State of California

  M E M O R A N D U M

  REFERENCE CODE:
  2002-052

  DATE:
  August 23, 2002

  TO:
  Personnel Officers
  Personnel Transactions Supervisors
  Return-to-Work/Claims Coordinators
  Health and Safety Officers

  FROM:
  Department of Personnel Administration
  Benefits Division

  SUBJECT:
  Revised Workers' Compensation Claims Kit

  CONTACT:
  Shelby Wineinger, Workers' Compensation Program Trainer
  (916) 445-9760, CALNET 454-9760
  FAX: (916) 322-3769
  Email: shelbywineinger@dpa.ca.gov


  The purpose of this memorandum is to notify Departments of 
  the availability of the Workers' Compensation Claims Kit: 
  Instructions for Completing the Forms Required to Report a 
  Work-Related Injury or Illness.  This claims kit replaces 
  the guide entitled, Workers' Compensation Claims Kit: 
  Instructions for Completing Employer's Report of 
  Occupational Injury or Illness.
  
  This kit provides managers and supervisors with 
  instructions for completing the forms required for 
  reporting a work-related injury or illness.  The kit also 
  provides a summary of the actions to take when an injury 
  occurs.
  
  This kit is available at the following Internet addresses:
  
  http://www.dpa.ca.gov/benefits/health/workcomp/wcmain.shtm 
  
  http://www.dpa.ca.gov/general/Publications.shtm 
  
  Click on the "Workers' Compensation Claims Kit" link to 
  open the document. 
  
  If you have any questions about this PML, please contact 
  Shelby Wineinger, Workers' Compensation Program Trainer, at 
  (916) 445-9760.
  
  
  Terri Westbrook, Chief
  Benefits Division