Each Employee is responsible to immediately report to their Supervisor that they have injured themselves while working. If your injury is an emergency, your Supervisor will call 911 for immediate treatment. If it is not an emergency:
With you present, your Supervisor calls 1-888-375-9779 and gives Code “CSIG” Company Nurse, BEFORE you leave the premises. A Company Nurse Registered Nurse will gather information on your injury through the medical triage process and make care recommendations:
- First Aid Advice Only – The Nurse will provide advice, which you are to follow. You may return full time to your regular position. If medical situation worsens or does not improve, you must call back Company Nurse for appropriate medical referral prior to seeking treatment, unless it is an emergency.
- Medical Referral – If the Nurse determines medical treatment is needed, they will offer a Telemedicine visit (if appropriate) or refer you to your district’s designated Medical Facility; you then seek medical treatment as directed (unless you have pre-designated your personal physician prior to the injury).
Step 3 (* is not applicable for Substitutes or Volunteers):
Employee returns copy of Work Status Slip provided to you by the Medical Facility to District Claims Coordinator:
- Release to full duty
*Released with Work Restrictions or limitations
No release to work – remain off work
*If work restrictions apply , the District Claims Coordinator will work to either modify your usual job or provide a Temporary Work Assignment, if possible, completing the Temporary Work Agreement for Work Related Injuries.
CCCSIG will mail you a DWC-1 Workers’ Compensation Claim Form to complete immediately to begin the claim process. State law requires that this form be provided to you or a dependent within one (1) working day of receiving notice or knowledge of any injury being work-related.
With your input, Supervisor will complete an Accident Investigation Form to evaluate any potential safety conditions or hazards for prevention purposes.