5_Yr_Loss_Run_WC.xlsx
XLSX spreadsheet 542 KB Posted
- Attached to
- WORKERS’ COMPENSATION THIRD PARTY ADMINISTRATION AND MANAGED CARE COST CONTAINMENT SERVICES RFP
- Solicitation number
- 2026-RFP-00430
- Issued by
- San Mateo County, California
About this file
This is a Workers' Compensation Loss Run document for the County of San Mateo covering workers' compensation claims data from June 1, 2021, through May 31, 2026. The document provides a comprehensive five-year historical analysis of the County's workers' compensation claims by coverage type and loss year, with data generated on June 16, 2026. The loss run details 694 total open claims comprised of 643 indemnity claims, 36 medical claims, and 15 first aid/information-only claims, with 249 claims involving Safety employees. Claims are categorized by coverage type including medical, bodily injury/comprehensive, indemnity/property damage/collision, legal, and other expenses, along with recovery and subrogation information. The document tracks both paid and incurred amounts for each claim, with loss dates spanning from 1996 through 2021, though the majority of claims occurred during the 2021 fiscal year.
The loss run reflects significant workers' compensation activity across San Mateo County's approximately 7,250 employees in 29 departments. Notable claim patterns include repetitive motion injuries, cumulative trauma claims, COVID-19 related claims, assaults and restraint-related injuries (particularly among correctional and law enforcement personnel), motor vehicle accidents, needle stick injuries, and occupational exposures. Total incurred losses across all claims demonstrate substantial costs, with individual claims ranging from minimal amounts to over $680,000 in aggregate incurred costs. The data captures claims across various county operations including correctional facilities, law enforcement, healthcare, parks and recreation, social services, and administrative functions. This historical loss run data serves as a critical baseline for the County's evaluation of third-party administrator proposals and cost containment strategies for its self-insured workers' compensation program.
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Sheet1
| SanMateo County |
| Loss Run of WC Claims by Coverage and Loss Year |
| Net Incurred Total |
Loss Run of WC Claims by Coverage and Loss Year
| Filter: | Coverage is equal to WC and Report Date is between 06/01/2021 and 05/31/2026 |
| Groups: | Coverage then Loss Date Annually |
| Sorts: | No Sorts |
| Additional Options: | Incurred Formula is Net Incurred |
| Data Generated: | 6/16/26 |
| Med/BI/Comp | Med/BI/Comp | Expense | Expense | Ind/PD/Coll | Ind/PD/Coll | Legal | Legal | Other | Other | Recovery | Recovery | Subrogation | Subrogation | ||||||||||
| Claim Number | Coverage | Loss Date | Report Date | Status | Loss Description | Paid | Incurred | Paid | Incurred | Paid | Incurred | Paid | Incurred | Paid | Incurred | Paid | Incurred | Paid | Incurred | Total Incurred | Total Paid | Loss Year | |
| WC-1996-13853 | WC | 12/31/96 | 11/2/22 | Closed | Claim details/employee department are unknown. | 0.00 | 0.00 | 18.00 | 18.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 18.00 | 18.00 | 1996 | |
| WC-2010-15790 | WC | 7/10/10 | 11/13/23 | Closed | Employee has filed an application for adjudication. Employee claims injury to the back, knees, bilateral lower extremities, stress/ psych, and DVT. | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 2010 | |
| WC-2012-15810 | WC | 8/24/12 | 11/15/23 | Closed | Employee has filed an application for adjudication. ADJ18468887 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 2012 | |
| WC-2014-11383 | WC | 6/1/14 | 1/25/22 | Closed | Employee has filed an application for adjudication of claim through their attorney. | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 5,423.72 | 5,423.72 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 5,423.72 | 5,423.72 | 2014 | |
| WC-2016-16651 | WC | 1/1/16 | 3/20/24 | Closed | Lower back L4-L5 sciatica radiating down left leg. | 0.00 | 0.00 | 654.08 | 654.08 | 13,000.00 | 13,000.00 | 7,333.65 | 7,333.65 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 20,987.73 | 20,987.73 | 2016 | |
