Stockton Unified School District

In Case of an On-the-Job Injury
If you are injured while on the job, it is important to seek prompt medical attention and report the injury immediately. The Workers’ Compensation process must be followed to ensure your injury is properly documented, and treatment is covered under the District’s insurance.

Process to Report an Injury and Seek Medical Treatment:

1. Contact Company Nurse to report the injury:

• Call 1-833-686-5119 and use code STUSD.
• Company Nurse will direct you to a District-designated medical facility for treatment.

2. Report to your Supervisor to obtain the necessary forms for filing the claim.

3. Complete Required Forms:
   Forms should be provided to the injured worker at the site level before seeking medical treatment.

• DWC1 Claim Form (Injured worker to complete top portions 1-9):
  DWC 1 Claim Form
• Workers Compensation Supplement Form
  Workers' Comp Supplement
• Record Only Form (if medical treatment is not sought):
  Record Only Form

Note: A copy of these forms goes to the injured worker, and the original forms must be submitted to Risk Management.

4. Provide a Doctor’s Note to Risk Management before returning to work:

• If the doctor’s note includes work restrictions, Risk Management will work with your supervisor to determine if modified work duty is available. Note: It is District policy to provide modified work when possible.

5. Workers’ Compensation Leave (OJI):

• Workers’ Compensation Leave (OJI) applies when a full day of work is missed due to injury, supported by a doctor’s note.
• The Workers’ Compensation Administrator must approve the claim and time off before OJI leave is coded.

Need Assistance?
If you have any questions or need support during this process, please contact the Risk Management Department:
Email: RiskMgt@stocktonusd.net
Contact Senior Insurance Technicians

As of September 29, 2023, Dameron Occupational Medicine will be closing and will no longer be seeing patients after this date. Effective immediately, Dameron will not be accepting any new injuries.

Please contact Risk Management if there is a need for emergency assistance or a new injury that requires medical treatment. For existing injured workers treating at Dameron, please contact your workers’ compensation examiner for information regarding transfer of treatment to a designated clinic.

Senior Insurance Technicians
FMLA/CFRA, Long-term Disability and Workers' Compensation (OJI)
Last Name: A - Gom
Chris Carnahan
(209) 933-7110 ext. 2554

Last Name: Gon - N
Amanda Sarisky
(209) 933-7110 ext. 2552

Last Name: O - Z
Jamie Dadasovich
(209) 933-7110 ext. 2555

Adelita Valadez
Coordinator, Risk Management
(209) 933-7110 ext. 2570