Human Resources Division

Employee's Responsibility

Injured workers must immediately report their injury/illness to their Supervisor/Manager, whether or not they are seeking medical treatment or have lost time from work. Proper documentation of the incident will alleviate any questions or concerns if the injured worker should seek medical treatment at a later date.

Please contact your manager/supervisor for medical treatment requests.

In order for the County of San Joaquin to provide medical treatment that is reasonably required to cure or relieve the effects of a work-related injury/illness, the following steps shall be followed:

Injured workers requesting medical treatment must obtain a “Request for Medical Treatment” form, from their Supervisor/Manager who will sign and date the form. The injured worker will take the request to a medical provider of their choice. A starter list of Occupational Medicine Clinics can be found below, please note that you can be seen at any facility that accepts workers comp insurance.

Occupational Medicine Clinics (Starter List)

The following forms must also be completed to begin processing your claim, please see your Supervisor/Manager.

Required Forms:

  1. Employee Request for Medical Treatment, S&T 201
  2. Employee’s Claim for Workers’ Compensation Benefits, DWC1
  3. Notice of Leave of Absence for Temporary Disability Indemnity Payment, Form 29
  4. Request for Leave of Absence, RLOA (leave 3 days or more)

Work Status & Doctor Notes

Doctor’s work status/notes will determine the length of the workers’ compensation leave period upon approval of the TPA. In order to prevent any interruptions or benefits due the injured worker, it’s the injured worker’s responsibility to provide any and all doctor’s reports, disability, leave from work notes to their Supervisor/Manager. There are no provisions under Workers' Comp for reimbursement of leave accruals used for physical therapy and/or follow up office visits.

San Joaquin County Health Benefits

Employees who are currently receiving health benefits from San Joaquin County and are currently off work will need to contact the Benefits department to review and discuss payments that may be due.

The benefits department can be contacted by phone or email: (209) 468-9987 or employeebenefits@sjgov.org.

Requesting Medical Treatment after Declining Treatment

If an injured worker initially declined medical treatment due to a work-related injury/illness, and later it is determined that they feel the need to seek medical treatment, the injured worker should notify their supervisor/manager.

Questions concerning your Workers’ Compensation benefits, contact the Risk Management Workers’ Compensation Team or your claims adjuster.