| WC-2017-10254 | WC | 9/1/17 | 9/30/21 | Closed | The injured worker states that she has experienced persistent pain in the last four years whenever she performs repetitive motion tasks. | 0.00 | 0.00 | 150.00 | 150.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 150.00 | 150.00 | 2017 | |
| WC-2018-15731 | WC | 9/1/18 | 10/30/23 | Closed | Employee has filed an application for adjudication. CT for R shoulder. 9/1/18-10/11/23. | 0.00 | 0.00 | 100.00 | 100.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 100.00 | 100.00 | 2018 | |
| WC-2018-14772 | WC | 11/28/18 | 5/3/23 | Closed | 0.00 | 0.00 | 25.00 | 25.00 | 0.00 | 0.00 | 1,669.96 | 1,669.96 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 1,694.96 | 1,694.96 | 2018 | ||
| WC-2018-14425 | WC | 10/22/18 | 2/27/23 | Closed | EE has filed a CT10/22/18-12/20/22 for psyche, depression, panic anxiety, sleep, head, asthma, headaches, Gerd and upper GI. (Nervous and respiratory) | 3,987.50 | 3,987.50 | 2,120.50 | 2,120.50 | 40,000.00 | 40,000.00 | 16,291.32 | 16,291.32 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 62,399.32 | 62,399.32 | 2018 | |
| WC-2019-10602 | WC | 12/1/19 | 11/30/21 | Closed | Employee has filed an application for adjudication of claim through their attorney. | 0.00 | 0.00 | 18.00 | 18.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 18.00 | 18.00 | 2019 | |
| WC-2019-14771 | WC | 2/15/19 | 5/3/23 | Closed | 0.00 | 0.00 | 25.00 | 25.00 | 0.00 | 0.00 | 1,442.00 | 1,442.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 1,467.00 | 1,467.00 | 2019 | ||
| WC-2019-18012 | WC | 5/1/19 | 1/29/25 | Open | Employee has filed an application for adjudication of claim through their attorney. Cumulative trauma to the knee, lower extremity and back. | 3,326.00 | 15,000.00 | 7.50 | 7.50 | 0.00 | 56,260.00 | 224.54 | 10,000.00 | 0.00 | 5,000.00 | 0.00 | 0.00 | 0.00 | 0.00 | 86,267.50 | 3,558.04 | 2019 | |
| WC-2019-19376 | WC | 3/30/19 | 10/20/25 | Open | Employee has filed an application for adjudication through his attorney for cumulative trauma from 3/30/14-3/30/19 for circulatory system/heart. | 503.75 | 10,000.00 | 96.00 | 2,500.00 | 0.00 | 0.00 | 1,451.50 | 10,000.00 | 0.00 | 3,500.00 | 0.00 | 0.00 | 0.00 | 0.00 | 26,000.00 | 2,051.25 | 2019 | |
| WC-2020-18505 | WC | 5/5/20 | 5/12/25 | Open | Employee has filed an application for adjudication through their attorney for cumulative trauma while performing regular work duties. | 0.00 | 10,000.00 | 50.00 | 50.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 1,025.00 | 0.00 | 0.00 | 0.00 | 0.00 | 11,075.00 | 50.00 | 2020 | |
| WC-2020-17253 | WC | 12/22/20 | 8/22/24 | Closed | Injured while performing regular work duties. | 0.00 | 0.00 | 50.00 | 50.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 50.00 | 50.00 | 2020 | |
| WC-2020-15984 | WC | 6/14/20 | 12/21/23 | Open | Employee has filed an application for adjudication. Employee suffered a cumulative trauma injury (prostate cancer) while in the normal course of employment. | 8,775.31 | 59,657.75 | 1,602.50 | 1,602.50 | 0.00 | 21,895.00 | 14,983.96 | 23,500.00 | 0.00 | 6,000.00 | 0.00 | 0.00 | 0.00 | 0.00 | 112,655.25 | 25,361.77 | 2020 | |
| WC-2022-11659 | WC | 1/1/20 | 2/14/22 | Closed | Employee has filed an application for adjudication of claim through their attorney. | 0.00 | 0.00 | 78.00 | 78.00 | 6,806.00 | 6,806.00 | 2,907.60 | 2,907.60 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 9,791.60 | 9,791.60 | 2020 | |
| WC-2020-12180 | WC | 8/1/20 | 3/1/22 | Closed | The injured worker states that she feels pain in her hands due to her daily work routine. | 4,417.44 | 4,417.44 | 371.07 | 371.07 | 4,974.48 | 4,974.48 | 183.54 | 183.54 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 9,946.53 | 9,946.53 | 2020 | |
| WC-2020-14661 | WC | 1/14/20 | 1/14/23 | Closed | Employee sustained injuries due to repetitive work. Employee has filed an application for adjudication of claim through their attorney. | 10,000.00 | 10,000.00 | 1,643.00 | 1,643.00 | 0.00 | 0.00 | 10,421.36 | 10,421.36 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 22,064.36 | 22,064.36 | 2020 | |
