University Health Services

Workers’ Compensation is a state-mandated program that provides benefits to employees who are injured or develop an illness as a result of their job. Employers are required to provide benefits in case of injury, illness, aggravation of a pre-existing condition, or death resulting from employment. The University of California is legally self-insured for these benefits. Be Well at Work-Disability Management coordinates this program for the Berkeley campus. Administration of claims and benefits is handled by the University's third-party administrator, Sedgwick.  

The amount of Workers' Compensation benefits and the process for paying claims are mandated by law. Once a claim is determined to be compensable, the benefits are automatically paid to employees. These benefits include all authorized medical and hospital expenses, partial replacement of income if the employee is temporarily disabled, permanent disability payments if the employee is permanently injured, and death benefits for financial dependents if an injury or illness results in death. 

When an injury or illness results in time away from work, the University also offers supplemental benefits above and beyond the state-mandated benefits. See the State Benefits/University Supplemental Benefits section of Chapter 4: When an Injury or Illness Results in Time Away from Work, for more detailed information.  

Who is Eligible?

UC Berkeley individuals who are eligible to receive Workers' Compensation benefits are: 

• Faculty and staff 
• Student employees
• Postdoctoral scholars
• Visiting scholars and visiting student researchers 
• Volunteers few exceptions*
• Fellows (unless excluded as a provision of the appointment)

Volunteers must be registered within their departments prior to an injury or illness to be eligible. The Workers' Compensation Program Registration Form for Volunteers must be completed in order to be eligible for benefits. *Students whose volunteer work results in school credit or a grade, would not be eligible.  

How is an Injury or Illness Defined?

According to the California Labor Code, the term "injury" includes any injury, illness, or disease arising out of employment and occurring in the course of employment (AOE/COE). Injuries are categorized as follows:

Specific: An injury resulting from a specific incident and to one or more body parts (Example: On a specific date an Employee falls down stairs and is injured)  

Cumulative: An injury from repetitive exposures over a period of time (Example: Employee experiences hearing loss due to repeated noise exposure) 

Aggravation: A pre-existing or non-work-related condition, which is aggravated by an occupational injury or disease. Medical treatment is provided until the employee returns to the pre-injury status of the pre-existing condition (Example: Employee’s previous back injury is aggravated by continued heavy lifting)  

Types of Workers' Compensation Claims

Claims can be classified into three types: 

First Aid: Refers to a one-time treatment of minor injuries, I.e. scratches, cuts, burns, splinters, etc. which do not ordinarily require medical care, or follow-up visits. 

Medical Only: Refers to medical treatments typically not to exceed six months and the employee has lost than three calendar days. 

Indemnity: Refers to a claim that has medical treatments expected to exceed six months and has three or more lost or restricted calendar days; or the claim has payments expected to exceed a defined level.  

Workers' Compensation Benefits

Benefits include:

Medical Treatment: Medical care required to help recover from a work-related injury or illness. Care may include doctor visits, lab tests, diagnostic tests, physical therapy, and hospital services. Limits may apply to medical services such as physical therapy, occupational therapy, and chiropractic care.

Temporary Disability (TD): A benefit payment for lost wages, or partial income replacement, when unable to work temporarily due to injury or illness while recovering. The payment parameters and payment are set by State law.

Permanent Disability (PD):A benefit payment for less than complete permanent recovery from the injury or illness. Payment rates are established by State law and are based on medical limitations, age, and occupation.

Supplemental Job Displacement Benefits: A voucher issued for retraining or skill enhancement, at an approved school if unable to return to work at the University, as the result of the injury or illness. Eligibility and limits are set by State law.    

Death Benefits: Benefit payment due to financially qualified dependents if the injury or illness results in death. A burial allowance is also provided. Benefits are set by State law.