Workers' Compensation

St. Helena Unified School District

How to Report an Injury

Company Nurse Hotline 1-877-778-2576

Step 1:

Each employee is responsible to immediately report to their Supervisor that they have injured themselves while working

Step 2:

For emergencies, please call 911 for immediate treatment then contact Company Nurse following treatment

Step 3:

For non-emergencies, the employee/supervisor calls Company Nurse at 1-877-778-2576 before the employee leaves the premises. Company Nurse will determine the following;

A. First Aid Advice Only – The nurse will obtain information about the incident and will provide advice for home care for the employee to follow. The employee may return to their regular position. If medical condition worsens or does not improve, the employee must call Company Nurse back for a medical referral to a designated clinic.

B. Medical Referral – If the nurse determines medical treatment is necessary, Company Nurse will refer the injured worker a designated clinic for treatment (unless they have pre-designated their personal physician prior to the injury)

Step 4:

If the employee seeks medical treatment, they are required to return a copy of the Work Status Slip to the District Contact with a copy to NBSIA. This slip will confirm the appropriate release: Full Duty, Modified Duty, and Temporarily Disabled

A. If modified work is given, NBSIA will work with the District Contact to arrange a Bridge Assignment. Please refer to the NBSIA’s Early RTW Program for additional information.

B. If an employee is Temporarily Disabled, the claims adjuster will coordinate benefits with the District Contact. Please refer to the RTW brochure

Step 5:

Upon receipt of the Employer’s Report of Injury, NBSIA will mail employee a DWC-1 Workers’ Compensation Claim Form to complete immediately to begin the claim process. State law requires that this form be provided to the Employee or a dependent within one (1) working day of receiving notice or knowledge of any injury being work-related