| WC-2019-13632 | WC | 6/16/20 | 9/21/22 | Closed | Employee has filed an application for adjudication of claim through their attorney. | 18,948.16 | 18,948.16 | 68.50 | 68.50 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 19,016.66 | 19,016.66 | 2020 | |
| WC-2021-14049 | WC | 12/30/21 | 12/12/22 | Closed | Employee has filed an application for adjudication of claim through their attorney. | 3,575.00 | 3,575.00 | 58.50 | 58.50 | 0.00 | 0.00 | 5,451.72 | 5,451.72 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 9,085.22 | 9,085.22 | 2021 | |
| WC-2021-11482 | WC | 12/31/21 | 1/4/22 | Closed | The employee started to have Covid-19 symptoms. He then tested positive for Covid on 01/04/2022. | 0.00 | 0.00 | 150.00 | 150.00 | 5,874.51 | 5,874.51 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 6,024.51 | 6,024.51 | 2021 | |
| WC-2021-10826 | WC | 12/27/21 | 1/5/22 | Closed | Employee has tested positive for COVID and completed the DWC1 form received through contact tracing protocols. | 0.00 | 0.00 | 18.00 | 18.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 18.00 | 18.00 | 2021 | |
| WC-2021-11936 | WC | 9/1/21 | 2/25/22 | Closed | The employee reports that she is having pain to the right forearm and the elbow area. The employee also reports that she types for 6 hours a day five days a week. | 1,107.35 | 1,107.35 | 257.27 | 257.27 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 1,364.62 | 1,364.62 | 2021 | |
| WC-2021-14730 | WC | 10/1/21 | 4/26/23 | Closed | Employee bent over to place her trash can down and felt a pop to the left side of her lower back. | 1,000.00 | 1,000.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 1,000.00 | 1,000.00 | 2021 | |
| WC-2021-15757 | WC | 5/19/21 | 11/6/23 | Closed | Employee sustained a cumulative injury to his heart as a result of his job as a deputy sheriff for the County of San Mateo. Employee alleges a presumptive injury for hypertension and heart trouble per LC. EE has filed an application for adjudication. | 10,457.13 | 10,457.13 | 25.00 | 25.00 | 34,542.87 | 34,542.87 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 45,025.00 | 45,025.00 | 2021 | |
| WC-2023-15597 | WC | 12/6/21 | 10/4/23 | Closed | Employee has filed an application for adjudication of claim through their attorney for skin cancer. | 4,393.38 | 4,393.38 | 50.00 | 50.00 | 17,778.62 | 17,778.62 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 22,222.00 | 22,222.00 | 2021 | |
| WC-2017-12478 | WC | 10/1/21 | 5/16/22 | Closed | Employee has filed an application for adjudication of claim through their attorney. | 10,624.00 | 10,624.00 | 955.50 | 955.50 | 4,873.05 | 4,873.05 | 10,045.48 | 10,045.48 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 26,498.03 | 26,498.03 | 2021 | |
| WC-2021-11885 | WC | 12/10/21 | 3/7/22 | Closed | The employee states that the repetitive use of her keyboard for charting is causing her pain. | 891.65 | 891.65 | 265.50 | 265.50 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 1,157.15 | 1,157.15 | 2021 | |
| WC-2021-12996 | WC | 12/1/21 | 6/9/22 | Reopen | The employee began to have neck pain around 12/01/21. She believes this relates to all of the work she does on the computer. | 68,398.53 | 135,081.49 | 14,330.80 | 14,330.80 | 141,568.31 | 172,943.31 | 7,443.93 | 16,776.74 | 0.00 | 14,352.35 | 0.00 | 0.00 | 0.00 | 0.00 | 353,484.69 | 231,741.57 | 2021 | |
| WC-2020-13138 | WC | 9/27/21 | 6/23/22 | Closed | Employee has filed an application for adjudication of claim through their attorney. | 200.00 | 200.00 | 18.00 | 18.00 | 24,810.00 | 24,810.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 25,028.00 | 25,028.00 | 2021 | |
| WC-2022-11627 | WC | 7/14/21 | 2/8/22 | Closed | Cumulative injury 7/14/20-7/14/21. Applicant sustained cumulative injury to his ears in the form of hearing loss due to industrial factors. | ||||||||||||||||||
| Employee has filed an application for adjudication of claim through their attorney. | 3,033.44 | 3,033.44 | 31.52 | 31.52 | 0.00 | 0.00 | 618.56 | 618.56 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 3,683.52 | 3,683.52 | 2021 | ||||||
