Acalanes Union HSD Board Policy Work-Related Injuries

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1 Board Policy BP District employees shall be insured for on-the-job specific or cumulative injuries in accordance with law. In order to reduce costs and facilitate employee recovery, the Governing Board desires to have an efficient claims handling process. Employees are required to report any work-related injuries or illnesses to their supervisor as soon as practicable. (cf Claims and Actions Against the District) Legal Reference: EDUCATION CODE Industrial accident and illness leaves, certificated employees Industrial accident and illness leaves, classified employees GOVERNMENT CODE Employer not to separate for disability members eligible to retire LABOR CODE Workers' compensation, especially: 3550 Posting of notice re workers' compensation insurance carrier 3551 Written notice to new employees 3552 Indication of employee's personal physician Conditions of liability 3760 Report of injury to insurer 4600 Provision of medical and hospital treatment by employer 4906 Disclosures and statements Notice of injury or death Reports Policy ACALANES UNION HIGH SCHOOL DISTRICT adopted: December 5, 1995 Lafayette, California

2 Administrative Regulation AR Notifications The Superintendent or designee shall post a notice of employee rights related to workers' compensation and shall provide this information in writing to new employees. (Labor Code ) This notice shall also include a statement of the district's policy requiring employees to report work-related injuries as soon as practicable. Employees shall also be informed that pursuant to Labor Code 4906, it is a felony for an employee to make a false workers' compensation claim. District Responsibilities Supervisors receiving reports of a work-related employee injury shall gather appropriate information, including but not limited to: 1. The date, time and place of the injury 2. The name, occupation and signature of the injured employee 3. Details of how the injury occurred 4. The names of any witnesses Supervisors shall promptly remit information about work-related injuries to the Superintendent or designee. Whenever a work-related injury results in lost work time beyond the date of the injury or requires medical treatment beyond first aid, the employee shall be given a workers' compensation claim form and a notice of potential eligibility for benefits within one working day ofthe injury. (Labor Code 5401) In the case of stress claims, the claim form shall be provided only if the employee indicates that he/she is going to a physician or is unable to work. Within five working days of obtaining knowledge of any injury which results in lost time beyond the date of the injury or which requires medical treatment beyond first aid, the Superintendent or

3 designee shall file a complete report of the injury with the district's insurer. (Labor Code ) Employee Responsibilities Upon receiving treatment for a work-related injury, the employee shall obtain a medical verification of his/her condition, indicating any limitations on the employee's ability to work, the anticipated time needed for recovery from these limitations, and the type of work modification needed. (cf /4213.4/ Temporary Modified/Light-Duty Assignment) The district has designated a medical carrier where employees will be taken in case of a work-related injury. Employees who wish to be taken to their personal physician for treatment of work-related injuries must have a written request on file with the Superintendent or designee. It is the employee's responsibility to inform his/her supervisor that he/she has such a request on file. (Labor Code 4600) ( cf / Industrial Accident/Illness Leave) ( cf Industrial Accident/Illness Leave) To qualify for workers' compensation, employees must notify their supervisor of a work-related injury within 30 days. (Labor Code 5400) Regulation ACALANES UNION HIGH SCHOOL DISTRICT approved: December 5, 1995 Lafayette, California

4 Board Policy BP District employees shall be insured for on-the-job specific or cumulative injuries in accordance with law. In order to reduce costs and facilitate employee recovery, the Governing Board desires to have an efficient claims handling process. Employees are required to report any work-related injuries or illnesses to their supervisor as soon as practicable. (cf Claims and Actions Against the District) Legal Reference: EDUCATION CODE Industrial accident and illness leaves, certificated employees Industrial accident and illness leaves, classified employees GOVERNMENT CODE Employer not to separate for disability members eligible to retire LABOR CODE Workers' compensation, especially: 3550 Posting of notice re workers' compensation insurance carrier 3551 Written notice to new employees 3552 Indication of employee's personal physician Conditions of liability 3760 Report of injury to insurer 4600 Provision of medical and hospital treatment by employer 4906 Disclosures and statements Notice of injury or death Reports Policy ACALANES UNION HIGH SCHOOL DISTRICT adopted: December 5, 1995 Lafayette, California

