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Workers' Compensation

Safety is no accident

Workers' compensation insurance provides medical and wage benefits to employees who are injured or become ill at work. This coverage is mandated by each state and the wage and medical benefits vary by state. Worker Compensation benefits provide medical care for injured workers and help pay for lost wages caused by an injury if the employee is unable to work or is temporarily or permanently disabled. Mt. Diablo Unified School District (“District”) contracts with a third party administrator (LWP) for the management of its claims.

What To Do If You Are Injured At Work (Employee)

What To Do If Your Employee Is Injured At Work (Supervisor)

  • Once you have received notice of an employee injury provide the employee with the Employee Report of Injury form and  DWC 1  form to complete. The DWC 1 form is only completed if employee is opening a claim and is going to the doctor.
  • Explain to the employee that they have the right to file a Workers’ Comp Claim and receive medical care.
  • Give the employee the blue brochure entitled “Workers’ Compensation What To Do If You Are Injured at Work” for a list of our healthcare providers.
  • Complete the  Supervisor Report of Injury  form. If a DWC 1 form is completed by employee, the supervisor needs to complete questions #12, 13, 14 and sign the form.
  • Submit all forms as a PDF document immediately to or fax to 925-680-2505. Originals must follow via District pony mail.

Please contact:

Herbert Lester, Director of Risk Management & Safety

925-682-8000 ext: 4001

Jill Knipstein, Worker's Compensation Liaison

925-682.8000 ext: 4005


MDUSD strives to return injured/temporarily-disabled employee back to the workplace as soon as is medically appropriate. Our Return to Work Program (RTW) provides our employees with the opportunity to return to work in a transitional work assignment while they recover.