For the purposes of administering Workers’ Compensation benefits, the word “employee” within represents faculty, staff, volunteers, and student assistants.
All injuries, illnesses, or near-miss incidents must be reported to Human Resources Management within 24 hours. The employee may be entitled to Workers' Compensation benefits if they are injured or become ill within the course and scope of their employment, or as a victim of a workplace crime. Workers' Compensation may cover most work-related physical or mental injuries. If an employee is injured or ill, they must notify their manager and Human Resources Management immediately to ensure timely medical treatment and the necessary forms are completed.
Employee/Volunteer Report of Injury/Illness
For all work-related injuries and illnesses, or near-misses, please complete the Employee/Volunteer Report of Injury/Illness form and return it to Human Resources Management.
Workers' Compensation Claim Form (DWC-1)
If an injury or illness requires more than first aid treatment, please complete the Workers' Compensation Claim Form (DWC-1) and Notice of Potential Eligibility. Complete and sign the "Employee" portion of this form and return it to Human Resources Management in Welch Hall (WH) 340 or submit to the Workers' Compensation Secure Dropbox.
Medical Treatment
Prior to going for treatment or evaluation, the employee will need to obtain a Treatment Authorization form from Human Resources Management. The form authorizes treatment and lets the medical facility know that the employee is being seen for a work-related injury or illness. Please contact Human Resources Management at (310) 243-3771, visit WH 340 or email workerscompensation@csudh.edu for a medical authorization form.
Managers and Supervisors
If an injury or illness requires medical treatment beyond first aid, the manager must inform the employee to visit Human Resources Management to complete all necessary forms.
For more information, please contact Human Resources Management at (310) 243-3771.
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