Workers' Compensation FAQs

Employee Workers' Compensation FAQs

  • What is the purpose of Workers' Compensation?
  • The purpose of Workers’ Compensation is to provide medical care and benefits to employees who are injured at work or who develop a job-related illness as a result of their employment. Benefits may include payment for medical bills, lost wages and a vocational rehabilitation voucher. All job-related injuries and illnesses sustained by UCLA employees are covered by the University’s Workers’ Compensation self-insurance program.
  • What do I do if I get injured at work?
  • If you are injured on the job, immediately inform your supervisor. Here are four important facts for you to keep in mind: 
    1. Your Supervisor or HR Rep will provide you with Workers’ Compensation Claim Form (DWC-1) within one working day of notifying them of the injury/illness. Please complete and return the claim form to your supervisor within 24 hours. Also, you will be given this form if/when you are seen at UCLA Occupational Health.
    2. If your injury requires a medical evaluation, your supervisor or HR Rep will send you to the UCLA Occupational Health (OH) at 17-240 Center for Health Sciences, 10833 Le Conte Avenue. OH operates Monday through Friday from 7:30 a.m. to 4:30 p.m.
    3. If your injury occurs outside of these hours, or you require urgent immediate medical attention, you may receive treatment 24 hours a day at the UCLA Ronald Regan Hospital Emergency Department located at 757 Westwood Plaza (ER entrance Gayley Avenue, north of Le Conte Avenue). You must follow up with UCLA Occupational Health the next business day.
    4. If your injury occurs off-campus and it requires acute attention, please seek treatment at the nearest emergency care facility. If your injury is not of an urgent nature, please call your supervisor, who will refer you to see a University-approved physician nearby. A list of Occupational Health Clinic Partners is located at the following link: OH Clinic Partners.
  • Who administers and pays for my Workers' Compensation Claim?
  • Sedgwick Claims Management Services (CMS) administers and pays workers’ compensation claims on behalf of UCLA.  When you report an injury, the appropriate UCLA Workers’ Compensation office will report the injury to Sedgwick, CMS, for handling.  Your Sedgwick, CMS claim adjuster may contact you to discuss your claim.  It is important that you respond to the Sedgwick, CMS adjuster as this will assist them in completing their investigation of your injury/illness to determine Workers’ Compensation benefits that may be owed.  Please note that failure to respond to the Sedgwick, CMS adjuster may result in the denial of your claim.
  • May I use my own doctor for a Workers' Compensation Injury/Illness?
  • If you sustain an injury/illness, medical care will arranged for you for the entire course of your treatment. If you wish to be treated by your own doctor within the first thirty (30) days of an injury/illness, you must have on file with your department a written “Designation of Treating Physician” form prior to any illness or injury occurring. If an injury occurs and you choose to see your previously designated physician, you must immediately notify Sedgwick, CMS so that there is no delay in considering your medical bills for payment.
  • What types of benefits does Workers' Compensation provide?
  • Key benefits are:

    MEDICAL COVERAGE
    Workers’ Compensation will pay 100 % of all approved medical, hospital and prescription bills arising from the industrial injury/illness with no out of pocket cost to you. If you receive a bill or have out of pocket medical costs, email these documents to: wcreports@irm.ucla.edu. IRM will forward to the appropriate Sedgwick, CMS adjuster.

