Workers' Compensation

If you are injured or contract an illness at work, here's what you need to do:

If you are injured or contract an illness at work, here's what you need to do:

Report the injury or illness to your Supervisor immediately.
Call “Company Nurse” (our medical triage service provider) at 1-888-770-0933 to provide them details about the injury. They will recommend the appropriate medical course of action for you to take. (note: If your injury is a true medical emergency, call 9-1-1 first and follow up with Company Nurse as soon as possible thereafter).
If you are directed to seek medical attention, Company Nurse will direct you to visit the Healthpointe Medical clinic (Click here for address and map).
If medical treatment is not required, only the “Employee's Report of Work Injury/Illness” (click here for form) needs to be completed and sent to the Workers' Compensation Department by FAX (909) 381-1225; email WorkersComp@sbcusd.k12.ca.us: then pony the original to the District Office - Workers' Comp.
If medical treatment is required, the entire work comp claim packet of forms must be completed (All forms are available below). Print out and complete forms, and send to the Workers' Compensation Department by FAX (909) 381-1225; email WorkersComp@sbcusd.k12.ca.us: then pony the original to the District Office - Work Comp.

If you need help navigating through the process, please contact anyone in the Work Comp Unit - we are here to help!

Workers' Compensation is a mechanism required by law in California that requires all employers to provide for medical care for injuries/illnesses caused by working your job. Many employers buy Workers' Compensation insurance to cover the costs of that care, and some, like SBCUSD, cover those costs directly out of District Funds. The District contracts with a third party administrator for the management of its claims.

Worker's Compensation Claim Packet

Worker's Compensation Claim Packet

Predesignation of Personal Physician

Prior to sustaining an injury or illness related to your employment, you may be treated for such injury or illness by your personal medical doctor (M.D.), doctor of osteopathic medicine (D.O.) or medical group. Please complete the attached form and return to the Workers' Compensation Office.

Predesignation of Personal Physician (DWC Form 9783)

Notice of Personal Chiropractor or Personal Acupuncturist (DWC Form 9783.1)

Jeff Haynes
Director
Email

Sandra Rios
Secretary III
Email

Sugey Juarez
Claims Examiner
Email

Eneida Morales
Claims Examiner
Email

Rachel Ward
Technician
Email

Nicole Johnson
Clerk II
Email

777 North F Street
San Bernardino, CA 92410

Phone: (909) 381-1166
Fax: (909) 381-1225

Hours
8 a.m. - 4:30 p.m.
Monday - Friday

Third Party Administrator

Keenan & Associates
License #0451271

P.O. Box 2707
Torrance, CA 90509
(951) 715-0190

USEFUL LINKS

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