• Workers Compensation


    Instructions for Reporting Industrial Injuries/Illness

    All work related injuries must be reported to your Supervisor immediately, don't delay.  If you wait too long you take risk of losing your rights to benefits.  

    1. Review and complete the occupational accident report form with designated site personnel.  All injuries and illnesses must be reported to your Supervisor before the end of your work shift during which the incident occured, regardless of whether medical attention is necessary.

    2. Call Company Nurse to report injury within 24 hours of incident.  At that point you will receive self-care instructions or clinic referral.  

    COMPANY NURSE
    1-877-518-6701
    Use Search Code:  SMC12

    3. If referred to a clinic for treament by Company Nurse, SAN BRUNO PARK SCHOOL DISTRICT has the following treating facilities designated for workers' compensation injuries: 

    Kaiser Occupational Health
    Bayhill Medical Offices
    801 Traeger Avenue Ste 212 
    San Bruno, CA  
    (650) 742-7110
    Clinic Hours: 
    Mon - Fri 8 a.m. - 5 p.m.

    Kaiser On the Job Occupational
    1400 Veterans Blvd
    Redwodd City, CA  
    (650) 229-4785
    Clinic Hours: 
    Mon - Thurs 8 a.m. - 5 p.m.; Fridays until 4:30 p.m.

    4.  If treated by one of the above medical providers, or medical attention is required/needed, injured employees must report to Cecille Mendiola (District Office) and provide a copy of the work status report.  At that time, it may be necessary to complete time sensitive workers' compensation document(s) that are required for receipt of workers' compensation benefits.

    5.  Should the treating physician determine there are work duty modifications/limitations; those will be addressed with the Supervisor.  San Bruno Park School District will make every attempt to return injured employees to modified duty.  Temporary modified or light-duty assignments can allow the employer to continue the use of the employee's valuable knowledge, skills and abilities while minimizing time away from work.  Temporary modified assignments may also serve to facilitate the employee's transition back to their regular or full-time work.

    6.  Follow up Appointments should be scheduled outside of regular work hours for department efficiency; and for the least possible impact to the program, co-workers, and students.  If you choose to seek medical attention during scheduled working hours, normal absence procedures should be followed according to District Policy and Education Code guidelines.  Please keep all scheduled appointments.  If you cannot keep an appointment, please call your assigned claims examiner with Keenan and Associates, the medical facility, and the Human Resources Department.  Missed appointments may result in a loss of benefits and your ability to participate in the return to work program.  

    IMPORTANT NOTICE

    "Workers' Compensation fraud is a felony" = anyone who knowingly files or assist in the filing of a false workers' compensation claim may be fined up to $50,000 and sent to prison for up to five years (Insurance Code section 1871.4)

    SAN BRUNO PARK SCHOOL DISTRICT OCCUPATIONAL ACCIDENT FORM 

    PHYSICIAN-PRE-DESIGNATION FORM

     If you are injured on the job, you have the right to be treated by your personal physician.  If the employer is notified in writing prior to the injury.  To be eligible you must meet the following criteria: 

    • Your pre-designated personal physician must be your primary treating physician that has previously directed your medical care and who retains your medical history and records. 
    • Your pre-designated personal physician must be your treating physician that has limited his or her practice of medicine to general practice and who is board-certified or board eligible internist, pediatrician, obstetrician-gynecology or family practitioner. 
    • You must provide the name and address of your pre-designated personal physician in writing prior to being injured and you must provide written documentation that your physician has agreed to be pre-designated.