Workers' Compensation

Workers' Compensation


In compliance with California Workers' Compensation Law, an employer must report all work related injuries or illnesses arising out of and in the course of employment and covered by the California Workers' Compensation System. To comply with this law, all supervisors should complete the necessary forms within 24 hours and adhere to the following workers' compensation procedures.

Employees are covered for any injury/illness arising out of or in the course of employment. Octagon Risk Services, A Sedgwick CMS Company is the Third Party Administrator (TPA) for the CSU Workers' Compensation Program.

All job-related injuries or illnesses should be immediately reported to the employee's supervisor and the Human Resources Department (SH-110).

Medical Attention


Medical treatment will be authorized if necessary. CSUSB has designated Central Occupational Medicine Providers (COMP) and St. Bernardine's Occupational Health Services as medical facilities to provide medical treatment for injured employees.

However, if prior to an injury, the Human Resource Department has been provided with a Pre-Designation of Personal Physician Form naming a personal physician, employees may seek medical care from this physician immediately after injury.

Supervisor's Injury/Illness Report


When an employee is injured on the job, the supervisor must complete a Supervisor's Injury/Illness Report (EHS-SIPR Form). After completing Form EHS-SIPR, please fax a copy to Human Resources at (909) 537-7019. The original copy must be mailed to the Human Resources Department within 24 hours of the report of injury/illness or you must call and report the injury to Human Resources.

Employee's Claim for Workers' Compensation Benefits


After the necessary medical attention has been received, the supervisor is required by law to provide the injured worker with an Employee's Claim for Workers' Compensation form within one day of receiving notice of an injury which results in lost time beyond the date of injury, or which results in medical treatment beyond first aid. Examples of first aid could include: minor scratches, cuts, burns, splinters etc.

If the employee elects to file a workers' compensations claim, the employee will complete the top portion of this form and then immediately return the DWC-1 in person to Lillian Hernandez, Manager of Workers' Compensation, in the Human Resources Department. In the event the employee is off work and unable to return the form in person, the supervisor should immediately send the form to: Human Resources Department, Attn: Lillian Hernandez. The Human Resources Department will complete the bottom portion of the claim form and advise the employee of the claim process.

If an employee qualifies for workers' compensation, all approved medical bills will be paid in addition to any temporary or permanent disability payments to which an employee is entitled.

Industrial Disability Leave


If an employee is unable to work as a result of a work-related injury or illness, he or she may elect to receive Industrial Disability Leave (IDL) in lieu of temporary disability payments.

  • IDL is available to CalPERS members
  • IDL provides full pay for the first 22 days of disability, with two-thirds pay for the next 11 months of disability.
  • IDL is available for a maximum of 52 weeks within the two-year period beginning with your first day of lost time.
  • While on IDL, you may be eligible to supplement your Workers' Compensation benefits with sick leave.
  • Employees disabled for 14 days or less do not receive IDL for the first three days (waiting period) unless hospitalized.

If you are not a member of CalPERS, Workers' Compensation benefits will be available through California Workers' Compensation Temporary Disability (TD).