The mission of the Workers' Compensation unit is to ensure that all components of the workers' compensation program are effectively meeting the needs of the injured worker and UC Davis Health with the highest degree of integrity.
The functions of the unit include oversight of all issues relating to workers' compensation for employees of the UC Davis Health. In addition, workers' compensation monitors the functions of our third party administrator. Program responsibilities include providing education, technical assistance and training to department supervisors/managers in the areas of workers' compensation, office ergonomics and injury prevention issues; ensuring legal compliance with the labor code and UC Davis Health policies. The filing of all claims is initiated by the program. Advice is provided to departments regarding the implementation of the Transitional Return to Work policy.
Workers' compensation is also actively involved with the UC Davis Health's Injury/Illness Prevention Initiative and conducts office-ergonomic evaluations.
Workers' Compensation Forms
- Designation of Physican's Form (Word)
- Doctor's First Report (PDF)
- Slip and Fall Incident Review Form (PDF)
- Worker's Compensation - Employee's Claim Form (PDF)
- Worker's Compensation - Employee Instructions/DWC-1 (PDF)
- Worker's Compensation - Injury/Illness Worksheet Form (PDF)
- Patient Handling Injury Form (PDF) (Word)
Workers' Compensation Updates
- Discomfort - What to do should you experience it (PDF)
- Slip, trip and fall injuries on the rise (PDF)
- Signal Light Report FAQs (PDF)
- Insurance Fraud Poster (PDF)
Policy and Procedures
- Policy and Procedures
- Work-Incurred Illness and Injury (PPSM 44) (PDF)
- Notice to Employees - Injuries Caused By Work (PDF)