Workers' Compensation is a state-mandated program, funded completely by the employer, and is designed to guarantee the payment of specified benefits to employees who are injured on the job. The District is self-insured for workers' compensation benefits, and such benefits are paid using district funds.
York Risk Services Group, Inc. is the claims administrator for the District’s workers’ compensation claims. York can be reached toll-free at (866) 548-2701.
The Site/Department is required to call CalOSHA at (619) 767-2280 in the event of a serious injury of an employee (one that might require overnight hospitalization or death).
*Call within 8 hours of the accident. Reporting delays can result in CalOSHA fines to your department.
*Call Risk Management if there is any question whether to contact CalOSHA regarding an employee illness or injury.
All work-related injuries/illnesses must be reported immediately
- Call 911 if the injury or illness is an emergency.
- Promptly provide or obtain necessary first aid when appropriate.
- When to Call Cal-OSHA
What to do if you are injured on the job
- Notify your supervisor immediately if you experience a work-related injury/illness.
- Seek medical treatment, when needed, at the nearest authorized Clinics and Hospitals (Occupational Medical Facilities). The list of facilities is posted at your site and on the Risk Management website.
- Provide work status reports/updates from your doctor to your supervisor immediately after every doctor's visit regardless if you are working or not working.
- Employees who have a pre-designated personal physician on file with Risk Management will be directed to see their own doctor. Contact Risk Management to confirm that a completed form is on file by calling (858) 627-7345.
Supervisors are required to
- Direct the injured employee, when needed, to the nearest authorized Clinics and Hospitals (Occupational Medical Facilities). The list of facilities is posted at your site and on the Risk Management website.
- Investigate every work related injury or illness immediately upon occurrence.
- Complete, print, and immediately fax the Supervisor's Report of Injury/Illness - Form 78 to the Risk Management Department at (858) 627-7353 or scan/email to firstname.lastname@example.org; do not wait for a principal/department head’s signature.
- After faxing, give the form to the principal/department head for review and signature.
- Fax or scan/email a copy of the Form 78 with principal/department head signature to the Risk Management Department, retaining the original report for site records.
- Obtain Work Status Reports/Updates from the injured employee after every doctor's visit, regardless if they are working or not working.
List of District Occupational Medical Facilities
Workers' Compensation Forms
- Supervisor's Report of Injury/Illness - Form 78
(NOTE: Form 78 is always completed by Supervisor; not by injured employee or volunteer)
- Witness Statement
- Pre-Designation of Physician Form (English)
- Clinics and Hospitals (list of Occupational Medical Facilities)
- Work Status Form (for physicians)
- Reporting Work-Related Injury/Illness Flow Chart (Revised March 2015)
These forms are for informational purposes only and should not be used for any purpose other than providing information to SDUSD employees.
York RSG Mobile Technology for Reported Claims
If you have a Workers’ Compensation Claim you can obtain access with your smartphone.
Contact your Claims Administrator with York Risk Services Group to have the app activated.
Workers' Compensation Related Administrative Procedures
- Administrative Procedure 7131- Industrial Accident and Illness Leave
- Administrative Procedure 5002 - Incident Reporting
Workers' Compensation Fraud
Workers’ compensation fraud, defined as “any person who makes, or causes to be made, any knowingly false or fraudulent material statement or material representation for the purpose of obtaining or denying workers’ compensation benefits or payments is guilty of a felony” is a crime. Persons committing workers’ compensation fraud may be fined up to $50,000.00 and sent to prison for up to five years (Labor Code Section 1871.4)
If you suspect an employee is committing fraud, please notify Risk Management