1. Employees: Notify your supervisor immediately if you experience a work-related injury, exposure, or illness.
2. Employees and supervisors: Follow the steps below to report the incident to the UCSD Workers' Compensation Office.

1. Use either option below to report the incident:
   • Option 1:
     • Print, complete, and immediately fax the Employee and Supervisor sections of the Occupational Incident Report form (PDF) (Word) to the UCSD Workers' Compensation Office: (858) 534-5202.

     Note: Both employees and supervisors have a section of the form to complete. Supervisors must complete both sections if employees are unable to complete their sections.

   • Option 2:
   • Call the 1-800 Reporting Line: 877-6UC-RPRT (877-682-7778) to report the incident,
     and
   • Print, complete, and immediately fax the Supervisor section of the Occupational Incident Report form (PDF) (Word) to the UCSD Workers' Compensation Office: (858) 534-5202.

   Note: Completing this Incident Report form does not file a claim for workers’ compensation benefits. See step 4.

1. Medical treatment options:
   • 24-hour walk-in service:
   • Thornton Hospital Emergency Room, (858) 657-7600
   • UCSD Medical Center (Hillcrest) Emergency Room, (619) 543-6400
   • By appointment only:
   • UCSD Occupational & Environmental Medicine, (619) 471-9210

Note: Submitting the Incident Report form in step 1 does not file a claim for workers’ compensation benefits.

1. After receiving your Incident Report form, the UCSD Workers’ Compensation Office will monitor your medical treatment to determine if level of care exceeds first aid treatment.
   • First aid treatment may be appropriate treatment and is not considered a workers’ compensation benefit, although first aid costs will be paid by your employer.
   • If medical treatment exceeds first aid treatment at the initial or subsequent medical visits, the UCSD Workers’ Compensation Office will send you a State of California Workers’ Compensation Claim Form (DWC-1).
2. If you wish to initiate a claim:
   1. Complete and sign the Employee portion of the DWC-1 form.
   2. Describe your injury or illness completely. Include every affected part of your body.
   3. Make a copy of the form for your records.
   4. For expediency, fax a copy of the form to the UCSD Workers’ Compensation Office: (858) 534-5202.
   5. Mail the original form to Mail Code 0925. By returning the DWC-1 form, you are actually filing a claim for workers’ compensation benefits.
3. For details on procedures relating to workers' compensation claims, benefits, and responsibilities, check the following guides for:
   • Employees (PDF)
   • Supervisors (PDF)