WHO IS THE CITY OF FRESNO’S INSURANCE COMPANY?

A.           Injured employee notifies their supervisor as soon as possible.

B.           The supervisor completes the necessary Workers Compensation forms and returns them to the personnel & Training Office by the end of their shift. 

1. The Supervisors Report of Injury needs to be completed and forwarded to the Personnel and Training Office by the end of shift.

      B.  The Injury requires medical treatment, or the employee is expected to be off

           work for one full day after the injury:

           1. The Supervisors Report of Injury needs to be completed and

               forwarded to the Personnel and Training Office by the end of the shift.

           2. Complete the Employee Claim for Workers Compensation Benefits DWC-1

               form.

           3. Complete Medical Service Order for treating Physician or facility.

           4. Send the injured worker for treatment:

               A. If a minor injury occurs during business hours, send the employee to one of

                   the clinics listed below.  For serious injuries, or late night treatment, send

                   the injured employee to the hospital emergency room.

• NOTE:  An employee may seek treatment for an on-the-job injury from their

                        personal physician only if a notice of selection of physician for

                        Workers Compensation form is on file at the City of Fresno Risk

                        Management Office prior to the injury.

           5. Send all completed form to Personnel and training by the end of the shift.

LIST OF MEDICAL PROVIDERS FOR INITIAL TREATMENT, AN EMPLOYEE IS AUTHORIZED TO GO TO ONE OF THE BELOW LISTED MEDICAL PROVIDERS:

1

Employee’s Personal Medical Doctor

That he, or she, has pre-designated in writing to Risk Management prior to the injury. (Chiropractors are not authorized for initial treatment)

2

CONCENTRA

7265 North First Street, #105 Fresno, CA (559) 431-8181    Office Hours: 7am to 7 pm  M-F

3

CONCENTRA

2555 South East Avenue  Fresno, CA (559) 445 0606  Office Hours: 7 am – 6 pm  M-F  &  8 am – noon  Sat.

4

CONCENTRA

2610 Tuolumne St. Fresno, CA (559) 268-0666 Office Hours: 8am - 5 pm  M-F

5

CONCENTRA (MADERA)

509 south First, Suite A  Madera, CA (559) 673-9020  Office Hours: 8am - 6 pm  M-F 

6

ST AGNES OCCUPATIONAL HEALTH CTR

1189 East Herndon, #103   Fresno, CA559) 440-7777 Office Hours: 8am - 5 pm  M-F

7

Functional Industrial Rehabilitation Medical

6042 North Fresno Street, #101  Fresno, CA (559) 224-6754  Office Hours: 8am - 6 pm  M-F 8 am – 5 pm   Sat

8

Serious injuries or After HoursSend Employee to the Emergency Room

FRESNO POLICE DEPARTMENT

2323 Mariposa Mall

Fresno, California 93721

CITY OF FRESNO RISK MANAGEMENT

2600 Fresno Street

Fresno, California 93721

Physical Address:    Mailing Address: PO Box 9783   Fresno, California 93794

Web Site:   http://www.aarla.com

Karla Artist (Claims Supervisor)

 (559) 271-3516

(559) 271-3570