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:
- 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.
- 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:
- Work Partners Treatment Authorization Form
- FOR EMERGENCIES ONLY: Tri-City Hospital
- 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).
- 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.
- Know your rights and responsibilities. Please review the Rights and Responsibilities document regarding your claim.
- 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.
- Worker's Compensation for VUSD is administered by Keenan & Associates.
- 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.