• Facts about Workers’ Compensation benefits for school district employees



    What is Workers’ Compensation?

    California's no fault compensation law was passed over 75 years ago by the State Legislature to guarantee prompt, automatic benefits to employees who sustain an injury or illness as a result of their employment.

    The school districts in Contra Costa County are self-insured for workers' compensation benefits. The school districts' Joint Power of Authority program is administered by Contra Costa County School Insurance Group (CCCSIG) who is responsible for all benefit coordination for district employees who sustain an injury or illness arising out of and in the course and scope of their employment.

    Who is entitled to benefits?

    If an injury or illness occurs as a result of your employment you are entitled to workers' compensation benefits. With few exceptions, all California employers are subject to State Workers' Compensation laws.

    How are benefits claimed?

    The first step is to immediately report your injury to your supervisor or employer. At that time, the supervisor immediately calls:
     
    Company Nurse
    (888) 375-9779 - give Group Code CSIG
     
    Report the incident/injury and initiate the claim filing process. Company Nurse will gather information and facts about the injury from you.

    Your claim information will be sent to CCCSIG who is responsible for handling your claim and notifying you about your eligibility for benefits. When a claim has been established, CCCSIG will provide you with a DWC-1 form, also known as a Claim Form, with instructions for you to complete the "Employee" section and return.

    Prompt reporting of you injury is the key. Benefits begin immediately as required by State regulations, but this cannot occur until you report your injury to your Supervisor and call the injury hotline. Ensure your rights to benefits by reporting every injury.

    Are there time limitations for filing a claim for injury or illness?

    To claim benefits for an industrial injury you should be aware that such a claim is subject to certain time limitations. Any delay in reporting may delay workers' compensation benefits and you may not be able to receive benefits if you don't file a claim within one (1) year of the date of injury, the date you knew the injury was work related, or the date benefits were last provided. An employee also has one (1) year from the date of injury or last date benefits were provided to institute proceedings for workers' compensation benefits. The date of injury for occupational diseases or cumulative injuries is defined in the Labor Code as the date upon which the employee first suffered disability from and either knew, or in the exercise of reasonable diligence should have known, that such disability was caused by his or her present or prior employment.

    Employees who are victims of crime that occur at employee's place of employment shall be given notice of their right to receive workers' compensation benefits as a result of that crime should an injury or illness occur.

    Where do I go for medical care?

    Once you report your injury to your supervisor or employer, and contact Company Nurse, any care recommendations or medical treatment directions will be provided by the Nurse. In the event medical care is required, Company Nurse® will direct you to one of the district's Medical Panel of physicians who specialize in the treatment of occupational injuries. These physicians are also aware of the workers' compensation reporting requirement for physicians. When doctors are not familiar with these requirements, it may delay benefits.

    You are entitled to be treated by your own personal physician, if you have notified your employer, in writing, prior to your injury of your pre-designation selection. Your physician has to have actually served as your "personal" physician and/or surgeon and must agree to be pre-designated. If you wish to change your physician, please contact CCCSIG so that the appropriated information, as required by the State regarding a change, may occur.

    Return to work process for injured employees.

    After a work-related injury occurs, and you are seeking medical treatment, you will go to a designated medical facility for treatment.

    You will receive a Work Status Slip from the physician at each appointment. Immediately give the Work Status Slip to the District Claims Coordinator. The Work Status Slip will state that you are either:

    • Released to full duty
    • Released with work restrictions or limitations for a temporary period of time
    • Not released for work

    If released to full duty, you will return to your regular job duties.

    If released with work restrictions or limitations, the District Claims Coordinator will work with your site supervisor to determine:

    • Whether to temporarily modify your regular job duties (Modified Work Assignment) or
    • Place you temporarily in a Bridge Assignment, based on the medical restrictions from the physician.
    • If your regular site is unable to temporarily accommodate you in either the Modified Work Assignment or a Bridge Assignment, the District Claims Coordinator will determine if another school /district site can accommodate you in a temporary work assignment.
    • A pre-designated Bridge Assignment may be provided during this determination process.
    • If a Modified Work Assignment or Bridge Assignment has been designated, the District Claims Coordinator will review the work assignment and the temporary return to work agreement with you, and the Site Supervisor will conduct orientation prior to your beginning the temporary work assignment.
    • You will continue to go to your scheduled physician appointments, obtaining a new Work Status Slip at each visit and provide it to the District Claims Coordinator; this process continues until full duty release by the physician or the District can no longer provide you with a temporary work assignment.
    • If you choose not to accept the temporary work assignment the District is providing, your sick leave benefits are required to cover your time off absence.
    • If at any time you are unable to report to work during your temporary work assignment, call the District Claims Coordinator.

    If you do not feel you are medically able to perform the temporary work assignment (which is based on the physician's evaluation), you must immediately return to the Workers' Compensation medical doctor/facility to be re-evaluated and contact the District Claims Coordinator.

    If the district is unable to provide you with a temporary work assignment, you will receive temporary total disability benefits through Workers' Compensation while you are temporarily medically unable to work and remain off work duty to your workers' compensation injury.

    Workers’ compensation fraud is a felony.

    Anyone who makes or causes to be made any knowingly false or fraudulent material statement for the purpose of obtaining or denying workers' compensation benefits or payments is guilty of a felony.

     

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