Step #1: Get Medical Attention: Employees should obtain medical treatment at OHF for non-emergencies that occur during normal business hours, or the RRMC/SMUCLA Emergency Department for emergencies and/or off-hours treatment. See below for additional information:
Step #2: Complete Necessary Forms
Workers' Compensation Claim Form (DWC 1) & Notice of Potential Eligibility
Must be provided by a supervisor within 24 hours of the report of injury or illness
Step #3: Report the Injury to HR/Workers' Compensation
Provide the necessary information when reporting a serious injury:
Serious injury includes:
- Injury resulting in serious degree of permanent disfigurement such as crushing injury or severe burn
- In-patient hospitalization in excess of 24 hours for other than medical observation
*If serious injuries are not reported within 8 hours, departments can be fined $5,000.00 by Cal/OSHA.
Download a copy of the Serious Injury Poster (PDF).
A. FAX a copy of the completed form to the WC FAX line: Health System HR (310) 794-3337 or
B. EMAIL to firstname.lastname@example.org or
C. CALL 877-6UC-RPRT (877-682-7778) with the information on the forms