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ANR Kearney Research and Extension Center

Reporting an Work Related Injury or Illness

 

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CALL 911 immediately if so deemed

 

Send someone to bring the Automatic External Defibrillator (AED)

 

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An employee who has a work-related injury or illness shall immediately notify her or his supervisor.

If medical treatment is needed, or if the employee asks for initial treatment for a work-related illness or injury, the employee shall be taken to: 

 

JOBCARE

1142 Rose Ave., Suite B  PRINT DIRECTIONS

Selma, CA 93662

(Across the street from Selma District Hospital)

(559) 891-8940

 

 

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Also immediately notify KREC Safety Coordinator, Alan Cary (559) 646-6013

 

If immediate treatment is needed and JOBECARE is closed, the employee may be sent to the Selma District Hospital.

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Kearney Research & Extension Center (KREC)  Employees – Injuries must be reported to the UC Davis Workers’ Compensation office at (530) 757-3266, within 24 hours of knowledge of the injury. Forms may be downloaded Here

 

  

An  "Employer's Report "must be submitted within 24 hours. The employee fills out the form and gives it to his/her supervisor.

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Both an "Employer's Report " and an "Employee Report of Accident" form need to be completed and filed.  Copies should be given to the KREC Administration Office and to the KREC Safety Coordinator.

 

Copies of the competed reports need to be faxed to the UC Davis Worker's Compensation carrier and to Soo Hsieh at REC-AO by the KREC Administration Office within 24 hours of the incident. The original needs to be mailed to the same parties within 72 hours.

 

 

Instructions for Employer Report

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An employee may use his or her personal physician, instead of the above providers, if he or she has filed a Designation of Physician form (available at http://www.hr.ucdavis.edu/Forms) prior to the date of injury.