In compliance with California Workers' Compensation Law, an employer must report all work related injuries or illnesses arising out of and in the course of employment and covered by the California Workers' Compensation System. To comply with this law, all supervisors should complete the necessary forms and adhere to the following workers' compensation procedures.
Employees are covered for any injury/illness arising out of or in the course of employment. Octagon Risk Services is the Third Party Administrator (TPA) for the CSU Workers' Compensation Program.
All job-related injuries or illnesses should be immediately reported to the employee's supervisor and the Human Resources Department (SH-110).
Medical treatment will be authorized if necessary. CSUSB has designated US HealthWorks Medical Group and St. Bernardine's Occupational Health Services as medical facilities to provide medical treatment for injured employees.
However, if prior to an injury, the Human Resource Department has been provided with a Pre-Designation of Personal Physician Form naming a personal physician, employees may seek medical care from this physician immediately after injury.
When an employee is injured on the job, the supervisor must complete a Supervisor's Injury/Illness Report (EHS-SIPR Form). After completing Form EHS-SIPR, please fax a copy to Human Resources at (909) 537-7019. The original copy must be mailed to the Human Resources Department within 24 hours of the report of injury/illness or you must call and report the injury to Human Resources.
After the necessary medical attention has been received, the supervisor is required by law to provide the injured worker with an Employee's Claim for Workers' Compensation form within one day of receiving notice of an injury which results in lost time beyond the date of injury, or which results in medical treatment beyond first aid. Examples of first aid could include: minor scratches, cuts, burns, splinters etc.
If the employee elects to file a workers' compensations claim, the employee will complete the top portion of this form and then immediately return the DWC-1 in person to Marjorie Callaghan, Manager of Workers' Compensation, in the Human Resources Department. In the event the employee is off work and unable to return the form in person, the supervisor should immediately send the form to: Human Resources Department, Attn: Marjorie Callaghan. The Human Resources Department will complete the bottom portion of the claim form and advise the employee of the claim's process.
If an employee qualifies for workers' compensation, all approved medical bills will be paid in addition to any temporary or permanent disability payments to which an employee is entitled.
If an employee is unable to work as a result of a work-related injury or illness, he or she may elect to receive Industrial Disability Leave (IDL) in lieu of temporary disability payments.
If you are not a member of CalPERS, Workers' Compensation benefits will be available through California Workers' Compensation Temporary Disability (TD).
