Biblically Centered Education
Workers' Compensation Insurance Section 5.31 Dept: Human Resources Revised: June 28th, 2017

If, while on the job, an employee suffers an injury or illness resulting from work or the work environment that requires first aid or non-emergency medical care, the employee should notify his/her supervisor as soon as possible and report to the Biola Student Health Center to obtain treatment. The Biola Student Health Center is normally staffed from 8:00 a.m. to 5:00 p.m., Monday through Friday. If the Biola Student Health Center is closed, call Campus Safety at extension 5111 or (562) 777-4000. Either the Student Health Center or Campus Safety may provide first aid or direct the employee to an authorized medical facility close to campus. If the injury or illness is a life-threatening emergency, call Campus Safety at extension 5111 or (562) 777-4000.

Urgent Care Medical Facility

So Cal Immediate Medical Center

15330 Valley View Ave., Suite 1
La Mirada, CA 90638
(562) 802-0208, Fax (562) 802-0999
24 hours per day, 7 days per week

Urgent Care Alternate Medical Facility

Concentra Urgent Care Clinic

40 Centerpointe Dr.
La Palma, CA 90623
(714) 522-8020, Fax (714) 522-7633
24 hours per day, 7 days per week

All work related injuries or illnesses must be reported to Human Resources as soon as possible along with the required injury/illness report. Illnesses such as cold or flu are not covered under workers' compensation and injuries or illnesses taking place on lunch periods may not be covered. If a work injury or illness requires more than simple first aid, workers' compensation paperwork must be completed as soon as possible. The reported information will enable the university to review the circumstances surrounding the injury/illness, take corrective action, and where required, report recordable injuries and illnesses to OSHA.

Where a workers' compensation doctor determines that the injury requires time off work and/or a limitation of work activities, all documentation, including a release to return to work, should be submitted to the employee's supervisor and Human Resources. 

Biola's workers' compensation insurance carrier pays all medical costs up to $10,000 before a claim is accepted. In the State of California, there is a three-day waiting period for benefits other than medical to begin. If an accepted work injury/illness causes an employee to miss more than three days of work, the workers' compensation insurance will pay two-thirds of the employee's average wage, subject to minimums and maximums set by state legislature, starting after the third day of missed work. Accrued sick, personal, or vacation time shall be used to make up the remaining one-third of lost wages. If the employee is hospitalized or determined not able to return to work for more than 14 calendar days, the insurance carrier will pay lost wages starting on the first day. 

For the initial workers' compensation doctor visit, the injured employee will record the hours lost as regular time worked. Employees will need to use paid leave for subsequent visits for any doctor appointments that are scheduled during their normal work hours. If an employee has run out of paid leave, he/she should attempt to schedule visits outside of their normal work hours.

Biola workers' compensation carrier is a part of the Medical Provider Network. An injured employee needs to have an authorization slip and go to one of the facilities listed above for his/her first visit to an urgent care medical facility. Employees are allowed to request a different doctor within the Medical Provider Network after the initial doctor visit.

If an employee has pre-designated his/her own physician for workers' compensation treatment, he/she can still go to one of the facilities listed above for treatement or to his/her own approved physician. In order for an employee to go to a pre-designated physician, he/she must first report to Biola's Human Resources and have a doctor signed pre-designation form on file in the Human Resources Department before the date of injury.

Depending on the nature of the workers’ compensation claim, the insurance carrier may investigate the compensability of the claim. In the State of California, a workers’ compensation insurance carrier has up to 90 days from the date of injury to accept or deny the claim. This investigation period does not affect the medical coverage benefits, but it may delay, or eliminate Temporary Total Disability (TTD) or Temporary Partial Disability (TPD) payments. If the investigation period results in the postponement, or denial of any loss wage benefits, an employee may consider filing for state disability to supplement those loss wages at least until the end of the investigation period. If the claim is accepted at the end the investigation, the workers’ compensation insurance will repay two-thirds of loss wages to the claimant, and repay any state disability used during the investigation period directly to the state.

Any wage short fall due to the workers’ compensation process, including the State Workers’ Compensation mandatory three-day waiting period, shall be supplemented by the employee’s accrual benefits, which may include, sick, personal, and vacation time.

Workers' Compensation fraud is a felony. "Any person who makes or causes to be made any knowingly false or fraudulent materials statement or material representation for the purpose of obtaining or denying workers' compensation benefits or payments is guilty of a felony and may be punished by imprisonment in county jail for one year, or in state prison for up to five years, and/or fined up to $150,000 or double the value of the fraud (whichever is greater), and ordered to pay restitution for any medical evaluation or treatment." (Insurance Code Sec. 1871.4)

 

Biola University
13800 Biola Ave. La Mirada, CA 90639
1-562-903-6000