How to Report an Injury

Step 1:

Each Employee is responsible to immediately report to their Supervisor or delegate that they have injured themselves while working.

Step 2:

Step 3:

Employee/Supervisor calls 1-877-778-2576 Company Nurse On Call 24/7 to report the incident with Employee present, BEFORE employee leaves the premises. Then Company Nurse will determine:

a. First Aid Advice Only – The Nurse obtains information about the incident and will provide advice which the Employee is to follow. The Employee may return fulltime to their regular position. If medical situation worsens or does not improve, the employee is to call back Company Nurse for appropriate medical referral to a designated clinic.

b. Medical Referral – If the Nurse determines medical treatment is needed, they will refer Employee to a Designated Medical Facility. Employee then goes to designated Medical Facility for treatment (unless they have a Predesignation of their personal physician prior to the injury).

Step 4:

Company Nurse transmits Supervisor’s Report of Injury to County Claims Contact (Debbie Egan) and the NBSIA Contact who reviews and completes missing data (i.e., wages, occupation, etc.)

Step 5:

Employee returns a copy of the Work Status Slip to the County contact (Debbie Egan):

· Released to full duty

· Released with Work Restrictions or Limitations

· No release to Work

Step 6:

NBSIA will mail Employee a DWC-1 Workers’ Compensation Claim Form for completion to begin the claim process.

Should you have any questions or need help reporting an injury, please contact Debbie Egan at Napa County Office of Education – 707•253•6819