| WC-2021-11625 | WC | 12/30/21 | 1/14/22 | Closed | Application Filed 1/14/2022 Alleging Injury to Low Back, Hypertension and Heart | 47,840.14 | 47,840.14 | 901.13 | 901.13 | 81,591.62 | 81,591.62 | 9,854.34 | 9,854.34 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 140,187.23 | 140,187.23 | 2021 | |
| WC-2021-11400 | WC | 12/22/21 | 1/26/22 | Closed | Employee has filed an application for adjudication of claim through their attorney. | 0.00 | 0.00 | 854.00 | 854.00 | 160,000.00 | 160,000.00 | 13,848.19 | 13,848.19 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 174,702.19 | 174,702.19 | 2021 | |
| WC-2021-11982 | WC | 12/23/21 | 4/6/22 | Closed | Employee was exposed at work and tested positive for COVID. | 0.00 | 0.00 | 18.00 | 18.00 | 2,308.62 | 2,308.62 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 2,326.62 | 2,326.62 | 2021 | |
| WC-2021-10607 | WC | 11/30/21 | 11/30/21 | Closed | The supervisor states that the co-worker was loading up the concrete rubble. He struck a piece of concrete with the tractor and it hit the employee. | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 2021 | |
| WC-2021-10608 | WC | 10/29/21 | 12/1/21 | Closed | Employee was provided and completed a DWC-1 through contact tracing procedures. | 0.00 | 0.00 | 18.00 | 18.00 | 0.00 | 0.00 | 515.00 | 515.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 533.00 | 533.00 | 2021 | |
| WC-2021-15178 | WC | 12/1/21 | 12/1/21 | Closed | The employee stated she started having a rash on her right hand. She was trying to treat it with otc topical relievers but weren't helping. Due to the constant use of gloves, hand sanitizer, and soap, she developed dermatitis in both hands. She went to her doctor and she was prescribed steroidal topical relievers. | 0.00 | 0.00 | 182.50 | 182.50 | 0.00 | 0.00 | 175.39 | 175.39 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 357.89 | 357.89 | 2021 | |
| WC-2021-10619 | WC | 11/24/21 | 12/6/21 | Closed | Employee completed a DWC-1 as part of contact tracing protocols. | 0.00 | 0.00 | 18.00 | 18.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 18.00 | 18.00 | 2021 | |
| WC-2021-10623 | WC | 12/6/21 | 12/6/21 | Closed | The supervisor reported that the employee stated that this injury is a culmination of sitting in front of a computer. | 470.00 | 470.00 | 168.00 | 168.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 638.00 | 638.00 | 2021 | |
| WC-2021-10624 | WC | 12/6/21 | 12/6/21 | Reopen | The employee was walking into the freezer to get bread when she accidentally slipped on ice, causing her to fall to the ground on both knees. She put both hands out to break her fall. | 69,961.50 | 96,202.75 | 24,085.05 | 24,085.05 | 68,469.05 | 73,314.94 | 0.00 | 0.00 | 0.00 | 22,257.65 | 0.00 | 0.00 | 0.00 | 0.00 | 215,860.39 | 162,515.60 | 2021 | |
| WC-2021-10653 | WC | 12/6/21 | 12/6/21 | Closed | The employee was walking. The employee twisted her left foot. The employee fell on her right knee. | 0.00 | 0.00 | 18.00 | 18.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 18.00 | 18.00 | 2021 | |
| WC-2021-10640 | WC | 11/29/21 | 12/7/21 | Closed | The employee states he has been experiencing some severe wrist and forearm pain. He believes the pain is caused by working and usage over time. He states there was no particular incident that induced this. He states that he does data entry and uses the computer mouse to click and this could have caused the pain. | 2,468.94 | 2,468.94 | 413.16 | 413.16 | 0.00 | 0.00 | 341.22 | 341.22 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 3,223.32 | 3,223.32 | 2021 | |
| WC-2021-10649 | WC | 12/8/21 | 12/8/21 | Closed | The employee injured his calf when he restrained an individual during a court proceeding. | 0.00 | 0.00 | 18.00 | 18.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 18.00 | 18.00 | 2021 | |
| WC-2021-10751 | WC | 11/15/21 | 12/8/21 | Closed | The injured worker states that he injured his right hand, wrist, and forearm due to his daily work routine. | 1,232.23 | 1,232.23 | 253.28 | 253.28 | 0.00 | 0.00 | 109.95 | 109.95 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 1,595.46 | 1,595.46 | 2021 | |
