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Workers’ Compensation Reporting Reminder

To: All Employees

Fr: Tiffany Perry, Workers’ Compensation, ADA, and Leave Specialist, Payroll and Benefits

Re: Workers’ Compensation Reporting Reminder

The following information is a reminder to all employees regarding Sonoma State University’s Workers’ Compensation Program and the obligation for timely reporting of on the job injuries.

  • Employees must report work-related illnesses and injuries to their appropriate administrator immediately. Contact Workers’ Compensation at (707) 664-2664 with any questions.
  • The purpose of workers’ compensation is to provide medical care and benefits to employees who are injured within the scope of their job duties. Within 24 hours of the incident, managers are required to:
    • Complete the Supervisor’s Report of a Work Related Injury/Illness form;
    • Provide the Workers’ Compensation Claim Form (DWC1) to the injured employee to complete and sign; and
    • Return both forms to hrleaves@sonoma.edu or fax to (707) 664-4049.
  • In the event of an emergency, call 911. Injured employees in need of immediate medical attention are to seek treatment at the Kaiser Emergency Room in Santa Rosa.
  • Injured employees who need medical attention, but not immediately, are required to contact Workers’ Compensation at (707) 664-2664. The Workers’ Compensation Office will coordinate an appointment with Kaiser Occupational Health Services. Injured employees are not to contact Kaiser Occupational Health Services directly nor should they seek treatment from their personal physician (unless a Designation of Personal Physician form is filed with the Workers’ Compensation Office prior to the injury occurring).

Questions? Please contact the Workers’ Compensation Office at (707) 664-2664 or hrleaves@sonoma.edu.