Workers' Compensation Program
If you become ill or are injured because of your job, you may be entitled to Workers' Compensation benefits. This coverage includes the cost of all reasonable medical care and/or hospital bills, wage compensation benefits if you are temporarily disabled, and permanent disability benefits of applicable.
If you become injured or ill, you must notify your supervisor immediately. Your supervisor will complete the Work Related Injury/Illness Form and provide to you the Claim Form DWC 1 within 24 hours of their knowledge of your injury/illness. Late reporting could delay or jeopardize Worker's Compensation benefits.
All CSU work related injuries/illnesses are managed by a third party administrator, Sedgwick CMS. The adjustor assigned to our campus will contact the injured worker and supervisor regarding each injury to obtain additional information. Your cooperation in answering their questions and providing pertinent details is critical in the review and acceptance of your workers' compensation claim.
For staff or faculty, Med Stop* or Sierra Vista* are the designated local facilities for work related injuries unless an employee has completed a predesignation of personal physician form and it has been filed through the Worker's Compensation Analyst.
*Are the designated local facilities for work related injuries
Work Related Injury/Illness
New Hire Notice
Includes Injuries Caused by Work, Predesignation of Personal Physician, Chiropractor, or Acupuncturist
To report injuries or request information about an injured employee
This email and phone number is monitored during business hours by Hudson to ensure a timely response.
Supervisor’s must report any known injury to the Worker's Compensation Analyst
California (WC) laws require California State University facilities to provide Workers' Compensation Benefits to employees who are injured or who develop an illness as a direct result of their employment. The University is required to report work-related injuries or illnesses. Serious injuries must be reported to CAL/OSHA within eight (8) hours from the time of the incident.
RESPONDING TO A MEDICAL EMERGENCY
In the event of a medical emergency, call 911 from any phone to contact Cal Poly Police. Tell the dispatcher where you are and answer any other questions they may have. The campus police dispatcher will send the appropriate personnel. Examples of medical emergencies are excessive bleeding, broken bones, loss of consciousness, or severe chest pains. When in doubt about the severity of a medical emergency, always dial 911 from any phone to contact the police.
Employees in these situations often minimize the extent of their injury or try to refuse treatment. Be firm in requiring a medical evaluation. Do not allow employees in these situations to leave campus until University Police have responded. Please wait to complete any injury/illness reporting forms until after the emergency has been resolved.
Student health care is covered by the Student Health Center with the following exceptions: student workers or students working on a work-study program. Student interns should report the injury/illness and seek medical treatment. Student intern injuries/illnesses are managed pursuant to the work agreements and can take time to review. These students should immediately report the injury/illness to their instructor and seek medical treatment.
SEEKING/DRIVING NON-MEDICAL TREATMENT
If an injury or illness requires only First Aid treatment, such as removing a splinter or the treatment of minor cuts and abrasions, utilize the First Aid kit located in the department. The University's Student Health Center does NOT provide First Aid or medical treatment to faculty, staff, or student employees who sustain a work-related injury/illness.
If an injury or illness requires medical treatment beyond First Aid, and the employee is unable to drive, please contact a staff member to arrange transportation to an urgent care facility.
REPORTING AN INJURY
Employee / Volunteer / Student Worker
Employees may be entitled to Workers’ Compensation (WC) benefits if they sustain a work-related injury/illness, or they become a victim of a workplace crime. WC covers many injuries however, the decision is determined by our third-party administrator, Sedgwick CMS. If an employee is injured/ill, they must notify their supervisor or manager immediately.
Employee/Volunteer Injury/Illness Report
For all injuries/illnesses, employees/volunteers/student workers must complete an Employee/Volunteer Injury/Illness form. Complete and sign the "Employee" portion, then the manager or supervisor completes and signs the “Supervisor” portion.
Employees Claim for Workers' Compensation Benefits
If an injury or illness requires more than First Aid treatment, the manager or supervisor should provide the employee employees/volunteers/student workers with an Employee's Claim for Workers' Compensation Benefits form. Complete and sign the "Employee" portion of this form and return the form to the WC office. The WC office will complete the “Employer” portion of this form.
Seek medical treatment if needed. Prior to going for treatment or evaluation, the employee will need a Medical Service Order form. The employee must bring the form, signed by a supervisor/manager or WC staff member to let the medical facility know that they have the authorization to be seen for a work-related injury/illness.
If an injury/illness requires medical treatment beyond First Aid, the manager/supervisor should immediately provide the injured employee with the necessary forms. State law requires that employers provide the injured employee with an Employee's Claim for Workers' Compensation Benefits form within one (1) working day of the notice of knowledge of the work-related injury/illness. However, the form only needs to be completed if the employee needs medical treatment beyond first aid.
RETURNING TO WORK AFTER AN INJURY / ILLNESS
Released to work with no restrictions. If the employee is released to return to work without restrictions, the employee must obtain from the treating physician, a written release to return to full duty and give the release to his/her manager or supervisor upon returning to work.
Released to modified or light duty. If the physician releases the employee to "modified" or "light" duty work, the employee's supervisor and the WC staff member will review the work restrictions and determine if the department is able to accommodate the temporary modified or light duty work, to assist the employee in transitioning back to their full job duties.
If a temporary transitional assignment is feasible, the employee's supervisor will meet with the employee to review the transitional assignment and the work restrictions prescribed by the physician. The temporary assignment will be reviewed at regular intervals to ensure that the employee is continuing to improve. Changes will be made as appropriate.
If a temporary transitional assignment is not available, the WC staff member will contact the employee to discuss the available options. The employee's supervisor should not allow the employee to return to work without a written release from the treating physician.