Workers' Compensation Claims
The City of Stockton is self-insured for Workers' Compensation benefits. This means the City pays benefits directly to injured employees, rather than purchasing an insurance policy to pay these benefits.
All City employees are eligible to for Workers' Compensation benefits if injured or made ill by their jobs. There is no qualification period for eligibility, such as working a minimum time period or a minimum number of hours per week. If an employee believes he or she was injured on the job, a claim for benefits can be filed with the employee's supervisor.
Effective December 15, 2012, the City of Stockton implemented a Medical Provider Network (MPN) Program. This has been implemented in an effort to control costs of Workers' Compensation claims.
City Employees not in sworn Public Safety positions will automatically be enrolled into an Integration Program if they have a Workers' Compensation Claim. This program ensures employee pay is made whole through the use of accrued leave balances, until these balances are exhausted. Employees who do not wish to participate may opt-out, but this decision is final; the employee will not be allowed to opt back in.
Workers' Compensation Forms
- Completed Workers' Compensation Forms Matrix
- Employee Workers' Compensation Claim Form (DWC-1)
- Form 5020 - Employer's Report of Occupational Injury or Illness (only fill out if online 5020 system unavailable)
- How to File Workers' Compensation Claim
- Medical Treatment Authorization Form
- MPN On-The-Job Injury Poster
- MPN Pamphlet
- Notice to Employees - Injuries Caused By Work (DWC-7; English)
- Notice to Employees - Injuries Caused By Work (DWC-7; Spanish)
- Opt-out Form (Temporary Disability Integration)
- Pre-Designation of Medical Physician Form
- Receipt of Workers' Compensation Claim Information
- Supervisor's Investigation Report
- Workers' Compensation Handbook
CorVel Corporation is the local Third Party Administrator who handles the City of Stockton's Workers' Compensation Claims.
State of California - General information about California Workers Compensation
State of California - Frequently asked questions and workers' comp reforms
This City of Stockton web page last reviewed on --- 10/6/2015