The employee and supervisor are responsible for completing the UCSC
Incident Report (Spanish)and faxing the report to the Office
of Risk Services at (831) 459-3268.
If the supervisor is unavailable to complete the report, the employee should complete and immediately fax to Risk Services.
If the employee is unable to complete the Employee section of the report, it is the supervisor's responsibility to complete the report for the employee and immediately fax to Risk Services. If the employee's injury or illness is medically determined to meet the state of CA definition of injury as a workers compensation claim, the Office of Risk Services will provide the employee with a Workers' Compensation Claim Form (DWC-1).
Note that by law an employee has one year from the date of injury to complete and return the Workers' Compensation Claim Form (DWC-1) to ensure consideration of workers' compensation benefits.
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