Overview

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This article summarizes the process for reporting and managing work-related injuries and subsequent leaves for employees on the UC San Diego Campus.  UC San Diego Health Systems employees will follow their own processes.

Please Note: This article covers the Workers Compensation process only.  If you have questions about other applications, e.g. UCPath or Timekeeping, please reach out to the applicable Central Office (HR for questions about UCPath Leaves of Absence, and Core Central Payroll (CCP) for Timekeeping questions.

Critical Concepts

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UC San Diego’s Risk Management Office explains the process and responsibilities of parties involved in the Worker's Compensation Employee's Guide.

Click here to review the UC San Diego Workers Compensation Business Process.

Steps to Take

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When a work-related injury occurs, the employee notifies the Workers Compensation Office at UC San Diego by completing a form on BLINK.  Once employee completes the form, the supervisor must complete one as well:

• Employee's Occupational Incident Report 
• Supervisor's Occupational Incident Report

Employees may also call the 1-800 Reporting Line: 877-6UC-RPRT (877-682-7778) to report the incident, and supervisors complete the Supervisor Report page of the online Workers' Compensation Supervisor’s Occupational Incident Report (link above).

Important: Completing an Occupational Incident Report form does not file a claim for workers’ compensation benefits.

After receiving employee’s Occupational Incident Report form, the UC San Diego Workers’ Compensation Office will monitor their medical treatment to determine if level of care exceeds first aid treatment. First aid treatment may be appropriate treatment and is not considered a workers’ compensation benefit, although first aid costs will be paid by employer. If medical treatment exceeds first aid treatment at the initial or subsequent medical visits, the UC San Diego Workers’ Compensation Office will send employee a State of California Workers’ Compensation Claim Form (DWC-1).

The Workers' Compensation Office obtains the information necessary to determine the category of your injury or illness:

1. Incident - No medical treatment received. The Report of Injury is retained at the Workers' Compensation Office.
2. First Aid - Minor medical treatment is received, no time is lost beyond the day of injury, and there are no modifications of job duties. The Report of Injury is forwarded to Sedgwick for payment of the first aid bill.
3. Claim – Employee’s injury will be processed as a claim when any of the following occur:

• • Medical treatment beyond first aid is received.
  • Time is lost beyond the day of injury per medical disability slip.
  • The injury causes employee to work modified duties. If injury or illness is categorized as a claim, employee’s Report of Injury is forwarded to Lincoln.

When a work-related injury is classified as a claim, numerous offices at UC San Diego are involved.  These offices include Environment Health & Safety/Risk Management Office, Human Resources, Core Central Payroll, employee’s Department or VC HR administration, to name a few.  The roles and responsibilities of each are explained in the UC San Diego Processes link in Critical Concepts above.

In cases where the injury requires the employee to be absent from work, HR Initiators must initiate a Request for Extended Leave of Absence in UCPath. Please refer to the following Job Aid: How to Request a Leave of Absence

Please Note:  For VC -Resource Management Planning, Human Resources, Information Technology Services and VC - Advancement, Marco Hermosillo (mahermosillo@ucsd.edu) will submit the leave request in UCPath. 

The Worker’s Compensation Election Form must be provided to the employee for their completion, and it must be added as an attachment to the transaction when Worker’s Comp leave type is selected. 

In addition to the state-mandated benefits, the University of California provides supplemental benefits described as follows: 
Supplemental Leave - If employee works 50% time or more, they will remain on 100% salary by using sick leave to supplement the Workers' Compensation temporary disability payments paid by Sedgwick . Once employee’s sick leave balances are depleted, they have the option of using vacation leave and/or comp time to continue receiving a 100% paycheck. For more detailed information on leave options and usage, refer to the Risk Management Office’s Employee Guide link in Critical Concepts above.

Sedgwick will notify employee of the status of their claim within 14 days after they receive it for processing.

Three possibilities exist:

1. Accepted
2. Denied
3. A letter of delay is issued if more time is required to investigate the claim

For claims that are denied, Sedgwick will mail a letter to employee’s home explaining why the claim has been denied. A copy of this letter will also be mailed to the employee's supervisor and department timekeeper. Any time lost on the day of the injury will no longer be considered Administrative Leave. Employee’s accrued leave balances would be used to cover time lost on that day.

Additional Information

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• For UC Campus departments, the payroll department will do the following:
  
  • Contact the department when the UCPath Workers Comp team advises that the employee needs to be placed on leave if they are already not on leave in the UCPath System (80% ESL, Intermittent leave or unpaid leave).
  • Place the employee on Contingency Fund when given direction from Risk Management.
• There is no need for departments to submit time for an employee on leave unless they fall under these three categories:
  
  • 3 Day Waiting Period – the employee will have to use his/her own time to cover this period determined as the “waiting period”. This time will typically be entered via time & attendance (I-181).
  • Intermittent Leave – hours should still be submitted in order for UCPath Center to determine and calculate supplemental pay.
  • Waiting to be Accepted – there may be a period which an employee will have to wait for the claim decision from Sedgwick. If the department allows the employee to use his/her balances until the claim is accepted, once the claim is accepted UCPath Center will credit back any leave balances due to the employee and process adjustments.
• Shift Differential/Alternative Work Schedule form should be submitted with the extended absence request. This typically is used for safety employees that work varying 12, 24 hour shifts etc. UCPath center needs this in order to calculate correctly.

 

Additional Resources

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