Risk Management: Workers Compensation

REPORTING A WORK RELATED ILLNESS OR INJURY

Notice to Employees: A safe working environment is our number one priority. However, should you become injured or ill as a result of your job or your work as a volunteer with the District, we want you to receive quality medical treatment. The steps below should be followed when reporting a work related injury or illness:

1. Report your injury to your immediate supervisor. You will be given the proper forms, including a Workers' Compensation Claim Form DWC 1 to fill out and sign. The DWC1 will contain information regarding your workers compensation rights.
2. Obtain treatment. Unless you have a Pre-designation of Personal Physician Form on file with the District prior to your illness or injury, you will be directed to report to one of the two pre-authorized treatment centers for initial visits. You will be provided with a treatment authorization form to one of these locations:
   1. Work Partners Treatment Authorization Form
   2. FOR EMERGENCIES ONLY: Tri-City Hospital
3. As stated above, unless you have a Pre-designation Form on file with the District prior to your illness or injury, you must be treated by a physician within the District's Medical Provider Network (English)) and Medical Provider Network (Español).
4. Work status. After your visit, the physician will provide you with a work status report. Please provide a copy to your supervisor. If the physician determines you may return to work with restrictions, you will need approval from an Administrator or Director of Human Relations.
5. Know your rights and responsibilities. Please review the Rights and Responsibilities document regarding your claim.
6. Supervisor's role. Your supervisor will complete a Supervisors Report of Employee Injury Form when you report your claim. All of these documents are processed by the Human Relations Department as part of your claim.
7. Worker's Compensation for VUSD is administered by Keenan & Associates.
8. A claims examiner from Keenan will contact you regarding your claim.

Please call Lillian Lopez at (760) 726-2170 x92309  for all workers compensation questions.