Workers' Compensation

1. Employee Responsibilities

If you experience a work-related injury or illness:

• Report Immediately: Notify your supervisor as soon as possible—no later than 24 hours after the incident.
• Seek Medical Care: Obtain emergency care if needed. For non-emergencies, contact HR or your supervisor for information on approved medical providers.
• Complete Required Forms: Work with HR to complete the Employee’s Claim for Workers’ Compensation Benefits (DWC-1) form.
• Stay in Contact: Keep HR and your supervisor informed of your medical status, any work restrictions, and your anticipated return-to-work date.
• Follow Treatment Plans: Attend all appointments and follow medical advice to support your recovery.

2. Supervisor Responsibilities

When an employee reports a work-related injury or illness:

• Ensure Immediate Care: Contact emergency services if needed and assist the employee in getting medical attention.
• Notify HR Promptly: Report the incident to Human Resources the same day it occurs.
• Document the Incident: Provide details, witness statements, and information about how the injury occurred.
• Maintain Communication: Stay in touch with HR and the employee throughout the recovery and return-to-work process.
• Promote Safety: Work with HR and Risk Management to address hazards and prevent future incidents.

3. Human Resources Responsibilities

Human Resources manages compliance, claims, and communication throughout the process.

• Provide and Process Claim Forms: Issue the DWC-1 form and submit all required documentation (Form 5020, etc.) to the workers’ compensation carrier on time.
• Coordinate Medical Care: Assist the employee in accessing approved medical providers.
• Monitor the Claim: Track the employee’s recovery and communicate with the insurance carrier and supervisor as needed.
• Support Return-to-Work: Coordinate light-duty or modified assignments in line with medical restrictions.
• Ensure Compliance: Maintain confidentiality and meet all state and organizational reporting requirements.

4. Return-to-Work Process

1. The employee provides HR with medical documentation and any work restrictions.
2. HR and the supervisor review available modified or light-duty work options.
3. The employee returns to work when medically cleared or as approved for transitional duty.

Questions and Support

For questions or guidance about the Workers’ Compensation process, reporting procedures, claim status, or return-to-work options, contact  Human Resources hr@stmarys-ca.edu 

1. Assist Employee in Getting Medical Attention.
 

In the event of a life-threatening or limb-threatening medical emergency:

• Call 911
• Call Public Safety 925-631-4282 or psadmin@stmarys-ca.edu
• For non-emergency medical attention, an employee may make an appointment at one of the
  following Occupation Medical Clinics:

2. Notify Human Resources

• Immediately report workplace injury or illness, accident to hr@stmarys-ca.edu
• Ensure employee completes the Injury and Illness Incident Report within 24 hours and submits the
  DWC-1 Form to hr@stmarys-ca.edu
• Submit any Work Status Reports given to you by employee to hr@stmarys-ca.edu 

3. Address/Report the Hazard. 

• Investigate the accident. Work with Environmental Health & Safety (EHS) to
  correct any immediate hazards and prevent further injuries.
• Coordinator for EHS: Peter Wells (925)631-8287 pjw6@stmarys-ca.edu
• If repairs and/or maintenance is needed, please file a Work Order with Facilities ASAP.
• Do NOT discard equipment or furnishings/equipment that may have been involved in the incident.
• Restrict people from the hazard area.
• Remove the equipment from service, but do not discard.
• Take pictures as appropriate.

For questions or assistance, please contact hr@stmarys-ca.edu or (925) 631-5049
 

Reminders:

• Injured employees who have been determined to be 100% disabled by a medical provider are NOT
  allowed to work in any capacity.
• Medical clearance is required prior to employee returning to work. Human Resources will notify
  Supervisor of employee’s return to work status.
• Injured employee may be given restrictions and/or modifications by medical provider. Human Resources
  will work with the employee and the supervisor to determine if restrictions/modifications can be accommodated.

1. Immediately Inform Your Supervisor if you have a work injury, illness or accident. 

Reporting your injury promptly helps to prevent delays in receiving benefits, including the medical care you may need to prevent further injury.

2. Seek Medical Attention. 

For Medical Emergencies go to the nearest Emergency Room. If you need medical attention for an injury that is not an emergency, call and make an appointment at one of the following Occupation Medical Clinics:

3. Complete Required Forms

• Complete the Injury and Illness Incident Report within 24 hours of reporting your injury or illness and submit to hr@stmarys-ca.edu.
• Complete the DWC-1 Form within 24 hours of reporting your injury or illness and submit to hr@stmarys-ca.edu.
• NOTE: You may seek medical care PRIOR to submitting report or form. Your injury or illness must be reported to your supervisor ASAP.

4. Communicate. 

Keep your supervisor updated on your status, recovery, and medical appointments. Submit all Work Status Reports provided to you during your medical appointment to your supervisor and hr@stmarys-ca.edu following a medical appointment. You can take a photo of the reports on your phone and email to hr@stmarys-ca.edu.

5. What to Expect After You File Your Claim. 

A Claims Adjuster will reach out to you, and provide more information regarding your claim.
 

For questions or assistance, please contact hr@stmarys-ca.edu or (925) 631-5049

Reminders:

• If you have been taken off work by your medical provider, you are NOT allowed to work in any capacity.
• Medical clearance is required prior to returning to work.
• You may be given restrictions and/or modifications by your medical provider. HR will work with you and your supervisor to determine if restrictions/modifications can be accommodated.