Protocol for Workers Compensation Claims
Step 1: School Secretaries complete the Occupational Accident Report with the injured employee. Please make sure to include all details including contact information for witnesses. Please make sure to notify Kelly Gardner, Work Comp Supervisor at 822-7615 and email the report to both Kelly Gardner and Esmeralda Davis.
Step 2: School Secretaries or Supervisor will direct injured employee to call Company Nurse. The Company Nurse must be called even if the employee will not be seeking medical attention. The Company Nurse may or may not triage the injured employee to Rideout or Sutter Occupational Health. If you choose to be seen at Sutter Occupational Health, most follow up appointments will be in Roseville. Mileage will be reimbursed by Keenan, but appointments should be made on the employees’ personal time.
Step 3: School Secretaries or Supervisor will direct injured employee follow up to Kelly Gardner at the District Office post medical treatment with a doctor at Rideout or Sutter Occupational Health. Employee must provide the Work Status Report to the District Office after each doctor’s appointment.
Step 4: The injured employee will complete required state workers’ compensation forms with Kelly Gardner after their initial doctor’s visit. (DWC1 Form)
Step 5: In the event of limited duty due to injury, the interactive process will be initiated and return to work options discussed with injured employee and employee’s supervisor.
Step 6: Paperwork from workers’ compensation related doctor’s appointment(s) to be provided to Kelly Gardner at the District Office after each appointment. As recovery progresses, modified/light duty will be reevaluated about every 30-45 days.
For more information contact:
Yuba City Unified School District
750 Palora Avenue, Yuba City CA 95991
Phone (530) 822-7615 | Fax (530) 671-2454
Additional information may be found in the publication Workers’ Compensation in California: A Guidebook for Injured Workers. A complete copy of the Guidebook may be obtained on the Division of Workers’ Compensation website (see URL below) or by contacting an Information and Assistance (I&A) Officer of the Division of Workers’ Compensation.
Guidebook for Injured Workers:
Chapter 5: Temporary Disability: http://www.dir.ca.gov/InjuredWorkerGuidebook/Chapter5.pdf
Chapter 4: Resolving Problems with Medical Care & Medical Reports
For information about the workers’ compensation claims process and your rights and obligations, go to www.dir.ca.gov or contact an Information and Assistance (I&A) Officer of the State Division of Workers’ Compensation. For recorded information and a list of offices, call (800)736-7401.