    TEMPORARY DISABILITY
    If your treating physician determines that you are temporarily unable to work, you may be eligible for temporary disability payments. Disability payments are issued every two weeks and represent 2/3 of your gross wage, up to a statutory maximum amount.  Per the California Labor Code, the first three calendar days are designated as a waiting period and an are not eligible for temporary disability benefits. However, the University allows the use of your sick and/or vacation accruals to pay you during this time frame.
  • How are Workers' Compensation benefits coordinated with University benefits?
  • When Sedgwick, CMS begins payment of temporary disability benefits (TD) your designated Human Resources Representative will provide information on all options for supplementing your TD benefits in order to receive 100% of your base pay. This includes using your available sick leave and vacation accruals. These options are explained in detail at the following link (link). The Workers' Compensation Election Form (located on the UCPath Portal) must be completed and sent to UCPath and your department's Human Resources Representative in order to be accurately paid. If all sick time accruals are exhausted, the University will supplement your TD benefits to maintain salary at 80% of your base pay. This Extended Sick Leave benefit may not exceed 26 weeks.
    If you are missing time from work and your claim has been delayed or denied by Sedgwick, CMS, please contact your Human Resources Representative to discuss available options and/or visit Campus Human Resources website or call 310-794-0800.
  • Do I need a note from my doctor when I return to work?
  • Yes, you must present this medical documentation to your department/supervisor.
  • What happens if I can't perform all my regular job duties?
  • If your doctor determines that you can work but with temporary or permanent work restrictions, provide the medical documentation to your supervisor/Human Resources Representative. You may also contact UCLA Disability Management and a Consultant will assist you with reasonable accommodations.

    For UCLA Campus employees, please contact Insurance and Risk Management by emailing RTWMail@irm.ucla.edu or call (310) 794-6948 - Ask for Disability Management.

    For UCLA Medical Center employees, please contact Health Systems HR Workers’ Compensation Unit by emailing HRWorkersComp@mednet.ucla.edu or call 310-794-0500.
  • How will I get paid when attending follow-up medical appointments related to my work injury?
  • Your timesheet should be completed as normal, using hours of Sick Leave while attending medical appointments. You are encouraged to schedule follow-up medical appointments outside of your regular work schedule. Complete UC Policy and additional information pertaining to Workers' Compensation Temporary Disability benefits and UC benefits can also be found here.
  • What happens if I am injured away from work?
  • Please contact Campus Human Resources by visiting https://chr.ucla.edu/ or by calling 310-794-0800.
  • Who do I contact if I have questions regarding Workers' Compensation?
  • Please contact your department Human Resources Representative or Campus Human Resources or call 310-794-0800.

Supervisor Workers' Compensation FAQs

  • What is the purpose of Workers' Compensation?
  • The purpose of Workers’ Compensation is to provide medical care and benefits to employees who are injured at work or who develop a job-related illness as a result of their employment. Benefits may include payment for medical bills, lost wages and a vocational rehabilitation voucher. All job-related injuries and illnesses sustained by UCLA employees are covered by the University’s Workers’ Compensation self-insurance program.
  • What do I do if my employee is injured at work?

  • 1. Complete the Injury Report via the Electronic First Report (EFR) System. In order to use EFR, the following is required:

    UCLA Single Sign On – ID & Password

    Web Browser must be Firefox or Google Chrome  (Not compatible with Internet Explorer)

    Employee must be in the employee database (EDB). This system cannot be used for volunteers

    OR

    If you are unable to access EFR, then complete this Incident Report & Referral form and submit a copy to: wcreports@irm.ucla.edu

    If completing the Incident Report & Referral form, Employee and Supervisor complete and sign the top two sections. Send the form with the employee to give to the medical provider

    2. Provide your employee with Workers' Compensation Claim Form (DWC-1) & Notice of Potential Eligibility within one working day of your notice of the injury/illness. Also, employees will be given this form if/when they are seen at UCLA Occupational Health.

    3. If employee’s injury requires a medical evaluation, please refer them to the UCLA Occupational Health (OH) at 17-240 Center for Health Sciences, 10833 Le Conte Avenue. OH operates Monday through Friday from 7:30 a.m. to 4:30 p.m.

    4. If employee’s injury occurs outside of these hours, or they require urgent immediate medical attention, they may receive treatment 24 hours a day at the Emergency Medicine Center, located at 757 Westwood Plaza (ER entrance Gayley Avenue, north of Le Conte Avenue). Employees must follow up with UCLA Occupational Health on the next business day.

    5. If employee’s injury occurs off-campus and it requires acute attention, please refer them to seek treatment at the nearest emergency care facility. If employee’s injury is not of an urgent nature, please advise your employee to see a University-approved physician nearby.

     

    If the injured employee works at an off-campus location that would take more than 30 minutes to get to the UCLA Occupational Health, then the employee may be seen at an Occupational Health Clinic Partner.  A list of Occupational Health Clinic Partners is located at the following link: OH Clinic Partners.

