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Need Workers' Comp Help? University Business Services © UC Santa Cruz
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Workers' Compensation Handbook - Chapter 3 Summary: Chapter 3 Medical Treatment
Emergency Treatment ProceduresImportant: For a significant or life-threatening emergency, dial 911 and provide initial first aid until rescuers arrive. Do not be concerned with immediately providing the usually required workers compensation forms to a severely injured employee - speedy medical treatment for severe injuries is the Universitys primary goal. Prompt medical care is essential to a quick recovery from an injury or illness. Quality medical care and medical follow up can often mean the difference between complete recovery from an injury or illness or lasting physical disability. If an employee is severely injured at work, he or she needs to receive medical care immediately. It is the responsibility of the employees supervisor to ensure proper medical treatment is obtained. Once a supervisor become aware that an employee has experienced an industrial injury or illness and wishes to be treated by a physician, they must send him or her for medical treatment. In the case of a serious occupational injury requiring 911 response for emergency medical treatment, the supervisor must immediately notify campus Environmental Health & Safety and UCSC Risk Services at 459-2850 or if no answer, call 345-0950. Treatment in Santa Cruz CountyImportant: For a significant or life-threatening emergency, dial 911 and provide initial first aid until rescuers arrive. If the injury or illness is not life threatening, the employee should go to the following location for examination and treatment:
If SCOMC is closed, and an employee needs immediate medical attention, the employee should be directed to the following location:
Employees treated at the Dominican Emergency Department should obtain any follow-up care at SCOMC. Important: If an injured or ill employee prefers not to seek medical care, they may inform their supervisor of this choice. The supervisor can then assure them of their right to see a doctor for this injury or illness at a later time and be eligible for workers compensation, if they determine that a medical examination is needed. Cowell Student Health Center no longer provides medical or first aid treatment for occupational work injuries (including work injuries involving student employees). If an employee has a predesignated personal physician for treatment of occupational injury, he or she may be treated by their own physician (M.D. - Medical Doctor or D.O.- Doctor of Osteopathic Medicine) only. The completed physician pre-designation form must be on fiIe in the Risk Services Office prior to the date of injury. If the employee has designated a chiropractor as their pre-designated medical provider for industrial injury, the employee must first be seen at Santa Cruz Occupational Medical Center or other UCSC designated medical treatment facility for the initial visit. If after the initial visit, the employee wishes to be seen by their pre-designated chiropractor, they must then request a change of physician via their claims administrator at Sedgwick CMS. This is in accordance with California Labor Code Section 4601. Note: Not all predesignated physicians will provide treatment under the workers' compensation system. If the employee encounters this situation, refer him or her to SCOMC. Treatment Outside Santa Cruz CountyImportant: For a significant or life-threatening emergency, dial 911 and provide initial first aid until rescuers arrive. For non-emergency injuries, the employee should notify their supervisor who can then authorize treatment at SCOMC or a local clinic or urgent care facility if distance is a significant factor. Employees who reside in Santa Cruz County, should have any follow-up care at SCOMC. Benefits of SCOMCSeveral benefits are available to workers who obtain treatment at Santa Cruz Occupational Medical Center (SCOMC). These include the following:
Additional Off-Campus Treatment LocationsUCSC employees who do not work in Santa Cruz County may receive treatment at the following locations:
Follow-up Medical CareAn employee may continue treatment with SCOMC or with the employees pre-designated physician during the entire course of medical care. If the employee has a special medical problem, SCOMC or the employees predesignated physician will refer the employee to a medical specialist with prior authorization from Sedgwick CMS. Sedgwick CMS will pay for all medical care necessary to cure or relieve the effects of the work-related injury or illness, including physicians visits, hospital costs, and supplies. There is no deductible under Workers Compensation. Payments are made directly to the health care provider, avoiding out of pocket costs to the employee. Pre-Designation of PhysicianFor those employees who want to be treated by their own physician for a work related injury, a Designation of Physician form must be on file in UCSC Risk Services before the injury or illness occurs. If an employee does not file a designation, the University will designate the provider for his/her medical care for at least the first thirty days after the reported injury. An employee who chooses to pre-designate a physician, must designate a physician who has treated him/her in the past, has agreed by signature in advance to treat the employee for a work-related injury or illness, and has the employees medical records. The Designation form allows treatment for the entire period of the injury or illness, including the 30 day period immediately after the injury or illness is reported. However, if the employee has designated a chiropractor as their pre-designated medical provider for workers compensation, the employee must first be seen at Santa Cruz Occupational Medical Center or other UCSC-designated medical treatment facility for the initial visit. The employee must then request a change of treating physician to their predesignated chiropractor. Note: Not all physicians will provide treatment for work-related injuries. It is incumbent upon the employee to have their physician of choice agree by signature on the predesignation form that they will agree to treat the employee for a work-related injury or illness. Designation forms may be obtained from UCSC Risk Services. Changing Treating PhysicianIf the employee did not formally pre-designate a physician, they may choose their own treating physician thirty (30) days after reporting the injury or illness to the University. Employees should report any request to change treating physicians to Sedgwick CMS as soon as possible so that medical bills can be properly considered for payment. A workers compensation legal provision specifies a single change of treating physician during the course of one claim. Last revised: August 18, 2008 (am)
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