Workers' Compensation
About Workers' Compensation
The UCSC Workers’ Compensation office coordinates the claims process with Sedgwick and works closely with employees and their departments to identify transitional work assignments.In addition, the UCSC Workers’ Compensation office provides a comprehensive, longer-term approach in helping to reduce work-related injuries and improving health and safety through collaboration with various campus departments. This synergistic approach results in the campus’ continued commitment to providing a safe and healthy work environment for all UCSC employees.
Injury Reporting & Medical Treatment
See Injury Reporting & Medical Treatment to report a work-related injury and obtain medical treatment information. Contact the Workers’ Compensation office in Risk Services for assistance with workers’ compensation; (831) 459-1787 or (831) 459-2850. Please click here for detailed information on Injury Reporting & Medical Treatment.
Employee Benefits and Options
California Workers’ Compensation law guarantees prompt medical benefits to employees injured during the course of employment.
The University of California is self-insured for workers’ compensation and benefits are administered by Sedgwick CMS, our third party administrator; Oakland Office main number is (510) 302-3149. Information may also be obtained by visiting the following link: State of California Division of Workers’ Compensation.
Work-related injury may result in a loss of wages. That loss may be partially off-set by wages earned on a reduced work schedule and by payments of Temporary Disability (TD) made by the University’s Workers’ Compensation third party administrator, Sedgwick CMS. TD payments provide wage replacement up to 2/3 of gross wages, up to a maximum designated by law. The remainder of the wage loss would normally go uncompensated, however UCSC provides Extended Sick Leave (ESL) to eligible employees. Employees can choose to supplement TD with either of two options; sick leave only, or sick leave and then vacation leave. Those options will bring the total income to 100% of the employee’s regular earnings. Once those leaves are exhausted the employee would then be entitled to receive ESL. ESL will bring the total income to 80% of the employee’s regular earnings for a maximum of 26 weeks.
Workers' Compensation Forms
Workers' Compensation Forms, for assistance please contact the Workers’ Compensation office in Risk Services at
(831) 459-1787
or
(831) 459-2850
- Employer's First Report of Injury (EFR)
- Click on "Login" and then log in with your CruzID and Gold Password to access the online form. Click on "Create Claim."
- Employee Authorization for Medical Treatment of Occupational Incidents
- Volunteer Waiver and Election of Workers' Compensation
- Pharmacy Benefit - Workers' Compensation Prescription Program
- Beneficios Farmaceuticos - Workers' Compensation Prescription Program- Spanish
- Workers' Compensation ESL Election Form & Instructions
- Formulario Para Eleccion De La Compensacion De Los Trajadores -Workers' Compensation ESL Election- Spanish
- Facts About Workers' Compensation pamphlet and Predesignation of Personal Physician Form
- Informacion Acerca de la Compensacion de Trabajadores y Designacion Previa De Medico Personal
- Workers' Compensation Mileage Reimbursement 2023
- Workers' Compensation Mileage Reimbursement 2024
For Questions
Contact Cindy Delgado at cadelgad@ucsc.edu or 831-459-1787.
Contact Michelle Söhnlein at msohnlei@ucsc.edu or 831-459-2850.