Workers' Compensation - Supervisor's Guide

Supervisor's Guide - Frequently Asked Questions

What is an Occupational Injury?

The term "occupational injury" is used to describe any injury, illness, or disease which results from work or working conditions, and which occurs during the employee's service to the District. Even first-aid injuries are covered.  However, benefits may not be provided for those injuries that occur during voluntary participation in off-duty recreational, social, or athletic activities.

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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.

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How to Report an Injury and What are Your Responsibilities?

  • A supervisor must complete the supervisor's report with the employee within three business days of learning of the injury.

    The Los Angeles Community College District's mission is to provide a safe working environment for all employees and to minimize the adverse impact of work-related injuries. In this effort we provide a variety of safety and claims services for our employees. Our goal in requiring the reporting of incidents is to promote prompt notification of unsafe conditions so that prompt and appropriate remediation can take place. Incident reporting ensures that a record is on file with the employer. In no way does this waive the employee's right to workers' compensation benefits. If an incident takes place that results in an injury, First Aid may be appropriate in some cases. Filing of an incident and injury report with the Sheriff office is not a filing of a workers' compensation claim. An employee retains the right to file a workers' compensation claim.

  • See "Filing for a Workers' Compensation Claim" below.

  • Unless an employee has completed a Pre-Designation of Physician Form prior to the injury, an employee needing medical treatment should be referred to facilities on the Medical Referral Form that are authorized to provide medical care to injured employees. Employee should be instructed to provide the Medical Referral Form to the clinic as authorization for them to be treated at the chosen medical facility.

  • Important: If an employee is hospitalized other than for observation for 24 hours or more, or has an injury that results in a loss of limb (amputation) or loss of life, contact the Risk Management Department at (213) 891-2400 immediately, as these must be reported to OSHA within 8 hours of the event.

  • Forward the completed Supervisors Report of Employee Injury or Illness to the assigned Focal Point at your work location or fax it to the Risk Management Department at 213-891-2293.

  • When an employee has sought treatment for an occupational injury, s/he is to bring back a note from the treating physician indicating the employee's return to work status, and if there are any restrictions. Departments are to make a copy of all doctor's notes and correspondence for departmental files, and send the original to the Risk Management Department.

  • When the treating physician releases an employee with a work restriction, the supervisor should contact the Workers Compensation Claim Specialist to discuss return to work.

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What is Workers' Compensation?

Worker's Compensation is a state-mandated benefit for employees with work-related injuries and illness, awarded without regard to who is at fault. California worker's compensation laws are intended to insure 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.

If you have questions regarding the Workers' Compensation Policy and Procedure, please call or email:

Ross Lee, Workers' Compensation Claims Specialist
(213) 891-2397
LeeRG@email.laccd.edu

Leila Menzies, Vice President of Administration, Risk Management
(213) 891-2036
MenziesL@email.laccd.edu
Fax: (213) 891-2293

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Who is Eligible for Workers' Compensation?

Los Angeles Community College District employees and others who meet the campus definition of "Others for Workers' Compensation Coverage" below.

Definition of "Others for Workers' Compensation Coverage":

For the purpose of workers' compensation coverage, "other" is defined as a person rendering services to the District where:

  • The District has control and direct supervisory responsibility over the manner and result of the services rendered by the individual; and

  • The individual receives no compensation for such services other than meals, transportation, lodging, or reimbursement for incidental expenses, if appropriate.

  • The individual is under a contractual agreement indicating they are to receive their workers' compensation coverage from the District.

  • The following categories do NOT fall within the "other" definition:

  • The service provided is solely in pursuit of the individual's personal education goals;

  • The individual receives remuneration for services rendered from a non-LACCD payroll, e.g., visitors or guests, academic or research visitors receiving support from home institutions, etc.;

  • The individual is sponsored by an outside agency and provides service to the District through that sponsoring agency, e.g., Red Cross volunteers or United Way volunteers;

  • The individual is an off-campus volunteer who is sponsored or referred by the District but is not under the direct supervision and control of the District, e.g., Student Internships, Student Teachers, etc.; and/or

  • Guests of the District such as: casual visitors; computer users who are employees of an organization which has a formal contractual agreement to use computer facilities; or retired employees who desire occasional access to campus/laboratory/recreational facilities.

