(Injuries to Employees and Interns)
Worker's Compensation covers job-related injuries and illnesses. Report any and every work-related injury/illness to your supervisor immediately. Go to one of our clinics for care. If you are looking for EAP, go to http://myhss.org/well-being/eap.html.
Employees Read This
Work related injuries must be reported within 24 hours.
Complete your portion of the DWC-1 Employee's Report of Occupational Injuries (DWC) and give it to your supervisor to complete the rest. Read the entire claim form as it has important information for you.
Go Here for Treatment
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).
How to Submit Forms
SCAN and EMAIL these completed forms to Risk Services Coordinator Aaron Holmberg (email@example.com) for prompt service. Faxing and mailing causes delays that could delay service to our employees.
As a supervisor, an employee may come to you with a list of work restrictions from a doctor. This may or may not be related to a work comp case. If you get such a doctor note, DO NOT HANDLE ON YOUR OWN.
We have a process for these to make sure the employee is taken care of appropriately. Leilani (Lani) Battiste (Assoc. General Counsel, Title 5/EEO - 415.452.5053), Aaron Holmberg (Risk Services - 415.487.2482), and Dianna Gonzales (VC of Human Resources - 415.241.2255) need to review each such request, so contact one of us and the three of us will address it promptly. Again, do not handle restriction requests on your own. Thank you.