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Worker's Compensation

Workers’ Compensation Overview

In the event of an emergency, proceed straight to the St. Elizabeth Emergency Room for treatment

TCDE carries insurance to cover the cost of work-incurred injury or illness. Benefits help pay for your medical treatment and part of any income you may lose while recovering. Special benefits are prescribed by law depending on the circumstances of each case.

To be assured of maximum coverage, work-related accidents must be reported immediately to your supervisor and an incident report filed in Human Resource Services (HRS). HRS will file a timely claim. In order to be seen by your personal physician you will need to have a Pre-Designated Physician form filled out by your doctor and on file in HRS prior to the accident/injury. TCDE provides medical assistance through the Medical Provider Network(MPN). It is important that you Report a Work-related Injury to Company Nurse if you are injured in any way even if you do not require the services of a physician.

Workers’ Compensation
Industrial Accident Reporting and Forms

An industrial accident is an accident/injury that involves an employee carrying out his/her assigned duties. In the event of an industrial accident/injury: Report the accident/injury to your supervisor immediately.

  1. Employee calls Company Nurse to report injury.
  2. Supervisor completes the Supervisor’s Report of Employee Injury form and sends to HRS.
  3. Form is given to HRS within 24 hours.
  4. If medical attention is required, Company Nurse will triage injured employee an direct employee to self care; Lassen Medical Immediate Care Clinic, or the employee's predesignated physician; or the emergency room depending on the nature of the injury.
  5. After receiving medical care, employee must provide HRS with the physician's report of the employee's work status.
  6. If medical assistance is required beyond first aide, employee will receive the Employee’s Claim for Workers Compensation Benefits (DWC-1) form to complete and return to HRS in order for the employer to file the claim with Worker’s Compensation.
  7. If the employee must take time off due to accident/injury, a physician’s note must be returned to HRS and must advise of expected return date. Instructions for Injured Employee
  8. When the employee may return to work but has restrictions due to the accident/injury, he/she must take the Return To Work Order form to the physician to complete. Employee returns this form (or physician’s restrictions clearly stated on paper) to HRS.
  9. When the employee is cleared of all restrictions, a physician’s note to that effect should be submitted to HRS.