What to Do If An Injury Occurs at Work UCOP Goleta

1. What to Do If An Injury Occurs at WorkUCOP Goleta Prepared and Developed by Erin Choi, UCOP Student Intern

2. Injury at Work: Instructions on UCOP Webpage • UCOP Human Resources: • http://hrop.ucop.edu/ • Employee – Injury at Work: • www.ucop.edu/humres/workers_compensation/employee/injury.html • Supervisor/Manager – Injury at Work: • www.ucop.edu/humres/workers_compensation/supervisor/injury.html

3. What to Do If an Injury Occurs at Work(Employees) If injured at work: Report incident to your supervisor immediately Promptly obtain proper medical care If emergency care is needed: Go to nearest emergency room Report injury to your supervisor as soon as possible For follow up care, go to UCOP’s Occupational Health Center or your designated physician

4. UC Designated Occupational Health Facilities - Goleta • Webpage: • http://www.busserv.ucsb.edu/workerscompensation/mtaf.htm • Occupational Medicine Center - Sansum/Santa Barbara Medical Foundation Clinic (SSBMFC) • 101 S. Patterson, Santa Barbara 805-898-3311 Hours: Monday – Friday 8AM to 6 PM • Urgent Care/Hitchcock Branch - Sansum/Santa Barbara Medical Foundation Clinic (SSBMFC) • 51 Hitchcock, Santa Barbara 805-563-6133 Hours: Saturday – Sunday 9AM to 6 PM USE ONLY WHEN PATTERSON OFFICE IS CLOSED

5. UC Designated Emergency Medical Facilities - Goleta • Goleta Valley Cottage Hospital • 351 S. Patterson Ave., Santa Barbara 805-967-3411 Hours: Every Day, All Hours • Santa Barbara Cottage Hospital • Pueblo at Bath, Santa Barbara 805-682-7111 Hours: Every Day, All Hours

6. Medical Treatment - Employee’s Personal Care Physician • Employee can designate personal care physician • Must have completed pre-designation form • http://www.ucop.edu/humres/workers_compensation/employee/pre_form.pdf • Employee should discuss with personal care physician • Physician must agree to treat employee in accordance with California Workers Compensation Laws

7. What To Do If an Injury Occurs at Work(Employees Continued) • If the treating physician certifies you for disability - Provide your supervisor with medical certification of: • Any and all disability leave dates; • Any and all future changes in disability leave dates • It is your responsibility to keep your supervisor informed

8. Injury at WorkSupervisors – Three Immediate Actions Arrange medical care for the employee • If employee has signed the pre-designated physician form on file; the employee can go to their physician • Or refer employee to one of the UCOP Occupational Health Centers and contact HR Benefits Office Complete Incident Report – Section 2 • Employee completes Section 1 • Treating physician completes Section 3 Complete Employer’s Report of Occupational Injury/Illness Form (5020) http://www.ucop.edu/humres/workers_compensation/edb_prep/procedure_2.pdf

9. UCOP Incident Reports • Approximately 45 Incident Reports submitted every year • Why complete an Incident Report? • Documents the incident • Differentiate first aid/minor injury incidents from workers compensation-type injuries • Helps to significantly reduce UC’s workers compensation costs • Human Resources & Department Safety Officer opportunity to review/investigate all incidents

10. Section 1 of the Incident Report Completed by the employee

11. Incident Report Form Section #2 • Non-emergency situation: • Supervisor completes Section 2 first; then • Incident Report given to employee to complete Section 1 • Incident Reports • Handed/mailed to employee within 1 day of knowledge of on-the-job injury/illness • If mailed – Use proof of service mail delivery form

12. Incident Report Form Section #3 • Medical care provider • Completes Section 3 of the Incident Report (If medical care is required)

13. Completed Incident Report • Placed in employee’s workers compensation file • Copy to UCOP Benefits Office: • Hand delivered; or • Fax (510)217-6062 • Copy to Department Safety Officer: • Investigation and recommend corrective measures • Prevent similar incidents in the future

14. Employee Loses Time from Work(Supervisors) • Contact Employee Dept. Benefits (EDB) Preparer or Department Personnel Assistant (DPA) for: • Family Medical Leave Act (FMLA) Procedures and Eligibility Criteria • Notify UCOP Return to Work/Vocational Rehabilitation Program. • Reduce Lost Workdays: • Provide medically appropriate modified work during the transitional stages of your employee’s medical recovery • Call Roger Howland at (510) 987-0893 for: • Assistance/consultation in designing Transitional/Modified work • The day employee returns to work: • Notify UCOP HR Benefits Office to prevent overpayment of disability benefits.

15. Injuries • Call 9-911 (Emergency) • Call UCOP Benefit Services as soon as possible to report the serious injury: • (510) 987-0123 – Customer Service Line • (510) 987-0819 – Anne Buckland • (510) 987-0816 – Leslie Lyons • (510) 987-0893 – Roger Howland • Remove the equipment from service (If applicable) • Tag the equipment for identification (If applicable) • Contact Roger Howland at (510) 987-0893 to initiate an inspection • For additional assistance – Contact UCOP Benefit Services Office