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Filing for a Workers' Compensation Claim

If an employee states that s/he would like to file for a workers' compensation claim, have the employee report the incident to the Sheriffs office, and refer him/her to the work location Focal Point. The Focal Point will provide the Employee's Claim for Workers' Compensation Benefits (DWC-1) Form and the Referral for Treatment of Occupational Injury Form.

When an employee is not able to come in to complete the Employee's Claim for Workers' Compensation Benefits (DWC-1) Form and the Referral for Treatment of Occupational Injury Form, the Focal Point will send the forms to the employee via US Mail.

The District has contracted with "Southern California Risk Management Associates" (SCRMA) to serve as the workers' compensation administrator. A SCRMA claims administrator will discuss the claim with you and the injured employee to determine acceptance of the claim. Reporting an injury or submission of a claim does not imply automatic approval of the claim. Questions regarding claims and benefits may be referred to:

York Insurance Services Group Inc. (YORK)
3313 East Foothill Blvd
Upland, CA 917786
Phone: (909) 608-7171
Fax: (909) 608-7165

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Overview of 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:

  1. 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 01/01/2004, there is a limit on some medical services.

  2. Temporary Disability Compensation: Temporary disability payments are provided to injured employees to supplement their lost wages. 

  3. Permanent Disability Compensation: Permanent disability compensation is provided when there is a permanent disability;

  4. Death Benefits: Compensation is provided to the surviving dependents in the event of death; 

  5. Vocational Rehabilitation Services: These services help employees in returning to work. This benefit applies to injuries that occurred prior to 01/01/2004.

  6. Supplemental Job Displacement Service: A non-transferable voucher payable to a state approved school if an employee is injured on or after 01/01/2004, the injury results in permanent disability, the employee doesn't return to work within 60 days after temporary disability ends, and the District does not offer modified or alternative work.

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Procedure for Pending Claims

Southern California Risk Management Associates has ninety (90) days from the filing date of the claim to make a determination whether the claim will be approved or denied.

Southern California Risk Management Associates will mail a letter to the employee's address stating when the decision is expected to be made. Employees who have exhausted their sick leave before the claim is approved may use compensatory and vacation leave with department approval.

Upon acceptance or denial of the claim, Risk Management will notify the Department.

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Procedure for Approved Claims

Once a claim is approved, Southern California Risk Management Associates will send out a letter confirming that the claim has been approved and authorizes medical treatment and issues any temporary or permanent disability payments related to the claim. The Los Angeles Community College District is self-insured and the cost arising from the workers' compensation claims are paid directly by the District.

When an employee is losing time from work on an approved claim, the employee is entitled to two-thirds of his/her average weekly wage. The District pays the two thirds and supplements the amount with accrued sick leave providing the employee with their full salary. The Payroll Department issues a full paycheck as long as the employee has available sick time. Once the employee has exhausted his/her sick leave, Southern California Risk Management Associates will mail a check to the employee for approximately two-thirds of the employee's weekly salary, up to a maximum amount determined by the State of California.

By law, there is a three-day waiting period before workers' compensation temporary disability payments begin. This waiting period for temporary disability benefits is waived if the employee is hospitalized for treatment more than observation, or is disabled for more than 14 days. However the District pays the regular full time employee's full salary for the first 60 days of lost time for his/her industrial injury or illness.

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Types of Workers' Compensation Claims

  • Incident. No medical treatment is required for an incident. The Incident Report Form is retained at the campus Sheriff's Office.

  • First Aid. "First aid" means any one-time treatment, and any follow-up visit(s) for the purpose of observation of minor scratches, cuts, burns, splinters, or other minor industrial injury, which do not ordinarily require medical care. This one-time treatment and follow-up visits for the purpose of observation are considered first aid even though provided by a physician or registered professional personnel. No time is lost beyond the day of the injury.

  • Medical Only. These claims involve only medical payments for treatment rendered. The injured employee has not lost more than three calendar days from work and is not receiving any other workers' compensation benefits as a result of the injury or illness. (If the employee misses more than three calendar days from work due to the work-related injury/illness, the claim converts to an indemnity claim.)

  • Indemnity Claim (Lost Time). An indemnity claim involves temporary disability payments when an employee has lost more than three calendar days from work as a result of the occupational injury or illness. Time lost beyond three days is confirmed by a medical disability slip.

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