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    Risk Management

    Work Related Injuries

     

    If you believe you sustained a work-related injury, you have the option of filing a workers’ compensation claim to receive medical treatment for your work-related injury.   To start the claim process, contact the InterAid Nurse Triage Hotline (see below). 

    Report Only: If you do not wish to file a workers' compensation claim, then you are required to at least report the incident immediately by completing the Employee Incident Report Electronic Form, which is available by clicking here. 

    Additional information regarding the workers’ compensation process is located further below.   You may also contact our office at (714) 558-5856 or RiskManagement@sausd.us for additional information.

     

    lnterAID Nurse Triage Hotline

    1 (800) 367-5020 *

    AVAILABLE 24 HOURS A DAY

    Dial 911 if life or limb is threatened!

    *This service is only for SAUSD employees. 

    Independent Consultants or Contractors, such as

    Maxim employees, must report the incident/injury 

    to Risk Management AND contact their employer 

    for additional information. 

     

    Sketch of the Company Nurse logo covered with a forbidden sign

    We are NO LONGER using the 

    Company Nurse Hotline Vendor

    Please make sure to call the InterAID Nurse Triage Hotline

     

    Scroll down for information on:

    • Our Medical Provider Network (MPN)  
    • Pre-Designation of Personal Physician for a work-related injury
    • Prescription Services for a work-related injury  
    • Medical Mileage Expense Form for a work-related injury    
    • All Forms, Documents, & Notices relating to Work-Related Injuries / Workers' Compensation Claims
    • Our department contact information 

     

    Sketch of a doctor holding a clipboard Our Medical Provider Network (MPN)  

    Santa Ana Unified School District (SAUSD) has elected to provide you with the choice of a broad scope of medical services for work-related injuries and illnesses by implementing a Medical Provider Network (MPN), called InterMED Select MPN(ID: 3180).   The InterMED Select MPN includes a mix of doctors specializing in work-related injuries and doctors with expertise in general areas of medicine.

    You are automatically covered by the InterMed Select MPN if your date of injury or illness is on or after August 2006 and if you have not properly pre-designated a personal physician prior to your injury or illness.  See further below for information on how to pre-designate a personal physician for a work-related injury.  Please note, any treatment outside the MPN could be considered unauthorized and self-procured.      

    For additional information on the InterMed Select MPN, click here to download the MPN notice. Click here to download the Spanish MPN notice  

    Contact our office at (714) 558-5856 or RiskManagement@sausd.us for additional information.  

     

    Sketch of a doctor Pre-Designation of Personal Physician for a work-related injury 

    You may be able to pre-designate your personal physician for the treatment of a potential future work-related injury.  The requirements for a personal doctor to be considered a pre-designated physician are listed in the DWC Form 9783, which is available by clicking here.   

    Please be aware that the pre-designation form must be turned in PRIOR to a work-related injury.  Also, you must first contact our office prior to seeing your pre-designated physician for a work-related injury in order for our department to verify if your pre-designated physician is still valid.  After confirming that your pre-designated physician is valid, our department will issue a written authorization for treatment.   

    Contact our office at (714) 558-5856 or RiskManagement@sausd.us for additional information.  

     

    Sketch of an open prescription bottle that is spilling out some pills  Prescription Services for a work-related injury   

    If you need a prescription filled for a work-related injury or illness, go to an Optum Tmesys® network pharmacy.  Give the temporary Rx card to the pharmacist.  The pharmacist will fill your prescription at low or no cost to you.  This service is only available for employees that have already filed a workers' compensation claim for their work-related injury. 

    Click on the links below for additional information and for the temporary Rx card.   

    English - Click Here    Spanish - Click Here

    Contact our office at (714) 558-5856 or RiskManagement@sausd.us for additional information.

     

    Sketch of a vehicle Medical Mileage Expense Form  

    If you have to travel to get treatment for your work injury, you are entitled to re-payment of your travel costs.  The mileage rate typically varies per calendar year and is specified on the mileage form. Mileage for reasonable travel to the pharmacy, parking, bridge tolls, public transportation, and other travel-related costs are also included.  Please note, your request for reimbursement of fees for parking, bridge tolls, and/or public transportation must include the original receipts.  

    For travel / trips during the calendar year of 2024, Click here to access the Medical Mileage Expense Form.

    For travel / trips during the calendar year of 2025, Click here to access the Medical Mileage Expense Form. 

    Contact our office at (714) 558-5856 or RiskManagement@sausd.us for additional information.

     

    Sketch of two documents with lines representing text All Forms & Documents relating to Work-Related Injuries / Workers’ Compensation Claims

    Click here to view all our work-related injury or workers' compensation documents and forms. 

     

     

    Sketch of a red colored phone handle Our Contact Information

     

    Have Questions or Concerns? 

    Contact us.

     

    Workers' Compensation Administration

     

    Office Hours: Monday-Friday, 8 a.m. to 4:30 p.m. (Closed on Holidays)

    Main Line: (714) 558-5856    

    Fax: (714) 480-5320

    Email: RiskManagement@sausd.us

    Address: 1601 E. Chestnut Ave., Santa Ana, CA 92701