Contents
Cal Poly Pomona
Human Resource Services
Benefit
Services
Administrative Affairs Division
 
 
 
 

Workers' Compensation

Clip Art showing two individuals shaking hands, with forms in their other hands.

Employee Procedures

Employees (including student assistants and volunteer employees) are encouraged to report injuries/illnesses when they occur. Find out more about what to do if you become injured or ill at work:

Reporting Procedures for Employees

Workers' Compensation Claim Form (DWC 1)

Manager/Supervisor Procedures

Managers/supervisors are encouraged to review the Manager's and Supervisor's Procedures for Reporting Work-Related Injuries and Illnesses to ensure a prompt and appropriate response in the event of an employee injury. This guide provides information regarding:

  • What to do when an employee reports a work-related injury or illness
  • Where an injured employee can go to receive medical attention and how to refer them
  • Timelines for reporting a work-related injury/illness to Risk Management
  • What to do when an employee is given medical restrictions that impact their job

We suggest you keep a printed copy of the guide available for immediate access or in the event that the campus internet is unavailable.

Forms

Additional Information

U.S. HealthWorks is the designated industrial clinic for Cal Poly Pomona employees. For more information about U.S. HealthWorks visit their web site.

The California Department of Industrial Relations web site contains additional information on Workers' Compensation.

Workers' Compensation - California Department of Industrial Relations

Questions and Contact Information

Risk Management is here to help you respond to workplace injuries. If you have any questions regarding the Workers' Compensation program, please contact Victoria Lieding, Workers' Compensation Analyst, at 869-3725, or Valerie Eberle, Manager of Benefits, Workers' Compensation & Risk Programs, at 869-4846.