- In order for the employee to be paid properly by UCPath, the employee must select an option per the Workers’ Compensation Election Form.
- This form is located at the following link: https://www.ucop.edu/ucpath-center/_files/mypath/new-forms/workers-compensation-election.pdf. Instruction to complete this form is located at the following link: https://www.ucop.edu/ucpath-center/_files/mypath/new-forms/workers-compensation-election-instructions.pdf. The employee can choose one of the following:
- Option 1: Use sick and vacation leave accrual hours to supplement temporary disability checks from Sedgwick to equal 100% of employee's wages.
- Option 2: Use only sick leave accrual hours (not vacation) to supplement temporary disability checks from Sedgwick to equal 100% of employee's wages.
- Option 3: No use of leave accrual hours to supplement temporary disability checks from Sedgwick to equal 66 2/3% of employee's wages.
- This form is located at the following link: https://www.ucop.edu/ucpath-center/_files/mypath/new-forms/workers-compensation-election.pdf. Instruction to complete this form is located at the following link: https://www.ucop.edu/ucpath-center/_files/mypath/new-forms/workers-compensation-election-instructions.pdf. The employee can choose one of the following:
- Department personnel must provide the Workers’ Compensation Election form to the employee within 24 hours of notice that an employee is off work due to their injury and discuss the options above with said employee. Notice must be sent via trackable method (email is acceptable).
- The employee completes the Worker’s Compensation Election form and sends completed form to UCPath within 5 business days of being placed on workers’ compensation leave and provides a copy to their Human Resources department/representative. UCPath contact information is listed below. If this form is not received by UCPath within this time frame, the selection defaults to Option 2 (supplement using sick time accrual hours only).
- Department personnel emails a copy of this completed form to wcreports@irm.ucla.edu.
- Department personnel enters a new leave transaction into UCPath. If the employee chooses option 1 or 2 AND does not have accrual hour balances, then leave should be coded as Extended Sick Leave. Extended Sick Leave exhausts after 26 weeks/182 days. For instruction on entering leave transactions into UCPath, please review UCPath training materials or contact UCPath (see below).
UCPath Contact Information
UCPath: http://ucpath.universityofcalifornia.edu
UCPath Center email: ucpath@universityofcalifornia.edu
UCPath Center
14350-1 Meridian Parkway
Riverside, CA 92518
Phone: (855) 982-7284
Fax: (855) 982-2329
Monday - Friday: 8a.m. – 5 p.m.
IRM Contact Information
Workers' Compensation Program Manager: (310) 794-6954
Workers' Compensation Program Analyst: (310) 794-6952
