INTEGRATED DISABILITY MANAGEMENTDawn Watkins, Director
The Workers’ Compensation program provides state mandated benefits to LAUSD employees who sustain a work related injury/illness, without regard to fault. LAUSD is self-insured which means that the District, not an insurance company pays for the actual costs of claims. The District contracts with a third party administrator for the management of its claims.
- When an Injury Occurs
1. Promptly report your injury/illness to your Supervisor/Site Administrator. If your injury or illness developed gradually, report it as soon as you learn or believe it was caused by your job. Your employer will report the claim to Sedgwick, the Third Party Administrator (TPA) who handles the District's workers' compensation claims. Your employer will provide you with a State of California Claim Form (DWC 1). Complete the Employee section of this form and return it to your Employer as soon as possible. A delay in reporting your injury and/or returning this form could affect your rights to benefits.
2. Get medical attention if needed. If the injury is serious and needs immediate medical attention, call 911. Otherwise, all medical treatment for an industrial injuries must be obtained from a provider in the District's Medical Provider Network (MPN). Please see the Medical Provider Network section of this website for more information on how to access services and exceptions. Once you have reported your injury, your Supervisor/Site Administrator will put you in touch with a Triage Nurse to assist in arranging medical care within the MPN.
3. You will be contacted within a couple of days by a Sedgwick claim representative. Your claim representative will contact you to obtain additional information regarding your injury if needed, and to explain what workers' compensation benefits you may be entitled to.
4. Promptly fill out and return any forms sent to you. These forms are necessary to help determine what, if any, benefits you are to receive.
5. Please keep your medical appointments. Provide medical and return-to-work information to the Sedgwick claim representative assigned to your claim, as well as to your Supervisor/Site Administrator.
- Medical Provider Network
The District has a State approved Medical Provider Network (MPN); therefore, all treatment for industrial injuries must be obtained from physicians within this network, unless an employee has pre-designated a treating physician prior to the injury.
There are over 12,000 providers in the Medical Provider Network to choose from. Your work site should have a short list, the MPN Referral Panel, of immediate care facilities that can be used for quick access to a medical provider. This referral panel represents only a small portion of the providers available. The entire network can be accessed by going to: http://www.sedgwickproviders.com/campn1
To search the MPN:
- Select method of search: physician name, address search or region search
- Input the State and zip code
- Click "Find Provider"
- Pay While on Workers' Compensation
The labor code provides for Temporary Disability (TD) benefits to compensate an injured employee for lost wages while temporarily unable to work. The TD rate is two-thirds of an employee's salary up to statutory minimum and maximum. TD benefits are not taxable.
The Education Code provides District employees with 60 work days of full salary in lieu of TD benefits. It also allows for the TD to be supplemented from your illness and vacation bank after the 60 days of continued salary is exhausted.
Your workers' compensation benefits will be paid by the District's Payroll department. You will receive a paycheck on your regular pay date with the above noted benefits until you have exhausted all your illness and vacation benefits. At that point, you will be separated from the District and, if you are still entitled to TD benefits, they will be paid directly by Sedgwick.
Partial days off due to doctor's appointments will be paid only if the Salary Continuation Verification form is completed and submitted to Sedgwick. Upon authorization by Sedgwick, the District's Payroll department will process continued salary pay if the full 60 days has not yet been exhausted. Upon exhaustion of the 60 days of continued salary, all further absences for doctor's appointments will be charged as illness time.
- Leave of Absence
A leave of absence must be filed with the Personnel Commission or Human Resource Department after 20 days of lost time as with any other medical absence. Failure to file a request for leave can result in separation from the District.
Request for leave forms can be found on the Personnel Commission website for classified employees and the Human Resource website for certificated employees.
- Modified Work
The District is committed to bringing employees back to work as soon as possible. Please advise your supervisor/site administrator of any work restrictions you are given as modified work may be available.