Workers' Compensation
Types of Work Related Injuries/Illnesses
- Life threatening/serious injuries (e.g., excessive bleeding, broken bones, chest pain, unconsciousness)
Call 911 or go to the nearest ER. The employee’s work site must notify Human Resources immediately when a work incident requires transport by ambulance, ER visit or hospital admittance.
- Minor injuries/illnesses (e.g., minor bumps, scrapes)
These minor incidents do NOT impact an employee’s ability to continue working and require no medical treatment or care.
- Injuries/illnesses beyond first aid (e.g., back injuries, knee strains, exposure to hazardous substances)
Employees will be referred to a designated occupational medical facility for non-emergency medical care.
Contact Erika Ceja at 650-877-8704 or [email protected] with any questions concerning the necessary forms or procedures.
If Injured at Work
- In the case of an emergency, call 911 immediately.
- Report all incidents/injuries believed to be work-related to your supervisor / administrator immediately.
- Contact the company nurse at 877-518-6710 to report all work-related injuries/illnesses as soon as possible. The district search code is SMCS03.
- SSFUSD has elected to provide employees with the choice of medical services for work-related injuries and illnesses by implmenting a Medical Provider Network (MPN). For additional information regarding the MPN network, contact Erika Ceja at [email protected].
- You may pre-designate a qualifying personal physician/medical group to treat you in the case of work-related injury (LC 4600). Pre-designation must take place prior to your date of injury. Written veriffication that your personal physician/medical group meets the pre-designation requirements and agrees to be pre-designated must be provided. Inclusion of information regarding your insurance company, plan or fund providing health coverage for non-occupational injuries/illnesses is required.
- Contact Erika Ceja at (659) 877-8704 for additional information.
Reporting a Work-Related Injury
When an injury or illness to an employee occurs while working, the injured employee has the right to file a workers’ compensation claim.
The employee’s supervisor or school administrative assistant must be notified IMMEDIATELY no matter how slight the injury may be.
Any delay in reporting a work related injury/illness by either the employee or the employee’s supervisor can impact the progress of the claim or medical treatment.
SSFUSD will provide the injured worker the following required forms, and employees must complete the forms no later than one (1) working day from the injury notification.
The workers’ compensation check list must be used by school/department staff to ensure all necessary forms have been provided to the injured employee and completed as directed. This check list must be returned with all other items to HR.
Employees must complete this form describing the events surrounding their work-related injury/illness. Employees choosing not seek to medical care or who do not wish to file a workers’ compensation claim must still complete this form. Employees must return this directly to their supervisor for submission to HR.
Supervisor completes this form in its entirety every time an occupational injury/illness is reported and submits it to HR. This form is required whether or not an employee wishes to seek medical care or file a workers’ compensation claim.
Supervisor completes and/or provides the following additional items ONLY IF: (1) injured employee seeks medical treatment and/or (2) injured employee is filing a workers’ compensation claim.
This document provides information to the injured worker regarding their rights in choosing medical care for their work- related injury or illness.
This form should only be provided to and completed by injured employees who seek medical treatment for their workers’ compensation injury or those wishing to file a claim. All items on this form must be filled out by hand.
Employees must fill out the top portion marked “Employee”, and the supervisor fills out the portion marked “Employer.” Supervisor must provide employee a copy of the DWC-1 form and forward the original to HR.
For an employee seeking medical treatment, this form must be completed by the supervisor and provided to the injured employee to obtain medication, if prescribed by the workers’ compensation physician. This is a temporary RX card to be used until a more formal card is issued to the employee by the claims examiner/Keenan. A list of approved retail pharmacies is included.
If the injured employee does not have a pre-designated physician form on file with the HR department, the employee must be treated by one of the covered medical providers listed in the above document in order for their medical care to be covered under a workers’ compensation claim.
Returning to Work
The medical provider treating the employee’s work related injury/illness will issue the employee a Work Status Report after every visit. It is the employee’s responsibility to provide a copy of this report to the HR department after each appointment. An employee cannot return to work unless they have been authorized to do so by either their supervisor or the HR department.
If the treating physician releases an employee back to work with restrictions, the HR Department along with the employee’s supervisor will determine whether an employee’s work restrictions can be accommodated and/or if a transitional or modified work assignment is available.
The injured employee must remain off work until a decision has been made and the employee has been notified.