Employees: What to do if You Are Injured at Work
The Worker’s Compensation benefit system is a team effort. The system works best
when paperwork is completed promptly, medical appointments are kept, and supervisors
and the CSU Channel Islands Workers' Compensation Specialist are kept informed.
If you are injured, tell your supervisor immediately.
You must report any injury to your supervisor within 24 hours, no matter how small the injury may seem. Any delay in reporting may delay or bar your workers’ compensation benefits.
You will need to tell your supervisor when and where the injury occurred, what happened,
and if anyone witnessed the injury.
Once you report your injury to your supervisor, your supervisor will give you a "Workers’ Compensation Claim (DWC 1) Form" to complete.
Your supervisor will submit your claim form and a "Supervisor’s Accident Report and Investigation" form to the campus Workers' Compensation Specialist.
The Workers' Compensation Specialist, in turn, will report the injury to our claims administrator, Sedgwick Claims Mangagement Services, PO Box 3170, Rancho Cordova, CA 95741, telephone: (916) 851-8000. You will receive a notice from the claims administrator shortly after the injury report is filed.
Sedgwick Claims Management Services will make the final determination whether your injury is work-related, and determine what benefits you are entitled to receive. Occasionally Sedgwick may investigate the facts surrounding the injury and may delay providing benefits. Regardless of the decision by Sedgwick regarding compensation payments, medical treatment needed immediately after an injury will be provided.
In order to eliminate unnecessary delays, you will want to keep in close contact with
the campus Workers' Compensation Specialist and claims administrator. Always promptly
return paperwork that has been sent to you for completion.
Your supervisor will refer you for medical treatment. You will be sent to:
1851 Lombard Street, Suite 100
Oxnard, CA 93030
If you need first aid, this may be administered by campus personnel who are trained to provide first aid.
University Public Safety Officers will determine if further medical attention is needed.
All medical bills and reports will be sent to Sedgwick Claims Management Services, the University's claims administrator. Should you receive any medical bills, please mail them to:
Sedgwick Claims Management Services
PO Box 3170
Rancho Cordova CA 95741
The Workers’ Compensation Specialist needs to be aware of your continued absences
due to the injury. Please forward any medical status notes or reports that you receive
to the Workers’ Compensation Specialist, Human Resources, and provide a copy for your
Inform your doctor of CSU Channel Islands’ policy to provide you modified work (transitional work) while you are recovering from a work-related illness or injury. Such positions will be temporary in nature and will be monitored by your immediate supervisor, department manager and Workers' Compensation Specialist.
Be sure to have a doctor’s note or report indicating work restrictions, if any, when
you return to work. You must give this to your supervisor before you can start working
again. You must comply strictly with job restrictions, as defined by treating physicians.
Inform your supervisor and the Workers' Compensation Specialist if you are taken off work due to the injury or illness. If you are off work for any period of time, you must keep your supervisor and the Workers' Compensation Specialist informed of your progress and provide periodic updates from your physician.
You must also record your absences on the Absence and Additional Time Worked Report
(STD. 634) form. Forms are available from your timekeeper. Once our third party
administrator approves your time off work, your leave balance will be credited back
The campus Workers' Compensation Specialist, your supervisor and our claims administrator will be in contact with you.
More information on your workers’ compensation benefit is available on the main Workers’ Compensation web page. The link on that page entitled “Facts About Workers’ Compensation” provides a good summary of the program. If you have any questions or concerns, be sure to call the campus Workers' Compensation Specialist at (805) 437-2623.