Cornerstone Comp Claims

Claims Contacts for Cornerstone Comp Members

Procedures for Cornerstone Comp Members

Posting Notices – Must be posted in a location for all employees to view

  • DWC-7 in English and Spanish
  • MPN Notification (posted with the DWC-7). The MPN provider search may be accessed at www.monumentllc.com Click the red Monument MPN tab in the upper right-hand corner of the page.

New Hire Documents

Time of Injury Documents

  • Cornerstone Comp 5020 Employers Report of Occupational Injury or Illness. Must be completed at the time of injury and emailed/faxed to Athens.
  • DWC-1 Workers’ Compensation Claim Form & Notice of Potential Eligibility. Must be provided to injured worker within 24 hours of reporting the injury.
  • MPN Notification Copy given to injured employee at the time of injury.
  • MPN Acknowledgement Form Injured employee must sign the form. Copy to employee, and signed copy is provided to Athens.
  • Employers Approval for Medical Attention Send with injured employee to treating physician
  • Cypress Care First Fill Letter Provide to injured worker to receive their first fill of medications paid without out-of-pocket expense.

Resources