  • Who administers and pays for your employee’s Workers' Compensation Claim?
  • Sedgwick Claims Management Services (CMS) administers and pays workers’ compensation claims on behalf of UCLA.  When employee reports an injury, the appropriate UCLA Workers’ Compensation office will report the injury to Sedgwick, CMS, for handling.  Designated Sedgwick, CMS claim adjuster may contact you to obtain a supervisor statement regarding your employee’s claim.  It is important that you respond to the Sedgwick, CMS adjuster as this will assist them in completing their investigation of your employee’s injury/illness to determine Workers’ Compensation benefits that they may be owed.  Please note that failure to respond to the Sedgwick, CMS adjuster may result in the denial of employee’s claim.
  • What types of benefits does Workers' Compensation provide to injured employees?
  • Key benefits are:

    MEDICAL COVERAGE
    Workers’ Compensation will pay 100% of all approved medical, hospital and prescription bills arising from the industrial injury/illness with no out of pocket cost to the employee.     If an employee receives a bill or has out of pocket medical cost, email these documents to:     wcreports@irm.ucla.edu. IRM will forward to the appropriate Sedgwick, CMS adjuster.

    TEMPORARY DISABILITY
    If the treating physician determines that     an employee is temporarily unable to work, they will be eligible for temporary disability payments. Disability payments are issued every two weeks and represent 2/3 of your employee’s gross wage, up to a statutory maximum amount.  Eligibility for temporary disability starts with the fourth calendar day that the employee is unable to work.
  • How are employee’s Workers’ Compensation benefits coordinated with University benefits?
  • Once employee’s claim is received and they are off work due to the injury, the designated Human Resources Representative will provide information on the different options for supplementing an employee’s temporary disability (TD) benefits paid by Sedgwick, CMS with the use of the employee’s sick leave and vacation accruals. The Workers’ Compensation Election form (located on the UCPath Portal) must be completed and sent to UCPath and department’s Human Resources Representative. For example, to maintain 100% of employee’s base salary, employee may elect to use accrued sick leave and/or vacation to supplement the TD payments from Sedgwick CMS (which are 2/3 of employee’s base wages up to an established maximum). If all leave accruals are exhausted, the University will supplement employee’s TD benefits to maintain their salary at 80% of their base. This Extended Sick Leave benefit may not exceed 26 weeks for any injury or illness.

    If your employee is missing time from work and their claim has been delayed or denied by Sedgwick CMS, please refer the employee to their Human Resources Representative to discuss available options or by visiting Campus Human Resources or at 310-794-0800.
  • Does your employee need a note from their doctor when they return to work?
  • Yes, the employee must provide the department with a medical work status document. If the employee is released with work restrictions, determine if the work restrictions can be accommodated. If so, please complete a Transitional Return To Work Agreement (TRTW) and submit it to: rtwmail@irm.ucla.edu. If you are unable to accommodate the work restrictions, please contact your Human Resources Representative for guidance. For further information please see the IRM Disability Management website.
     

    For UCLA Campus employees, you may contact Insurance and Risk Management by emailing RTWMail@irm.ucla.edu or at (310) 794-6948 - Ask for Disability Management.

    For UCLA Medical Center employees, you may contact Health Systems HR Workers’ Compensation Unit by emailing HRWorkersComp@mednet.ucla.edu or at 310-794-0500.

  • How are employees paid when attending follow-up medical appointments related to their work injury?
  • Employees would fill out their timesheet as they normally would, using hours of Sick Leave for their lost time while attending medical appointments. Employees are encouraged to schedule their medical appointments outside of their regular work schedule. Complete UC Policy and additional information pertaining to Workers’ Compensation Temporary Disability benefits and UC benefits can be found here.
  • What happens if your employee is injured away from work?
  • Please contact Campus Human Resources by visiting https://chr.ucla.edu/ or by calling 310-794-0800.
  • Who do I contact if I have questions regarding Workers' Compensation?
  • Please contact your department Human Resources Representative or Campus Human Resources or by calling 310-794-0800.