Center for Human Resources
Workers’ Compensation

Work-Related Injuries

What To Do If You Are Injured At Work

Policies and Procedures

• Tell your supervisor immediately. You must report any injury to your supervisor within 24 hours, no matter how trivial the injury may seem. You will need to tell him/her when and where the injury occurred, what happened, and if anyone witnessed the injury.
  
  
• Complete the Claim Benefit Form. Once you report your injury to your supervisor, he/she will give you an Employee’s Claim for Workers’ Compensation Benefits Form  to complete should you desire medical treatment. Your supervisor will submit your claim form in addition to preparing a Supervisor’s Report of Work-related Accident/Illness Form  to the Risk and Workers’ Compensation Manager. In cases where injuries require medical treatment, the Risk and Workers’ Compensation Manager will report the incident to the university claims administrator:
  
  
  Sedgwick CMS
  P. O. Box 3170
  Rancho Cordova, CA 95741
  
  Sedgwick CMS makes the final determination of whether your injury is work-related and what benefits you are entitled to receive. In some cases, the Claims Administrator conducts an investigation into the incident — a process that may delay your receiving benefit compensation. You should receive a notice from the Claims Administrator shortly after the injury report is filed. It’s important to keep in touch with the Risk and Workers’ Compensation Manager, in addition to the Claims Administrator, to prevent unnecessary delays in resolving your case.
  
  
• You’ll receive a medical treatment referral. If your injury requires medical treatment, your supervisor will refer you to SDSU Health Services or to one of the authorized Sharp-Rees Stealy Occupational Health Services facilities or WorkMed Industrial Care Providers. All medical bills and reports will be sent to Sedgwick CMS. The Risk and Workers’ Compensation Manager needs to be aware of your continued absences due to the injury. Please forward copies of all work status slips you receive to the the Risk and Workers’ Compensation Manager and provide copies to your supervisor.
  
  
• You’ll be assigned a modified or light-duty work assignment. Inform your doctor of San Diego State University’s guidelines to provide you modified work, or light duty while you are recovering from a work-related illness or injury. Such positions will be temporary in nature and will be monitored by your immediate supervisor, department manager and Workers’ Compensation Manager. Job restrictions, as defined by treating physicians, will be strictly adhered to.
  
  
• Record time off work due to work-related injury or illness. Inform your supervisor and the Risk and Workers’ Compensation Manager if you are off work due to the injury or illness. If you are off work for any period of time, you must keep your supervisor and the Risk and Workers’ Compensation Manager informed of your progress and provide them periodic updates from your physician concerning your recovery. You are also responsible to record all absences, with your signature, on the “Absence and Additional Time Worked Report" (Form 634). Forms are available from your timekeeper. After the University’s Claims Administrator, Sedgwick CMS, approves your time off work, your leave balance will be credited back to you.
  
  
• We’ll be in touch. The Risk and Workers’ Compensation Manager, your supervisor, and the University’s Claims Administrator will be in contact with you. If you have any questions or concerns, call Rhonda Russell, the Risk and Workers’ Compensation Manager, at (619) 594-4664.

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Workers' Compensation Benefits

Brief Overview

Any current periods of absence will be charged to your personal leave accruals. If your claim is accepted, you will receive full pay on the day of injury. The first three calendar days of lost time (after date of injury) are considered as the waiting period and will be charged to leave credits. Any time off must be authorized by the doctor in order for the lost time to be covered under workers’ compensation benefits. Once you have returned to work, any visits to the doctor or therapy treatments are charged to your leave credits.

If your claim is accepted, you are entitled to medical treatment for the industrial injury. Our carrier will pay all medical expenses related to the industrial injury. These would include, but not limited to, doctor’s visits, physical therapy, mileage to doctor visits and prescriptions.

If you are a contributing member of the Public Employees Retirement System (PERS), you are entitled to Industrial Disability Leave benefits which provide 22 days of your net salary (not charged to your sick leave). If the industrial disability continues beyond 22 working days, the payment will be two-thirds of the gross monthly salary. Industrial Disability Leave benefits commence after the third day of absence.

California Workers' Compensation Laws give the employer the right to designate the attending physician for the first 30 days of treatment. After that time, you may change to a physician of your choice by notifying our claims administrator in advance.

You have the right to be treated by your personal physician during the first 30 days of treatment if you have submitted a “Workers’ Compensation Choice of Personal Physician” form prior to the injury. The “Notice of Personal Physician Pre-Designation” form must be on file in the Risk Management Office and a copy in your immediate supervisor’s office.

Depending on the nature of your injury, once you have completely recovered you may be entitled to permanent disability benefits. Our claims administrator will send you to a physician for disability rating purposes. If you are found by the Disability Ratings Bureau to have any permanent disability, our claims administrator will prepare necessary documents and forward those to you.

If you are injured such that you can no longer perform your work-related duties, then you may be entitled to Supplemental Job Displacement Benefits. This will be determined from the medical reports and our claims administrator will contact you.

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Last updated August 27, 2007
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