DEPARTMENT RESPONSIBILITY - 2580.2

(Revised: 12/2013)

Departments shall:

Appoint (at least one) Return to Work Coordinator (RTWC) who will be primarily

responsible for managing the department’s workers’ compensation claims and ensuring injured employees are returned to work as soon as medically feasible.

Choose a medical provider that is part of the State Fund Medical Provider Network (MPN) and can provide immediate treatment in the event of a work-related illness or injury.

Post the chosen provider along with other appropriate notices in conspicuous place(s).

Provide every employee at time of hire or by the end of the first pay period written notice of their rights under the workers’ compensation system an opportunity to pre-designate their personal physician to treat the employee in case of a work-related illness or injury.

Establish, implement and maintain written policies for prompt response to and reporting of a work-related illness or injury.

Train all supervisors and managers of their responsibilities in the event of a work-related illness or injury.

Provide the Workers’ Compensation Claim Form (DWC 1) & the Notice of Potential Eligibility (e3301) to the employee within one working day of knowledge of a potential work-related illness or injury.

Submit the Employers’ Report of Occupational Injury or Illness (e3067) to State Fund

Authorize first medical treatment at the posted facility or pre-designated physician within one day of receipt of the completed Claim Form (DWC 1) or within three days of knowledge of the illness or injury.

Provide transportation or accompany the employee to the first medical appointment.

Ensure payroll is processed properly so the ill or injured employee receives all required benefits timely; see section E300 and E400 of the State Controller’s Payroll Procedures Manual (PPM).

Maintain contact with the injured employee and facilitate return to work as soon as possible

Revisions

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