace Injuries
Any injuries that occur at the theatre or rehearsal studio, no matter how small, should be reported to a Stage Manager. They will log it in the daily report. If you decide to seek medical treatment, a Stage Manager will have you complete an Accident Report Form and file a claim. Claims are filed with our Worker’s Compensation (“WC”) insurance company, who will accept all bills related to the injury. Company Management is happy to assist in guiding you through your claim, but wish to respect everyone’s unique medical needs and privacy - please reach out if you would find assistance helpful.
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Claims Process
After filing an accident report with Stage Management, Company Management will report your accident to our worker’s compensation provider, Berkley Regional Insurance Company. You will receive a copy of this claim via email. This email is sent immediately upon submission, so please notify a stage or company manager if you have not received it. Save this email and your claim number once it is provided to you.
A Claims Adjuster from Berkley Regional Insurance Companymay contact you via phone and/or email after the claim is filed. They will ask you questions about the accident (what happened, where it occurred, if you lost any time at work [e.g. missed a performance due to the injury], etc.). They will also ask you if you are seeking treatment, and where. If you are seeing our in house physical therapist, please let them know that. This is a simple verification call - however, they need to hear from you before they can begin paying medical bills. Please communicate with your adjuster - ignoring these calls or emails can result in delays of treatment.
If you are not planning on seeking treatment immediately, you can simply let the adjuster know that - it will not stop you from seeking treatment in the future. When you do decide to seek treatment, simply let the adjuster know you are going to seek treatment so they can open the claim again for billing. Claims are automatically closed if they do not hear from you.
Doctors
Please reach out to Andrew and Lindsay if you would like an assistance in finding a doctor. We will always help find a doctor, but we will not seek out a doctor for you unless you ask us. Please reach out and we can send you options of doctors who are familiar with the unique needs of those in our industry. Remember that it can take a few days to get an appointment, so please let us know ASAP if you are thinking of seeking treatment. If you are making an appointment on your own – please be sure to ask doctors you are seeing if they accept workers compensation prior to booking your appointment. An office will likely ask you to provide your claim number at the time of the appointment.
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Here are some Orthopedists that we know to accept Workers Comp (subject to change):
Dr. David Weiss
Sports, Performing Arts Medicine
161 Madison Avenue (between 32nd and 33rd Streets)
Suite 10NW
New York, NY 10016
Phone: 212-889-8228
*Text: 347-979-7743 (*only during office hours, M-F 9-5)
Fax: 844-287-3555
Email: WeissMD.info@gmail.com
Web: www.DavidWeissMD.com
Dr. Phillip Bauman
343 West 58th Street #1
New York, NY 10019
Office: 212-506-0228
paborthomd@gmail.com
Dr. Jessica Gallina
Orthopedic Surgery, Foot & Ankle Surgery
(Dance Specialist)
240 Central Park South #2
New York, NY 10019
Office: 212-265-0255
jgallinamd@yahoo.com
Policy Information for Billing
Do not use your own health insurance for work-sustained injuries. Please pass along the below information:
Employer: Hadestown Broadway LLC
Employer Contact: 212.398.2133 x238
Employer Address: 630 Ninth Avenue | Suite 809 | New York, NY 10036
WC Insurance: Berkley Regional Insurance Company
WC Policy Number: # WCA7529291-10
Policy Term: 05/28/2025 – 05/28/2026
WC Claim Number: From your confirmation email
Prescriptions
If you are prescribed medication, do not use your personal health insurance at the pharmacy. The Berkley Regional Insurance Company and your adjuster will provide information about receiving pharmaceutical benefits.
Reminders and Tips
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Do not use your personal health insurance for work sustained injuries.
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If you have multiple injuries/claims open, please be sure you are giving the proper number for the proper claims.
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Save the above policy information, along with your unique claim number, on your phone for easy access.
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AEA Members should review the information posted on the callboard re: Work Sustained Injuries to read more about union benefits and supplemental workers compensation insurance.