Workers' Compensation

 1. When a Work Injury Occurs:

 If you are injured during the course of your duties,immediately report the injury to your supervisor and seek medical care as appropriate:

  1. EMERGENCY: Immediately call 911 or ask someone nearby to call 911. You will need to complete Employee’s Claim for Workers’ Compensation Benefits (DWC-1).

  2. FIRST AID: If the injury requires medical attention of a minor nature, requiring no more than 2 visits you may seek care at the Student Health Center. Examples of first aid include: minor injuries, illnesses, cuts, scrapes and scratches.

  3. BEYOND FIRST AID: If the nature of the injury is beyond First Aid, you will be referred to the campus’ occupational medical facility, US HealthWorks. If you have a Personal Physician Pre-designation Form on file with Human Resources, you may seek treatment with that doctor. You will need to request and complete Employee’s Claim for Workers’ Compensation Benefits (DWC-1)/


Provide copies of doctor’s notes (within 1 day) to your supervisor & the Human Resources Workers’ Compensation Coordinator. Contact Kari Dom (818) 677-3351. 

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2. When You are Released to Return to Work: 

Injured Employee Returning-to-Work without Restrictions:

If you are released by the physician to return to your regular duties, without limitations, you must obtain from the physician a written release to return to full duty. You must fax, mail, or deliver a copy to Human Resources & your supervisor in advance of your return to work. It is your responsibility to provide the release to return to work prior to the date of return.

Injured Employee Returning-to-Work with Restrictions:

If the physician releases you to "modified" or "light" duty work, your manager and the Workers' Compensation Coordinator (WCC) will review the work restrictions and work with your department to determine if temporary modified or alternate work is available. If a temporary transitional assignment is feasible, the supervisor and the WCC will meet with you to go over the temporary transitional assignment and to review the work restrictions prescribed by the physician.