Injur Injury R y Repor eporting P ting Procedur ocedure - - PowerPoint PPT Presentation

Workers’ Compensation Injur Injury R y Repor eporting P ting Procedur

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• Workers are required to report any injury to their supervisor as soon

as possible (within 24 hours)

• Supervisors must ensure medical treatment is obtained, if the need

goes beyond first aid

• If the worker cannot transport himself or herself to the medical

provider, the supervisor must make the arrangements for the injured worker

• Supervisors must complete the required WC forms, which are

available on SFMTA intranet: http://inside.sfmta.com:8088/wc/SitePages/default.aspx

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Complete Complete and Sub and Submit F mit For

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ACTIONS REQUIRED:

• Supervisor (within 24 hours):
• Completes Employer’s Report of Occupational Injury or Illness

(Form 5020)

• Provide the injured employee with the WC Claim form

(Form DWC-1)

• If the employee is physically incapable of filling out the Employee

Claim form and Employee Injury Report, mail the form to the employee’s address of record and document your efforts.

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After Hours Clinics

Please use when the other clinics are closed

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In the Event of an Injury at Work

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