File a Workers Comp Claim

If an employee gets hurt on the job, it’s important to take care of the injury first, and then file a claim.  The process is fully documented below.

1.  (OWNER)  We require that all employees report job-related accidents or injuries to the manager immediately, whether the accident occurred on or off company premises.

2.  (MANAGER)  Get the injured employee medical attention immediately by:

• Send injured worker to designated industrial clinic. If injury is serious, call 911
  • Designated Clinic:
    • Kaiser Permanente On-the-Job Occupational Health Center
    • 3975 Old Redwood Hwy
    • Ste 152 # Mob
    • Santa Rosa, CA 95403
    • (707)566-5555
  • For other available clinics; go to https://www-lv.talispoint.com/amtrust/campn/
    • Search By Address
• Employees who have predesignated can be sent to their personal physician.

3.  (EMPLOYEE)  Submit Workers Comp Incident Report through the Employee Reporting Portal

4.  (MANAGER)  Notification & Documentation:

• Bar Manager should notify Owner In Charge (in 24 hours).
• Bar Manager should work with injured employee to complete Workers Comp Claim Form (DWC1) (in 48 hours).  https://www.dir.ca.gov/dwc/dwcform1.pdf

5.  (MANAGER or OWNER)  File a claim with Amtrust Financial:

• Call Customer Service Center 888.239.3909 or
• Report Online: https://amtrustfinancial.com/claims click “report injury”

6.  (OWNER)  Update the annual log of individual claims on Dropbox.  The editable PDF log files can be found here:

• Beaux: Dropbox->Documents->All Bars->OSHA – Beaux-><Year> Beaux 300 OSHA Log of Work Related Injuries.pdf
• Edge: Dropbox->Documents->All Bars->OSHA – Edge-><Year> Edge 300 OSHA Log of Work Related Injuries.pdf
• MSun: Dropbox->Documents->All Bars->OSHA – MSun-><Year> MSun 300 OSHA Log of Work Related Injuries.pdf
• Rainbow: Dropbox->Documents->All Bars->OSHA – Rainbow-><Year> Rainbow 300 OSHA Log of Work Related Injuries.pdf