Main Content Region

Workers' Compensation

 

Supervisors

In compliance with California Workers’ Compensation Law, an employer must report all work-related injuries or illnesses arising out of and in the course of employment and covered by the California Workers’ Compensation System. To comply with this law, all supervisors should complete the Supervisor's First Report forms below within 24 hours of an incident occurring and adhere to the workers’ compensation procedures for supervisors.  An Incident Investigation will then need to be completed to determine the root cause of the injury or illness.  It will also facilitate ways to prevent their reoccurrence.

Learn more about supervisor procedures and responsibilities.

Supervisor's Incident Report

Employees

Employees are covered for any injury/illness arising out of or in the course of employment. All job-related injuries or illnesses should be immediately reported to the employee’s supervisor.  Employees may also report injuries to another Administrator in their area or to an Administrator in Environmental Health & Safety.  Workplace safety is our priority. When an injury happens, we want to learn from it. Understanding the root cause helps us find ways to improve our processes and prevent future incidents, ensuring a safer CSUSB for everyone.

Employees who desire to participate in the Workers' Compensation Benefit program must complete the Workers' Compensation (DWC-1) Claim Form to initiate the claims process. 

Note: Employees opting to complete the DWC-1 PDF form will be contacted by a member of the Risk Management team.

Learn more about employee procedures and responsibilities.

Workers' Comp BenefitDownload DWC-1 PDF

 

Procedures


 

Medical Facilities


Medical treatment is authorized by Risk Management when necessary. CSUSB has designated Healthpointe, Kaiser on the Job (any location), and Desert Urgent Care as medical facilities to provide medical treatment for injured employees. If an injury happens after normal business hours, notify the supervisor on duty. If a supervisor is not available, contact University Police to report and visit one of the below 24-hour medical facilities. If the injury was severe, call 911.

Kaiser on the Job Locations

Contact Information

Note: If the Campus is closed for an extended period of time, employees may fax the completed DWC-1 Form to Sedgwick CMS at (916) 851-8089.


 

CSUSB Workers' Compensation Program Specialist

Jorge Chilin
Phone: (909) 537-3939
Email: jorge.jimenezchilin@csusb.edu 

Sedgwick Claim Management Services (CMS)

Third Party (TPA) for the CSU Workers’ Compensation Program Randy Gee, Sedgwick CMS
Phone: (916) 852-2952
Fax: (916) 851-8089

Email: Randy.Gee@sedgwick.com