5 Administrative Regulation AR Notifications The Superintendent or designee shall post a notice of employee rights related to workers' compensation and shall provide this information in writing to new employees. (Labor Code ) This notice shall also include a statement of the district's policy requiring employees to report work-related injuries as soon as practicable. Employees shall also be informed that pursuant to Labor Code 4906, it is a felony for an employee to make a false workers' compensation claim. District Responsibilities Supervisors receiving reports of a work-related employee injury shall gather appropriate information, including but not limited to: 1. The date, time and place of the injury 2. The name, occupation and signature of the injured employee 3. Details of how the injury occurred 4. The names of any witnesses Supervisors shall promptly remit information about work-related injuries to the Superintendent or designee. Whenever a work-related injury results in lost work time beyond the date of the injury or requires medical treatment beyond first aid, the employee shall be given a workers' compensation claim form and a notice of potential eligibility for benefits within one working day ofthe injury. (Labor Code 5401) In the case of stress claims, the claim form shall be provided only if the employee indicates that he/she is going to a physician or is unable to work. Within five working days of obtaining knowledge of any injury which results in lost time beyond the date of the injury or which requires medical treatment beyond first aid, the Superintendent or

6 designee shall file a complete report of the injury with the district's insurer. (Labor Code ) Employee Responsibilities Upon receiving treatment for a work-related injury, the employee shall obtain a medical verification of his/her condition, indicating any limitations on the employee's ability to work, the anticipated time needed for recovery from these limitations, and the type of work modification needed. (cf /4213.4/ Temporary Modified/Light-Duty Assignment) The district has designated a medical carrier where employees will be taken in case of a work-related injury. Employees who wish to be taken to their personal physician for treatment of work-related injuries must have a written request on file with the Superintendent or designee. It is the employee's responsibility to inform his/her supervisor that he/she has such a request on file. (Labor Code 4600) ( cf Industrial Accident/Illness Leave) ( cf Industrial Accident/Illness Leave) To qualify for workers' compensation, employees must notify their supervisor of a work-related injury within 30 days. (Labor Code 5400) Regulation ACALANES UNION HIGH SCHOOL DISTRICT approved: December 5, 1995 Lafayette, California

7 Board Policy BP District employees shall be insured for on-the-job specific or cumulative injuries in accordance with law. In order to reduce costs and facilitate employee recovery, the Governing Board desires to have an efficient claims handling process. Employees are required to report any work-related injuries or illnesses to their supervisor as soon as practicable. (cf Claims and Actions Against the District) Legal Reference: EDUCATION CODE Industrial accident and illness leaves, certificated employees Industrial accident and illness leaves, classified employees GOVERNMENT CODE Employer not to separate for disability members eligible to retire LABOR CODE Workers' compensation, especially: 3550 Posting of notice re workers' compensation insurance carrier 3551 Written notice to new employees 3552 Indication of employee's personal physician Conditions of liability Report of injury to insurer 4600 Provision of medical and hospital treatment by employer 4906 Disclosures and statements Notice of injury or death Reports Policy ACALANES UNION HIGH SCHOOL DISTRICT adopted: December 5, 1995 Lafayette, California

8 Administrative Regulation AR Notifications The Superintendent or designee shall post a notice of employee rights related to workers' compensation and shall provide this information in writing to new employees. (Labor Code ) This notice shall also include a statement of the district's policy requiring employees to report work-related injuries as soon as practicable. Employees shall also be informed that pursuant to Labor Code 4906, it is a felony for an employee to make a false workers' compensation claim. District Responsibilities Supervisors receiving reports of a work-related employee injury shall gather appropriate information, including but not limited to: 1. The date, time and place of the injury 2. The name, occupation and signature of the injured employee 3. Details of how the injury occurred 4. The names of any witnesses Supervisors shall promptly remit information about work-related injuries to the Superintendent or designee. Whenever a work-related injury results in lost work time beyond the date of the injury or requires medical treatment beyond first aid, the employee shall be given a workers' compensation claim form and a notice of potential eligibility for benefits within one working day of the injury. (Labor Code 5401) In the case of stress claims, the claim form shall be provided only if the employee indicates that he/she is going to a physician or is unable to work. Within five working days of obtaining knowledge of any injury which results in lost time beyond the date of the injury or which requires medical treatment beyond first aid, the Superintendent or

9 designee shall file a complete report of the injury with the district's insurer. (Labor Code ) Employee Responsibilities Upon receiving treatment for a work-related injury, the employee shall obtain a medical verification of his/her condition, indicating any limitations on the employee's ability to work, the anticipated time needed for recovery from these limitations, and the type of work modification needed. (cf /4213.4/ Temporary Modified/Light-Duty Assignment) The district has designated a medical carrier where employees will be taken in case of a work-related injury. Employees who wish to be taken to their personal physician for treatment of work-related injuries must have a written request on file with the Superintendent or designee. It is the employee's responsibility to inform his/her supervisor that he/she has such a request on file. (Labor Code 4600) ( cf Industrial Accident/Illness Leave) ( cf Industrial Accident/Illness Leave) To qualify for workers' compensation, employees must notify their supervisor of a work-related injury within 30 days. (Labor Code 5400) Regulation ACALANES UNION HIGH SCHOOL DISTRICT approved: December 5, 1995 Lafayette, California

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