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San Bernardino Community College District

Occupational Injury/Illness Reporting

Last modified at 5/16/2024 4:17 p.m.




This page refers to work-related injuries or illnesses.    

CONTACT: Stacy Holloway, Assoicate Director, Human Resources
PHONE: (909) 388-6946

FIRST and foremost, if you need EMERGENCY medical attention, dial 911!!


Click here to follow step by step: WHAT TO DO IF YOU ARE INJURED AT WORK. If you believe you may have been injured or ill during the performance of your work assignment, you must report it to your immediate supervisor immediately and the Office of Human Resources whether or not medical care is desired.   

  • First, if the injury/illness is not an immediate medical emergency, call and report to the COMPANY NURSE. The Company Nurse gathers information over the phone, will triage, give guidance and helps injured workers access appropriate medical treatment. This document explains your RIGHTS under workers' compensation. You may refer to the applicable bargaining agreement for additional information. 
  • Second, fill out all appropriate forms that are required and submit them to the Office of Human Resources. 
  • Third, if you are accepting medical treatment, go to a pre-approved workers’ compensation medical provider listed here, unless you have a physician-designation form on file (see below for additional information).

It is important that any work-related injury or illness be on file even if you do not wish medical attention immediately. The San Bernardino Community College District is very serious about maintaining and enhancing safe work conditions; with your report on file, depending on how and why you were injured, safety issues can be addressed.

If an injury occurs after normal District Office hours, call the COMPANY NURSE Injury Hotline at 1-877-518-6702, and contact the Office of Human Resources (Associate Director, Human Resources, Stacy Holloway) and/or your immediate supervisor AS SOON AS POSSIBLE.  

If you are the immediate supervisor of a work-related injury/illness employee please click here to follow the proper steps of completing the Workers' Compensation paperwork (supervisor’s responsibility).

The San Bernardino Community College District maintains a Medical Provider Network (MPN) for injured employees. In addition, benefits-eligible employees may pre-designate a physician in case of future job-related injuries or illnesses. Once completed and signed by the employee and the designated physician, this form is placed in the employee personnel file for future workers' compensation claims.

Click here for a PHYSICIAN-PREDESIGNATION form (must be on file with the Office of Human Resources BEFORE an injury takes place).

Click here for the PRIME Advantage MPN Employee Notification.

Downloadable Forms:

SBCCD Employee Workers' Compensation Packet (Instructions/Process for Injured Worker)

SBCCD Supervisor Workers' Compensation Packet

SBCCD Employee Workers' Compensation Information-Brochures

Frequently Asked Questions