State Administrative Manual
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SAM - Chapter 2500

2581.2     RESPONSIBILITY OF SUPERVISOR OF INJURED 
(Revised 12/99)

The supervisor is responsible for carrying out state and departmental injury prevention policies.  In case of injury this responsibility includes initiating action to obtain prompt medical treatment for injured employees.  Supervisor includes every person having direction, management, control, or custody of any employment, place of employment, or any employee.

The supervisor shall:

Assure that first aid is administered for minor injuries and determine if employee is able to return to work, or arrange medical treatment by a physician when necessary.

For extreme emergency get the injured to any available doctor, hospital, or public medical service.

Arrange for first treatment by physician, refer to California Workers' Compensation Notice to State Employees form, STD. 621.

Arrange for transportation to doctor's office or to hospital.  Use state vehicle, ambulance, taxi, or whatever is appropriate at the time.

(Note: The supervisor or designated representative should accompany the injured to get medical treatment.)

Make a report of action taken and the facts about the accident by completing both sides of Employer's Report of Occupational Injury or Illness form, SCIF 3067 (STATE).

Submit the ORIGINAL and two copies of SCIF 3067 (STATE) to the designated reviewing officer and retain a copy.

Follow-up for injured employee.  The supervisor shall:

Maintain contact with injured employee.

Arrange for completion of STD. 634, for payroll purposes.

Discuss return to work with employee, physician, State Compensation Insurance Fund Claims Adjuster, and departmental Return-to-Work Coordinator.

Provide progressive recovery reports to his/her superior until the employee recovers from effects of injury.

 

Updated : 7/6/2007