Employee Workers' Compensation FAQs
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.
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 atUCLA Occupational Health.
2.If your injury requires a medical evaluation, your supervisor or HR Rep will send you to theUCLA 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.
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 atUCLA Occupational Health.
2.If your injury requires a medical evaluation, your supervisor or HR Rep will send you to theUCLA 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.
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.
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.
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.
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.
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). TheWorkers' 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 visitCampus Human Resourceswebsite or call 310-794-0800.
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 visitCampus Human Resourceswebsite or call 310-794-0800.
Yes, you must present this medical documentation to your department/supervisor.
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 emailingRTWMail@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.
For UCLA Campus employees, please contact Insurance and Risk Management by emailingRTWMail@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.
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 foundhere.
Please contact Campus Human Resources by visiting https://chr.ucla.edu/ or by calling 310-794-0800.
Please contact your department Human Resources Representative orCampus Human Resourcesor call 310-794-0800.
Supervisor Workers' Compensation FAQs
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.
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.
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.
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.
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.
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.
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.
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.
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.
Please contact Campus Human Resources by visiting https://chr.ucla.edu/ or by calling 310-794-0800.
Please contact your department Human Resources Representative or Campus Human Resources or by calling 310-794-0800.
