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Workers' Compensation

If you are experiencing a life-threatening medical emergency, call 911.

Work-related, industrial injuries or illnesses must be reported to your direct supervisor and the Workers' Compensation (WC) Team by emailing workerscomp@wsdk8.us and/or at 714-894-7311 ext. 1012. The 24-hour CompanyNurse Hotline, 877-518-6702 is available to triage your injury and refer you to the appropriate level of care.  A live medical professional will advise of self-care instructions or refer you to a medical provider for treatment, if needed.

If immediate medical attention is needed, Huntington Beach Hospital is the designated 24/7 ER service.  It is located at 17772 Beach Blvd., Huntington Beach, CA 92647 and phone number is 714-843-5000. 

The designated walk-in clinic is any open Akeso. The nearest Akeso location is 17122 Beach Blvd, Suite 104, Huntington Beach, CA 92647. Contact phone number is 714-964-4448.

Treatment by your personal physician for an industrial injury or illness is eligible with specific criteria as outlined in the Pre-designation of Personal Physician Letter.  The Pre-designation of Personal Physician Form must be completed and signed by the employee and your physician/doctor.  The completed form must be turned into WSD - Business Services Division with Anne Pham to be valid.

The Westminster School District's Workers' Compensation third-party administrator is Keenan & Associates under the Protected Insurance Program for Schools (PIPS).  Contact Anne Pham at 714-894-7311 ext.1012 or workerscomp@wsdk8.us to submit, file and turn in your workers' compensation claim packet for the work-related injury.

Standard Forms for WC Claim Packet

  1. Employee Checklist and Instructions
  2. CompanyNurse 24-hour Hotline Flyer
  3. *Employee Statement of Injury
  4. *Worker's Compensation Claim Form (DWC)
  5. Akeso Treatment Authorization Form - Direct Supervisor's signature required
  6. PRIME Employee Notification of Rights Materials (MPN)
  7. Cadence prescription ID Card - Valid with WC Claim Number
  8. Employee Assistance Program (EAP) Flyer
  9. Guidelines for Workers' Compensation Absences - It is your responsibility to provide/notify your direct supervisor and workerscomp@wsdk8.us on your work status, workers' comp absences, and call in your absences into AESOP/Frontline Substitute Management System
  10. *Acknowledgement or Receipt of Workers' Comp Forms
  11.  Witness Statement
  12. Medical Treatment Declination

*Required forms that must be turned into Business Services Division at workerscomp@wsdk8.us with Anne Pham 714-894-7311 ext. 1012. 

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