Workers’ Compensation

For assistance please contact the Office of Risk Services, Workers’ Compensation at: 831-459-1787, or 831-459-2850

• Employer’s First Report of Injury (EFR)
  • Click on “Login” and then log in with your CruzID and Gold Password to access the online form. Click on “Create Claim.”
• Medical Authorization Form
• Division of Workers’ Compensation-1 Form (DWC-1 Form)
• Predesignation Form & Facts About Workers’ Compensation
• Folleto con información sobre la compensación laboral- Spanish
• Volunteer Waiver and Election of Workers’ Compensation
• Pharmacy Benefit-Workers’ Compensation Prescription Program
• Beneficios Farmaceuticos-Workers’ Compensation Prescription Program- Spanish
• Workers’ Compensation Election Form & Instructions
• Formulario de elección de compensación laboral e instrucciones- Spanish
• Mileage Reimbursement Form- 2025

Goals & Objectives

The University of California Santa Cruz provides occupationally injured employees temporary modified work, as applicable, when they are temporarily restricted from performing the regular duties of their work by their workers’ compensation medical treatment provider. Studies have shown that employees often recover quicker from the effects of their injury when participating in a transitional modified work capacity.

What is a Transitional Work Assignment? (TWAs)

The modified work arrangements are referred to as Transitional Work Assignments (TWAs).
The modified assignments are discussed collaboratively between the employee, their supervisor and the UCSC Workers’ Compensation office through an interactive process to explore temporary accommodation options.
TWAs will be pursued outside of the injured employee’s home department when available if the home department is not able to accommodate their injured employee’s work restrictions.

Process

After an employee’s appointment with their workers’ compensation physician the office of Risk Services will obtain written documentation of the temporary work restrictions and any anticipated period of disability. Upon receipt of the written medical documentation, the Office of Risk Services will initiate an interactive dialogue with the employee’s supervisor and the employee regarding the establishment of a TWA. 

If the supervisor and employee cannot determine an appropriate TWA, the Office of Risk Services will facilitate an interactive discussion between the supervisor and employee. 

Workers’ Compensation TWAs will be documented by a TWA agreement and written for a period not to exceed 90 calendar days, unless otherwise specified by the Workers’ Compensation medical physician. 

Every effort will be made to place the TWA assignment in the employee’s home department. If, however, the home department cannot provide a TWA , every effort will be made to develop a TWA assignment in a different department. The TWA will be reassessed at the employee’s next appointment or when the employee’s work restrictions change.

Provision of Transitional Work is Beneficial

Department

TWAs allow departments to maintain productivity, decrease staffing shortage, and continue to be able to depend on the availability of the employee to perform the necessary and essential work of the University. 

An example would be if an employee has sitting only temporary work restrictions, the employee may assist in administrative duties such as filing, or answering phone calls to maintain productivity. 

What are the supervisor’s responsibilities when working in a TWA?

• Support employees by providing TWAs when able
• Monitor TWAs to ensure compliance of the temporary work restrictions.

Employee

TWAs allow employees to continue to be able to work at their regular rate of pay, reduce the potential for re-injury, have a quicker recovery, and an opportunity to gain new skills and work experience

An example would be if an employee sustains an injury to their leg and their current position requires standing and walking the majority of their shift. While your injury heals you may temporarily work in a sitting position.

What are the employee’s responsibilities when working in a TWA?

• Perform their work safely and observe all restrictions.
• Notify their supervisors if they:
  • Will miss work time before of scheduled medical exams and/or physical therapy.
  • Experience difficulty performing the TWA.

California Workers’ Compensation law guarantees prompt medical benefits to employees injured during the course of employment.

The University of California is self-insured for workers’ compensation and benefits are administered by Sedgwick CMS, our third party administrator; Oakland Office main number is (510) 302-3149. Information may also be obtained by visiting the following link: State of California Division of Workers’ Compensation.

Work-related injury may result in a loss of wages. That loss may be partially off-set by wages earned on a reduced work schedule and by payments of Temporary Disability (TD) made by the University’s Workers’ Compensation third party administrator, Sedgwick CMS. TD payments provide wage replacement up to 2/3 of gross wages, up to a maximum designated by law. The remainder of the wage loss would normally go uncompensated, however UCSC provides Extended Sick Leave (ESL) to eligible employees. Employees can choose to supplement TD with either of two options; sick leave only, or sick leave and then vacation leave. Those options will bring the total income to 100% of the employee’s regular earnings. Once those leaves are exhausted the employee would then be entitled to receive ESL. ESL will bring the total income to 80% of the employee’s regular earnings for a maximum of 26 weeks.