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This site is no longer being updated.  Please visit our new site at: 
www.yucaipaschools.com

 

 


Workers' Compensation

 

Instructions for Site Secretaries  

For all injuries:
  *  The supervisor and injured employee call the  Company Nurse (888-375-0280). The Company Nurse will discuss the injury and symptoms with the employee and determine if the employee needs to see a doctor.     The Company Nurse will then generate a Workers’ Compensation Claim Form (DWC-1, faxed), and a Supervisor’s Report (emailed). If the employee does not choose to see a doctor and the Company Nurse is in agreement, then the DWC-1 form is not to be completed.   The Supervisor’s Report that is emailed to you and your supervisor is for your information only. I also receive this report.    The injured employee will then need to complete the Employee’s Report of Work Injury/Illness. If the employee is not seeking medical treatment, he/she will need to sign off on the Employee’s Report of Work Injury/Illness that he/she does not require or desire medical attention at this time. The supervisor will need to complete the Supervisor’s Report of Work Injury/Illness.   Please forward to Julie Gainey in Human Resources within 24 hours:
Workers’ Compensation Claim Form (DWC-1) only if the employee is    seeking medical treatment. Otherwise, please destroy this form if it is faxed to you from the Company Nurse. If the employee decides to seek medical treatment at a later date, he/she just needs to let me know and I’ll generate this form.  
If it is determined that the employee needs to seek medical treatment, the Company Nurse will forward paperwork to the doctor/medical facility that is chosen by the employee as long as the doctor/facility is a part of our Medical Provider Network (MPN). If the employee is requesting to see his/her own private doctor and that doctor is not a member of the MPN, then there must be a predesignated physician form on file in human resources for that employee. You can call Julie Gainey to see if one is on file.  
If the doctor gives the employee any medical restrictions it must be determined by Human Resources whether or not the employee can return to his/her regular job or be given a temporary job with light duty restrictions.  
For any questions please call Julie in Human Resources at 797-0174, ext. 162 or email at julie_gainey@ycjusd.k12.ca.us.
 
 
   
 
 
Supervisor's Report of Work Injury/Illness (Form 9225)


Worker's Comp Claim Form(DWC-1)


EIAMPN Medical Provider Network Pamphlet


Acknowledgement of Receipt


Perscription I.D. Card


Employee Satisfaction Survey






 
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