| WC-2021-10677 | WC | 12/9/21 | 12/9/21 | Closed | The employee stated he was doing cleaning and maintenance on a machine. He was up and down the equipment. He started having pain afterward and has persisted. | 5,579.29 | 5,579.29 | 9,749.10 | 9,749.10 | 50,817.82 | 50,817.82 | 628.68 | 628.68 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 66,774.89 | 66,774.89 | 2021 | |
| WC-2021-10939 | WC | 12/11/21 | 12/11/21 | Closed | Employee has pain on her hand, her work activities require her to be at the computer typing most of the day. | 4,589.84 | 4,589.84 | 593.19 | 593.19 | 15,202.64 | 15,202.64 | 210.35 | 210.35 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 20,596.02 | 20,596.02 | 2021 | |
| WC-2021-10661 | WC | 12/13/21 | 12/13/21 | Open | The employee was injured when he was involved in a struggle with a suspect. | 20,676.94 | 54,975.36 | 5,035.64 | 5,035.64 | 95,269.44 | 102,499.98 | 0.00 | 0.00 | 0.00 | 10,132.92 | 0.00 | 0.00 | 0.00 | 0.00 | 172,643.90 | 120,982.02 | 2021 | |
| WC-2021-11814 | WC | 12/13/21 | 12/13/21 | Reopen | The injured worker states that she injured her left arm due to repetitive motion and carrying heavy binders. | 3,846.14 | 15,504.96 | 616.45 | 616.45 | 11,487.50 | 11,487.50 | 1,816.93 | 1,816.93 | 0.00 | 2,587.88 | 0.00 | 0.00 | 0.00 | 0.00 | 32,013.72 | 17,767.02 | 2021 | |
| WC-2021-10662 | WC | 12/14/21 | 12/14/21 | Closed | The employee was walking into her workstation. She was trying to seat down and the chair move causing her to fall to the floor. | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 2021 | |
| WC-2021-10664 | WC | 11/1/21 | 12/14/21 | Closed | Employee completed a DWC-1 as part of contact tracing protocols | 0.00 | 0.00 | 18.00 | 18.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 18.00 | 18.00 | 2021 | |
| WC-2021-10665 | WC | 11/30/21 | 12/14/21 | Closed | Employee states she works in the court with a non ergonomic set up. This has caused tingling to her right hand. | 517.09 | 517.09 | 267.84 | 267.84 | 0.00 | 0.00 | 197.95 | 197.95 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 982.88 | 982.88 | 2021 | |
| WC-2021-10666 | WC | 11/8/21 | 12/14/21 | Closed | Employee started to have pain on 11/08/2021. She types reports and that have caused pain on her wrist and right arm. | 84,548.86 | 84,548.86 | 28,060.02 | 28,060.02 | 224,330.12 | 224,330.12 | 30,904.04 | 30,904.04 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 367,843.04 | 367,843.04 | 2021 | |
| WC-2021-10685 | WC | 12/15/21 | 12/15/21 | Closed | Employee states he was taking a ground defense class. He was doing a particular move. When he tried to stand up, his left foot got jammed into some gaps on the matt. | 3,135.81 | 3,135.81 | 1,581.00 | 1,581.00 | 6,360.44 | 6,360.44 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 11,077.25 | 11,077.25 | 2021 | |
| WC-2021-10716 | WC | 12/16/21 | 12/16/21 | Closed | The employee took a COVID -19 test and later came down with symptoms. The test later came back positive for the COVID-19 virus. | 0.00 | 0.00 | 168.00 | 168.00 | 3,445.94 | 3,445.94 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 3,613.94 | 3,613.94 | 2021 | |
| WC-2021-10736 | WC | 12/16/21 | 12/16/21 | Closed | The employee stated she was recapping a used needle and the needle stuck in the right thumb. | 234.30 | 234.30 | 165.00 | 165.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 399.30 | 399.30 | 2021 | |
| WC-2021-10742 | WC | 12/19/21 | 12/19/21 | Closed | The employee got exposed to COVID-19 on December 19, 2021. The employee got a positive result from a COVID-19 self-test on December 22, 2021. The employee had a PCR test for COVID-19 on December 23, 2021. The employee's test result came back positive on December 23, 2021. The employee was placed on quarantine on December 22, 2021. | 0.00 | 0.00 | 168.00 | 168.00 | 4,599.50 | 4,599.50 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 4,767.50 | 4,767.50 | 2021 | |
