(Injuries to Employee & Interns)
Risk Services Coordinator
In the VCFA Office (Mailbox: GOU)
33 Gough Street
San Francisco, CA 94103
Phone: (415) 487-2482
Fax: (415) 241-2344
Worker's Compensation Liaison
Sr. Management Asst.
Phone: (415) 241-2234
For further information regarding Worker's Compensation: CLICK HERE
- Workers' Compensation Reference Manual
- Notice to Employees - Injuries Caused by Work (DWC-7)
- Designated Medical Treatment Facilities for On-The-Job Injuries or Illnesses *
Other Employee Forms
* The Treatment Facilities List is generated from here.
Supervisors Read This
As the supervisor, you must complete:
- The second half of the Employee's Report of Occupational Injuries (DWC-1) (The injured worker completes part of this)
- The Employer's Report of Occupational Injury or Illness (5020)
- The Supervisor's Investigation Report (SIR)
You must also Submit Work Order Request to get fixed what caused or contributed to the incident (based on the results of your SIR).
Send these completed forms to Risk Services Coordinator Aaron