Claims

How to report an occupational injury or disease claim:

  1. Report a workplace accident as soon as it happens.
  2. If you think you injury or health condition is work-related, tell the dispensary and make sure the doctor or nurse checks “claimed occupational” on all dispensary forms.
  3. If you injured yourself at work be sure to describe the accident to the doctor.
  4. If you developed a condition over time due to the wear and tear on you body from your job duties, make sure to describe your job duties to your doctor so he or she understands how the physical requirements of your job caused you to develop the condition.
  5. If you are claiming a work-related injury, you must file a form 18 with the North Carolina Industrial Commission. Filing an incident report is not enough. Form 18 can also be filled out and submitted on-line.
  6. You must file an accident report (F159) in the dispensary within 30 days of the accident.
  7. When you are on workman’s comp you must pay your medical, dental and life insurance premiums. You can download the form for this on this page to the get coupons you need to send in your payments.

 Instructions for filing a non-occupational disability claim:

If you are or will be out of work due to a non-occupation illness or disability, you are required to contact UNUM to start a non-occupational disability claim and notify your HR contact and/or management of your absence. You can reach UNUM at 1-866-779-1054. 

You can request FMLA through the Goodyear Self Service Portal at selfservice.goodyear.com   or call 1-330-796-1900