Filing a Workers' Compensation claim

Workers' Compensation

Filing a Workers' Compensation Claim

Submitting the Employee/Volunteer Report of Injury/Illness form does not file a claim for workers' compensation benefits.

After receiving your Employee/Volunteer Report of Injury/Illness form, the Workers' Compensation Manager will monitor your medical treatment to determine if the level of care exceeds first aid treatment.

If medical treatment exceeds first aid treatment at the initial or subsequent medical visits, Workers' Compensation will provide you with the State of California Workers' Compensation Claim Form (DWC-1).

First aid treatment may be appropriate treatment and is not considered a workers' compensation benefit even though first aid costs will be paid by the University.

If you wish to initiate a claim:

Please go to the Human Resources Management department to complete and sign the Employee portion of the DWC-1 form. Be sure to describe your injury or illness completely and include the affected body part(s).

If a form is mailed to you, please complete, sign and return the original to the Human Resources Management department. Please remember to make a copy for your records. Or you may submit to our HR -Workers' Compensation Secure Dropbox.