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  Needs Treatment by Doctor

When an injured employee or registered volunteer needs medical treatment beyond first aid take the following steps:
For a medical emergency – call 911
  1. Complete DWC 1 and give copy to employee and fax a copy to Risk Management.

  2. Complete Form 5020 and Fax a copy to Risk Management.

  3. Complete the appropriate Authorization for Treatment and give it to the employee to take to the medical provider: Authorization for Treatment, West LA Urgent Care or Authorization for Treatment, Brentview or Authorization for Treatment, Malibu.

  4. Provide the employee with a Return to Work form.

  5. Send them to the appropriate medical facility (their own MD if they pre-designated ahead of time with a form).

  6. Complete the Supervisor’s Accident Investigation form and send to Risk Management.

  7. Fax DWC1 and 5020 and accident investigation to Risk Management. Fax number: (310) 452-3468
Note: If the injury or incident results in death, disfigurement, or hospitalization the local office of the California Occupation Safety & Health Administration must be notified within eight (8) hours. Call Risk Management and the Assistant Superintendent of Human Resources immediately.
Instructions for reporting injury to Cal OSHA

Santa Monica-Malibu Unified School District
1651 16th Street
Santa Monica, California 90404