SNAP : MAIN MENU: Workers' Compensation

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MAIN MENU: Workers' Compensation

Process	Forms
Workers' Compensation - Questions and Answers to get you started... How To: Report a Work Related Injury/Illness for Employees for Supervisors Obtain Medical Care Request an Ergonomic Evaluation Request a Safety Investigation Comply with Family Medical Leave (FMLA) Enter Workers' Compensation Leave in the Payroll/Personnel System with pay without pay Request a Reasonable Accommodation - for Employee Request a Reasonable Accommodation - for Supervisor	DWC-1 (claim form) & Notice of Potential Eligibility (NOPE) Extended sick leave - Ballot Authorization Incident Report - online Medical Release forms: General Kaiser Mileage Reimbursement Pre-designation of Personal Physician
Resources	Policies and Publications
At Your Service - Summary of Workers' Compensation (.pdf) CAL/OSHA (Occupational Safety and Health) Computer Workstation Assessment Ergonomics - Computer and Office online by Cardinus Workstation Safety Plus (enroll using TED) Office Ergonomics Checklist UCI Computer Ergonomic Review Tool (.pdf version) Calif. Division of Workers' Compensation General Overview Information and Assistance Unit Disability Management menu Guide to Workers' Compensation: (.pdf version) Employees - English, Spanish Employers Environmental Health and Safety (EH&S) - UCI Family and Medical Leave Guide to Family Medical Leave - UCI Family Medical Leave - U.S. Dept. of Labor Injury and Illness Prevention Program - EH&S Injured Worker - educational fact sheets Introduction to Workers' Compensation (video) Liberty Mutual Sedgwick Claims Management Services UC Office of Risk Management Wellness website	Academic Personnel - Leave, Medical Separation, Reasonable Accommodation CAL/OSHA - UCI annual log 2009 2008 2007 2006 2005 Environmental Health and Safety (EH&S) policy at UCI Facts About Workers' Compensation pamphlet - provide upon hire Injuries Caused by Work - Employees' Notice English Spanish Leave Sick Leave Policy Work-Incurred Illness and Injury Procedure Medical Separation UC Policy 66 UCI Procedure 66 Reasonable Accommodation UC Policy 81 UCI Procedure 81 Self-Insurance Program- UC Workers' Compensation Transitional Work Program at UCI Guidelines Policy Work-related accidents and injuries - UC Irvine procedures
	Contacts
	Find an expert: We can lead you to the right person within the Workers' Compensation and Disability Management Unit (949) 824-7008, fax (949) 824-9299.