Workers' Compensation

Workers' Compensation FAQ

What to Do After a Work Injury Occurs:

• PROCEDURES FOR EMPLOYEES
• PROCEDURES FOR SUPERVISORS

Where to go for Medical Treatment:

• US HEALTHWORKS (Please fill out the appropriate intake forms below)
1. Patient Information Form (English & Spanish)
2. Established Patient Statement

What to do when an Employee is released to return to work with restrictions:

• EMPLOYEE - RETURNING TO WORK (With and Without Restrictions)
• SUPERVISOR - RETURNING TO WORK (With and Without Restrictions)

Workers' Compensation Forms:

• DWC-1
• 620 ACCIDENT REPORT
• 620 SUPERVISOR ACCIDENT REPORT GUIDELINES
• EMPLOYEE PRE-DESIGNATION OF PERSONAL PHYSICIAN

Resources:

• INDUSTRIAL DISABILITY LEAVE
• DIVISION OF WORKERS' COMPENSATION
• ENVIRONMENTAL HEALTH & SAFETY
• INSURANCE & RISK MANAGEMENT
• ERGONOMIC EVALUATIONS

Contact Kari Dom (818) 677-3351