Intercare is our claims administrator for the SDRMA Workers’ Compensation Program. Intercare has been a third-party administrator in California since 1994. Workers' compensation claims should be reported via Company Nurse 24/7/365 toll free injury hotline at 877.518.6711, and all completed forms should be submitted to administration@cambriacsd.org.

The district's insurance provider, Special District Risk Management Authority (SDRMA), has retained Company Nurse to provide a telephone-based nurse triage program for workers' compensation members and Intercare to administer workers' compensation claims. Intercare ensures that injured employees receive all applicable benefits in accordance with California Labor Code regulations. The CCSD provides all reasonable and necessary medical treatment to injured employees due to a work-related injury or illness. In the event of a work-related injury/illness, employees should immediately report an injury to his/her supervisor and complete the required forms. The injured employee is responsible for providing administration@cambriacsd.org with an updated Employee Status Report after each medical appointment.

Declining First Aid Injury Treatment

In the event of a work-related injury/illness and the injured employee has declined medical treatment, the injured employee or their representative must complete the following forms: 1) DWC 1 form within 24 hours of notification of work-related injury or illness; 2) Declination of Medical Treatment form; and, 3) Declination of Medical Treatment Incident Report Form.

The employee must do the following within 24 hours of employer knowledge of an employee injury or illness:

1. Call Company Nurse (877) 518-6711
2. Complete the employee portion of the Workers' Compensation DWC 1 Form.
3. Complete the employee portion of the Declination of Medical Treatment Form (if the employee does not need or request medical treatment).
4. Complete the supervisor portion of the Declination of Medical Treatment Form.
5. Complete the employee portion of the Declination of Medical Treatment Incident Report Form (this form should be completed only if the employee does not need or request medical treatment).

The supervisor must do the following within 24 hours of employer knowledge of an employee injury or illness:

1. Notify administration@cambriacsd.org  immediately following work-related injury/illness.
2. Complete the employer portion of the Declination of Medical Treatment Form.
3. Complete the employer portion of the Declination of Medical Treatment Incident Report Form.
4. Complete the employer portion of the Workers' Compensation Form DWC 1 Form.
5. Complete the Supervisor Incident Report Form.
6. Return all completed forms to administration@cambriacsd.org.

First Aid Injury with Treatment

In the event of a work-related injury/illness and the injured employee has requested medical treatment, follow all instructions prior to medical treatment. If the supervisor takes the employee to the medical facility, then the forms can be completed there. If there is an emergency call 911 first and then complete the forms as soon as possible after treatment. The injury employee or their representative must receive the DWC 1 Form within 24 hours of notification of work-related injury or illness.

The employee or their representative must do the following within 24 hours of employer knowledge of an employee injury or illness:

1. Call Company Nurse (877) 518-6711
2. Complete the employee portion of the Workers' Compensation Form DWC 1 Form.

The supervisor must do the following within 24 hours of employer knowledge of an employee injury or illness:

1. Notify administration@cambriacsd.org immediately following work-related injury/illness.
2. Complete the employer portion of the Workers' Compensation Form DWC 1 Form.
3. Complete the Supervisor Incident Report Form.
4. Return all completed forms to administration@cambriacsd.org.

Major Injury/Illness with Treatment

In the event of a work-related injury/illness and the injured employee has requested medical treatment, follow all instructions prior to medical treatment. If the supervisor takes the employee to the medical facility, then the forms can be completed there. If there is an emergency call 911 first and then complete the forms as soon as possible after treatment. The injury employee or their representative must receive the DWC-1 Form within 24 hours of notification of work-related injury or illness.

The employee or their representative must do the following within 24 hours of employer knowledge of an employee injury or illness:

1. Call Company Nurse (877) 518-6711
2. Complete the employee portion of the Workers' Compensation Form DWC 1 Form.

The supervisor must do the following within 24 hours of employer knowledge of an employee injury or illness:

1. Notify administration@cambriacsd.org immediately following work-related injury/illness.
2. Complete the employer portion of the Workers' Compensation Form DWC 1 Form.
3. Complete the Supervisor Incident Report Form.
4. Return all completed forms to administration@cambriacsd.org.