New Haven Home
 
  WORK RELATED INJURY INFORMATION

Designated Medical Providers

1. U.S. Healthworks Medical Group
(Varying locations)
US HEALTHWORKS - VISTA (new location)
New Hours: 8 a.m. - 7 p.m.
Saturday 10 a.m. - 3 p.m.

2. Tri-City Medical Center - Work Partners
3. Kaiser Occupational Health Center

PROCESS - in Brief! (flyer)

Our worker's compensation carrier provides us with a MPN pamphlet for you at time of hire and at time of injury.
We have also established a relationship with the above medical providers to treat your work injuries quickly and
assess your ability to return to work. Alternates may be
available if you are unable to obtain the care you desire
at the facility noted above - see HR.

If you are injured while working, we want you to receive the care you need as soon as possible. Here are some helpful suggestions:

1. If an injury appears critical, call 911 for immediate emergency medical. If not, notify your coworkers for assistance and contact your supervisor (or on-call contact).

2. If you are in any discomfort or question if you have an injury of concern, let your supervisor know that you need medical assistance. They will help you receive assistance and provide relief if your injury requires you to leave your shift quickly. Note that a safety investigation is to occur PRIOR to being referred to the designated medical provider unless the injury is serious or life-threatening (then the safety investigation will be completed after medical treatment). Your supervisor will provide you with directions to our medical provider. These directions are posted here and in each staff bulletin board areas. (Note, never drive to our provider if you are in pain and/or are impaired.)

3. If you believe that your injury does not require immediate medical assistance, still report your injury to your supervisor by the end of your shift. If medical treatment becomes necessary, an appointment will be scheduled for you with our treating physician.

4. Your supervisor (or on-call representative) will notify HR for all authorizations for medical treatment and to report the injury. (If an injury happens after hours or on a weekend, then employees are directed to a medical facility for treatment but still must report to HR the first adminstrative day following the injury). You, your supervisor, and an HR representative will complete paperwork to record your injury, evaluate the circumstances surrounding the event, and report any injuries that require medical assistance to our insurance carrier (Cypress Insurance through Berkshire Hathaway).

FORMS

First -Complete this:
Internal Injury Report

Supervisor's Report
Supervisor's Process

2nd - Meet with HR, complete:
DWC


3rd - Follow-up with Appointments &
Maintain Contact with HR

4th - Get better quickly - we care!


Notification of Rights

Employee Notice
Preferred Providers

about
Berkshire Hathaway
(Our WC Insurance)
effective 7/01/2011

Benefit Notice Manual

Workers Comp Guidebook

NOTICES
CA - Notice to Employees
re Injuries Caused by Work

MPN Notification Document