Work-Related Injury and Incident Procedures

If you experience a work-related injury or illness, seek medical care promptly.

Emergency Care

• Call 911 immediately

Non-Emergency Care

• Visit one of the approved medical providers listed below
• If you are outside the area, go to a local urgent care facility or hospital and inform the provider that this is a work-related injury

Approved Medical Providers

• Doctors on Duty
  During the academic semester only.
  3130 Del Monte Blvd., Marina, CA 93933
  
  Marina: 831-883-3330
  Seaside: 831-899-1910
  Monterey: 831-649-0770
  Aptos: 831-662-3611
  South Salinas: 831-422-7777
  Salinas Abbott: 831-755-7880
  Salinas Harden: 831-443-8200
  Watsonville: 831-722-1444
  Santa Cruz: 831-425-7991
• CSUMB Campus Health Center
  Building 80
  831-582-3965

Required Forms for Treatment

Supervisors or Human Resources will provide:

• Medical Referral Form
• Prescription Voucher

The Prescription Voucher must be used for workers’ compensation insurance to cover prescriptions. This ensures there is no out-of-pocket expense for the employee.

If you experience a work-related injury or illness, you are required to take the following actions:

• Report the injury or illness immediately to your supervisor and to Human Resources at 831-582-3389 or leaves@csumb.edu
• Obtain a Medical Referral Form and Prescription Voucher before receiving medical treatment or prescriptions, as both are required for workers’ compensation insurance to cover care and medications
• If transported to the emergency room or urgent care, inform the provider that the injury is work-related
• Complete the Employee Incident Report and submit it to your supervisor and Human Resources; this form is required if you seek medical treatment or are unable to work due to the injury or illness
• Ensure a pre-designation of physician form is on file with Human Resources prior to the injury if you wish to be treated by your personal medical provider
• Provide a work status report following each medical appointment

Prompt reporting and documentation help ensure timely medical care, workers’ compensation coverage and appropriate workplace accommodations.

When notified of a work-related injury or illness, supervisors are required to:

• Immediately contact Human Resources at 831-582-3389 or leaves@csumb.edu for assistance, required forms and next steps
• Ensure the employee receives a Medical Referral Form and Prescription Voucher, as appropriate, so medical treatment and prescriptions are covered under workers’ compensation
• Submit the Supervisor Incident Report to Human Resources within one business day to comply with OSHA reporting requirements
• Provide the Employee Incident Report and DWC-1 Claim Form to the employee for completion
• Implement Health and Safety Review recommendations to help prevent future incidents
• Coordinate work restrictions and job accommodations in consultation with Human Resources
• Contact Human Resources if treatment is requested at a later date to ensure proper documentation and coverage

Timely action supports employee well-being, regulatory compliance and a safe campus workplace.

A medical release is required before an employee may return to work following medical treatment for a work-related injury or illness.

All work status updates and any work restrictions must be provided immediately to the MPP supervisor and to Human Resources at leaves@csumb.edu. If the MPP supervisor is unavailable, documentation must be provided to the Director.

Employees may not return to work until the MPP supervisor has reviewed the medical documentation and approved the return based on the availability of temporary modified duty, if applicable.

Questions about pay related to work-related medical leave should be discussed with a leave analyst:

Phone: 831-582-3389
Email: leaves@csumb.edu