The University of California strives to provide a safe working environment for all employees and to minimize the adverse impact of work-related injuries. Workers' Compensation is a state mandated benefit for employees with work-related injuries and illness, awarded without regard to who is at fault. California's Workers' Compensation laws are intended to ensure that employees receive prompt medical treatment, among other benefits, when they are injured on-the-job. Under Workers' Compensation, an injury must meet the test of both arising out of employment and occurring during the course of employment to be compensable.
Report a Work Related Injury/Illness
Employees should report a occupational injury to their supervisor immediately and seek medical care when necessary.
Note: If an accident results in an employee being hospitalized, other than for observation, for 24 hours or more, or a loss of a limb (amputation) or loss of life, notify the Workers’ Compensation Office and EH&S immediately at (951) 827-5528. EH&S must report these types of accidents to OSHA within 8 hours of the event.
Unless an employee has completed a Designation of Personal Physician form prior to the injury, an employee who needs medical treatment should be referred to one of the three Occupational Medical Treatment Facilities that are authorized to provide medical care to injured employees.
If you have completed a designation of Personal Physician prior to the injury, you may go to your designated physician or a Occupational Medical Treatment Facility.
Click here for a list of Occupational Medical Treatment Facilities.
Types of Injuries and Illnesses
- Specific Incident
A single injury to one or more parts of the body resulting from a specific incident. Examples are injuries resulting from a “slip and fall,” a broken glass beaker, or lifting a heavy object.
- Cumulative Injury
An injury resulting from repetitive traumatic activities over a period of time. Examples are loss of hearing from loud work-related noises or overuse syndrome from repetitive use of a keyboard.
- Occupational Disease
Diseases that result over time that are directly related to a person’s work, such as asbestosis, which results from an employee’s long term exposure to asbestos.
- Aggravation of a Pre-Existing Condition
If employment aggravates a pre-existing condition, the employer could be liable for proportion due to the aggravation.
Workers’ Compensation Benefits
Specific benefits are individually determined based on a range of factors. Generally, injured employees are eligible for the following types of benefits:
- Medical Care
Doctor visits, hospital services, physical therapy, lab tests, x-rays, and medicines that are reasonably necessary to treat the injury. For injuries occurring on or after 1/01/2004, there is a limit on some medical services.
- Temporary Disability Compensation
Temporary disability payments are provided to injured employees to supplement their lost wages (temporary disability payments may also be referred to as workers' compensation payments).
- Permanent Disability Compensation
Permanent disability compensation is provided when there is a permanent disability.
- Death Benefits
Compensation is provided to the surviving dependents in the event of death.
Sedgwick CMS has a contract with the University of California to provide the services of a third party administrator for the University’s workers’ compensation self-insurance program. Sedgwick CMS responsibilities include:
- Investigating all claims to determine if, legally, they should be accepted or denied
- Ensuring effective medical care and prompt payment of bills
- Providing prompt delivery of benefits on compensable claims
- Consulting with the Workers’ Compensation Office for claims management and early intervention planning
- Calculating the amount of reserved funds needed for each claim
- Defending the University’s position on questionable or litigated claims
P.O. Box 14533
Lexington, KY 40512-4533
Phone: (877) 682-7778
Fax: (916) 788-9990
Cost Allocation Program
The Cost Allocation Program takes a two-pronged approach. The first prong will apply a rate per $100 of payroll uniformly to all fund sources. This uniform rate will be reevaluated on an annual basis and adjusted, if required.
The second prong will assess an Incident /Claim Fee of $5,000 per qualifying incident/claim.