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Workers' Compensation

Introduction

The Workers' Compensation Program at Capistrano Unified School District is permissibly self-insured. This means that CUSD pays all of the expenses associated with workers' compensation claims.

 

The District makes every attempt to provide a safe and healthful work environment for all employees. Job specific safety training is also provided to help employees reduce the possibility of being injured on the job. Unfortunately, accidents do happen that may require an employee to obtain medical care.

 

The District Insurance Office has one staff member dedicated to workers' compensation administration. Danny Brasso is available to assist you and may be reached at 949-234-9402. California State Law governs the procedures all employers must follow in the administration of workers' compensation claims. Workers' compensation laws are complicated, which can make navigating the workers' compensation system confusing and frustrating for both injured employees and employers. If you have questions, or if you are unsure as to whether or not you may have a claim, please feel free to call the District Insurance Office.

 

Capistrano Unified School District has also developed and implemented an Early Return to Work Program which provides injured employees a means to re-enter the workplace while still recovering from a work-related injury or illness. Working with the injured employee, his physician, and supervisor, this innovative program offers the injured worker transitional work performing meaningful tasks until the employee is recovered enough to return to his/her regular position.

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Program Procedures

Following is a brief explanation of the procedures that need to be followed and your workers' compensation benefits provided by Capistrano Unified School District, in accordance with State law.

 

In the event of an "industrial injury," an injury or illness which occurs while you are performing your work, you must:

 

1. Immediately report your injury to your supervisor, no matter how small the injury may seem to be. The California Labor Code requires that we provide you a Claim for Workers' Compensation Benefits (California State Form DWC-1) within 24 hours of the injury. So it is important that we know an injury has occurred in order to be in compliance with the Labor Code.

 

2. Complete the DWC-1, Employee's Claim for Workers' Compensation Benefits form. You may obtain this form from your site administrative office or the District Insurance Office. Your supervisor will forward the claim to the District Insurance Office, or you may do so directly.


FAILURE TO COMPLETE NO. 1 AND 2 MAY DELAY OR JEOPARDIZE YOUR RIGHT TO BENEFITS


Claims Administration:

Capistrano Unified School District employs an independent claims administrator to manage all workers' compensation claims. Once a claim has been filed with the District Insurance Office, the claim is turned over to the administrator, who then handles all aspects of the claim. This includes arranging doctors' appointments, approving treatment and medications, and making sure you receive all of the benefits you are guaranteed by law.

 

The District's claims administrator is:

CorVel Corporation
5694 Mission Center Road #700
San Diego, CA 92108
858-300-2500

 

3. If your injury requires medical treatment, check with your site office manager or contact the District Insurance Office at 949-234-9402 to obtain authorization for treatment at one of the following medical facilities or your pre-designated physician. The District Insurance Office must pre-authorize your medical treatment.

 

If you wish to seek medical care from your own physician, you must notify the district Insurance Office in writing prior to incurring a work-related injury. Your physician must also sign an agreement to provide treatment in accordance with the workers' compensation provisions of the California Labor Code.

 

CUSD currently refers injured employees for initial treatment to one of the following medical groups:

 

South Coast Family Medi-Center
25500 Rancho Niguel Rd., Suite 100
Laguna Niguel, CA 92656
949-643-0500

Hours: 8:00 am - 5:00 pm - M-F
9:00 am - 5:00 pm - Sat

South Coast Health Center
5 Journey, Suite 130
Aliso Viejo, CA 92656
949-389-8969

Hours: 8:00 a.m. - 8:00 p.m. - M-F
10:00 a.m. - 1:00 p.m. - Sat

If you prefer chiropractic treatment Boshman Chiropractic Center:

31411 Camino Capistrano, Suite 200
San Juan Capistrano,
CA 92675

949-493-4141

Hours: 8:00 am - 12:00 pm and
2:30 - 6:00 pm - MWF
2:00 pm - 7:00 pm - Tues-Thurs

 

4. If you are dissatisfied with the doctor treating you, you may request a change of physician by contacting the district Insurance Department or CorVel Corporation.

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Program Benefits

The following is a brief explanation of your workers' compensation benefits:

MEDICAL CARE: You receive medical treatment, surgery, hospitalization, prescriptions, and mileage at no cost to you.
 

COMPENSATION:
If you are unable to perform your regular assignment while convalescing, you may be eligible for 90 days of industrial disability leave, during which you will continue to receive full salary from CUSD. Per Education Code Section 44984, "full salary" is computed as the portion of salary due for any month in which the absence occurs as, when added to temporary indemnity under Division 4 or Division 4.5 of the Labor Code, will result in a payment of not more than full salary. After the 90 days are exhausted, you may still be eligible for temporary disability and extended sick leave benefits. If you are not eligible for the 90-day salary continuance, you may be entitled to temporary disability benefits.
 

PERMANENT DISABILITY:
If your industrial injury results in permanent disability, you will be entitled to compensation based on the extent of your disability. The amount you receive is based on a rating from the Workers' Compensation Appeals Board Rating Bureau. If you have a permanent disability as a result of your injury, CorVel Corporation will assist you in obtaining such a rating.
 

REHABILITATION SERVICES:
If your injury results in permanent disability which restricts your ability to work and prevents you from returning to your usual and customary position, the law entitles you to vocational rehabilitation benefits. These benefits may involve a training program and/or direct job placement and/or, if possible, adjustments to your regular duties.


It is the policy of Capistrano Unified School District to ensure that you receive workers' compensation benefits fully and promptly. If, however, you feel you are not receiving all of your benefits, or if you have any questions, you may contact:

District Insurance Office
 

 

Denise Scarola
Manager
Insurance Department
949-234-9389

Danny Brasso,
Benefits Technician
Workers' Compensation
949-234-9402

 

 

District Workers' Compensation Claims Administrator:
CorVel Corporation
5694 Mission Center Road #700
San Diego, CA 92108
858-300-2500
 

Should you prefer to seek advice from a third source, you may contact:

 

Workers' Compensation Appeals Board
Information and Assistance Officer
28 Civic Center Plaza, Room 451
Santa Ana, CA 92701 714-558-4597

 

 

FRAUD NOTICE:

Any person who makes or causes to be made any knowingly false or fraudulent material statement or material representation for the purpose of obtaining or denying workers' compensation benefits or payments is guilty of a felony. Such persons may be punished by imprisonment and/or a fine (Labor Code Section 3820; Penal Code Section 549; Insurance Code Section 1871).

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