The City of Burlingame strives to maintain a safe and healthy work environment for all full-time, part-time, casual and volunteer employees and is committed to providing those injured on the job with quick and easy reporting procedures, adequate medical care and reasonable accommodations to help get employees back on their feet as soon as possible.

The City’s Workers' Compensation benefits program provides medical care, therapy, rehabilitation services, temporary and permanent disability payments and supplemental job displacement benefits for employees injured on the job.

If you are injured on the job, follow the steps outlined below.

1. Report your injury or illness to your employer – Tell your supervisor immediately and call the Company Nurse at 877-854-6877. This will initiate the claims process.
   
   *In the event of an emergency, seek medical treatment immediately by going to the nearest emergency room, calling 9-1-1, or calling 650-777-4100 for Burlingame Emergency Services.
   
   
2. Meet with your supervisor to complete a DWC-1 claim form, Employee Injury Report and Supervisor Investigation Report and forward to the Human Resources Department as soon as possible.

You will be assigned a treating physician from Kaiser Occupational Medicine to see you through to your recovery. If you would like to designate a personal physician, a pre-designation form must be on file with Human Resources for at least 30 days prior to the date of injury. If no pre-designation form is on file at the time of injury, employees will continue to be treated by the assigned physician, but may request to select a new doctor after the first 30 days following the date of injury or illness.

Detailed procedures and corresponding forms can be downloaded by clicking the links below.

Administrative Procedures - Workers' Compensation
Company Nurse Reference Guide
DWC-1 Claim Form
Employee Injury Report
Supervisor Investigation Report
Pre-Designated Physician Form

Workers' Compensation Packet w/Instructions