What is employee compensation

what is employee compensation

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What to do if there is an Injury at Work

If An Employee Has An Injury/Illness That Requires Medical Assistance

  • If it is an emergency, call 911 immediately from any campus phone. You will be connected to a campus police dispatcher, who will send a police officer, and if needed, emergency medical personnel to assist you. The closest emergency room is:

Alvarado Hospital Emergency Room

  • If the injury requires medical attention, but is not an emergency, they must go to one of the Sharp Rees-Stealy, Occupational Health Services Facilities. See the Directory of Authorized Medical Providers. The employee may see their personal physician if they have a Notice of Pre-Designation of Physician Form on file with the Workers’ Compensation Manager ’s office prior to the injury.
  • Note: if the employee is unable to drive, the supervisor or supervisor’s designee should accompany the injured worker to an authorized medical provider for initial treatment.

    Employee Responsibilities

    • Tell your supervisor immediately. You must report any injury to your supervisor within 24 hours, no matter how trivial the injury may seem. You will need to tell them when and where the injury occurred, what happened, and if anyone witnessed the injury.

    In cases where injuries require medical treatment, SDSU Workers’ Compensation will report the incident to the University Claims Administrator, Sedgwick CMS.

    Sedgwick CMS makes the final determination of whether your injury is work-related and what benefits you are entitled to receive. In some cases, the Claims Administrator conducts an investigation into the incident — a process that may cause a delay with you receiving your benefit compensation. You should receive a notice from the Claims Administrator shortly after the injury report is filed. It’s important to keep in touch with SDSU’s Workers’ Compensation Manager. in addition to the Claims Administrator, to prevent unnecessary delays in resolving your case.

    • If necessary, seek medical treatment. You’ll receive a referral if your injury requires medical treatment. Your supervisor will refer you to one of the authorized Sharp-Rees Stealy Occupational Health Services Facilities. If it’s not medically possible to return to work, report to your supervisor and the Workers’ Compensation Manager via phone immediately following your medical evaluation.

    All medical bills and reports will be sent to Sedgwick CMS. SDSU’s Workers’ Compensation Coordinator needs to be aware of your continued absences due to the injury. Please forward copies of all work status slips you receive to SDSU’s Workers’ Compensation Manager and provide copies to your supervisor.

    • Inform your doctor of San Diego State University’s guidelines to provide you modified work or light duty. If possible, you’ll be assigned a modified or light-duty work assignment while you are recovering from a work-related illness or injury. Such assignments will be temporary in nature and will be monitored by your immediate supervisor, department manager and the Workers’ Compensation Manager. You are responsible for adhering to any job restrictions defined by your treating physician.
  • Record time off work due to work-related injury or illness. Inform your supervisor and the SDSU Workers’ Compensation Manager if you are off work due to the injury or illness. If you are off work for any period of time, you must keep your supervisor and SDSU Workers’ Compensation Manager informed of your progress and provide them periodic updates from your physician concerning your recovery. You are also responsible to record all absences, with your signature, on the Attendance Summary Form.

    Forms are available from your timekeeper. After the University’s Claims Administrator, Sedgwick CMS, approves your time off work, your leave balance will be credited back to you.
  • Provide a work status report from your doctor to your immediate supervisor and Workers’ Compensation Manager upon returning to work. If you are not able to return to your full duties, the university will conduct an interactive process with you to determine if there is a temporary or modified job assignment that you could perform. It is your responsibility to follow your medical provider’s recommendations with respect

    to established work restrictions, limitations, therapies and physical capacities. You will be able to return to your normal work assignment as soon as your medical provider deems it is safe.

  • Call if you have questions. SDSU’s Workers’ Compensation Manager, your supervisor, and the University’s Claims Administrator will be in contact with you. If you have any questions or concerns, call SDSU Workers’ Compensation Manager at 619-594-1142.
  • Supervisor Responsibilities

      Notify the Workers’ Compensation Manager in the Center for Human Resources within 24 hours of knowledge of injury.
    • Once the immediate needs of the employee have been taken care of, complete the Supervisor’s Report of Work Related Accident/Illness Form.

      Have the employee complete questions #1—#8 of the Employee’s Claim for Workers’ Compensation Benefits Form

      and you will complete questions #9—#18 of the claim form. Both of these forms need to be faxed to the Workers’ Compensation Office at 619-594-4013 within 24 hours of knowledge of the injury.
    • Once the immediate needs of the employee have been taken care of, complete the Supervisor’s Report of Work Related Accident/Illness Form.

      Complete questions #9—#18 of the Employee’s Claim for Workers’ Compensation Benefits Form

      and give a copy of the incomplete claim form to the employee within 24 hours of knowledge of the injury. Fax the Supervisor’s Report of Work Related Accident/Illness Form

      and the incomplete claim form to the Workers’ Compensation office at 619-594-4013 within 24 hours of knowledge of the injury. Inform the employee that if they need to seek medical treatment in the future, they will need to complete questions #1—#8 of the claim form and return it to their supervisor. The completed claim form should be faxed to the Workers’ Compensation office at 619-594-4013.
    • Deliver the originals to the Workers’ Compensation Manager, located in Room 406 of the Extended Studies Center or via campus mail at mail code 1625. The Workers’ Compensation Manager will forward copies to Sedgwick CMS, the university’s claims administrator.
      If the employee should lose time from work due to the incident, follow the required time-reporting procedures.
    • If the employee requires medical attention on the date of the injury, the employee is paid for a full day’s work regardless of the number of hours worked.
  • Absences due to the industrial injury are only allowed with a doctor’s note. Periodic doctor visits or physical therapy visits are deducted from the employee’s sick leave balance. The employee should make every effort to schedule these appointments around their work hours.
  • Notify the Workers’ Compensation Manager when the employee begins to lose time due to the industrial injury.
  • Maintain contact with the employee on a weekly basis.
    • Notify the Workers’ Compensation Manager when the employee returns to work.
    • The employee must provide a written release to return to work from the treating physician before they return to work. Forward copies of these documents to the Workers’ Compensation Manager.
  • Upon advice of the treating physician, the employee’s work duties may be restricted, i.e. lifting restrictions, restricted work hours, restricted movement, etc. while they recover from the injury or illness. Before the employee can return to work on modified duty, a meeting will be arranged between the employee and their immediate supervisor, to review work restrictions, determine the feasibility of modifications to their work duties and ensure that any modified duties are consistent with the work restrictions. It is recommended that the immediate supervisor consult with the Workers’ Compensation Manager regarding questions of accommodating work restrictions.
  • Ensure that the employee released to modified work is working within their job restrictions. The modified work should not be at a higher classification.
  • The Workers’ Compensation Manager will keep in contact with the treating physician to be in compliance with doctor’s orders and to provide feedback on the employee’s progress towards recovery.
  • Source: hr.sdsu.edu

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