| WC-2021-13128 | WC | 12/19/21 | 12/19/21 | Closed | The inmate was loading rice into a bucket. The bucket started to fall towards another inmate's hand and the inmate tried to catch the bucket. This caused him to pinch his finger. | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 2021 | |
| WC-2021-10696 | WC | 12/20/21 | 12/20/21 | Closed | Employee was provided and completed a DWC1 form as part of contact tracing protocols. | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 2021 | |
| WC-2021-10744 | WC | 12/20/21 | 12/20/21 | Closed | The employee was exposed to Covid-19 and has tested positive. He believes he was exposed via a coworker on Monday and received positive test results today around 3:00 p.m. | 0.00 | 0.00 | 18.00 | 18.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 18.00 | 18.00 | 2021 | |
| WC-2021-10747 | WC | 12/20/21 | 12/20/21 | Closed | The employee stated, he was working and started feeling symptoms of COVID-19. He then tested positive on a home test 12/21/2021. He got a test at his doctors on the 12/22/2021. He started quarantine on 12/21/2021. His projected return date is 12/30/2021. | 0.00 | 0.00 | 168.00 | 168.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 168.00 | 168.00 | 2021 | |
| WC-2021-10750 | WC | 12/20/21 | 12/20/21 | Closed | The employee started having COVID-19 symptoms on December 20, 2021. The employee got a positive result from a COVID-19 self-test on December 23, 2021. The employee had a PCR test for COVID-19 on December 23, 2021; the employee is waiting for the test result. The employee was placed on quarantine on December 23, 2021. | 0.00 | 0.00 | 7.50 | 7.50 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 7.50 | 7.50 | 2021 | |
| WC-2021-10724 | WC | 12/21/21 | 12/21/21 | Closed | The employee was taking the patient to her office. As she turned the patient started to fall. The patient's shoulder hit the employees right ankle, twisting it. | 0.00 | 0.00 | 168.00 | 168.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 168.00 | 168.00 | 2021 | |
| WC-2021-10746 | WC | 12/21/21 | 12/21/21 | Closed | The employee was walking in the side entrance. She states it had been raining. As she walked into the building, her heel slipped on the wet floor. She fell, twisting the left ankle, and landed on her right knee. | 1,110.74 | 1,110.74 | 228.00 | 228.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 1,338.74 | 1,338.74 | 2021 | |
| WC-2021-10748 | WC | 12/21/21 | 12/21/21 | Closed | The employee was walking down the stairs. The heel of her boot caught, causing her to fall forward. She caught herself, landing on her knees. She also hit both her ankles on the stairs. | 0.00 | 0.00 | 168.00 | 168.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 168.00 | 168.00 | 2021 | |
| WC-2021-10749 | WC | 12/16/21 | 12/21/21 | Closed | The employee was loading tables into his vehicle to leave an event. This caused him to feel a pull to his right upper shoulder, stiffness to neck, sharp pain to the middle, lower part of his back, this caused pain down his left leg to his foot. | 708.36 | 708.36 | 223.00 | 223.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 931.36 | 931.36 | 2021 | |
| WC-2021-10759 | WC | 12/21/21 | 12/21/21 | Closed | The employee was exposed to Covid-19 via a coworker while working together. He has tested positive for Covid-19. | 0.00 | 0.00 | 168.00 | 168.00 | 5,293.12 | 5,293.12 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 5,461.12 | 5,461.12 | 2021 | |
| WC-2021-10737 | WC | 12/22/21 | 12/22/21 | Closed | The injured employee tested positive for COVID-19 on December 22. | 0.00 | 0.00 | 168.00 | 168.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 168.00 | 168.00 | 2021 | |
| WC-2021-10740 | WC | 12/22/21 | 12/22/21 | Closed | The employee stated, she was exposed to covid sometime between 12/18 and 12/22 at work. She got tested on 12/22/2021 and received positive COVID results later that evening. She started quarantine on 12/23/2021 which is set to lst ten days. | 0.00 | 0.00 | 168.00 | 168.00 | 1,186.29 | 1,186.29 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 1,354.29 | 1,354.29 | 2021 | |
| WC-2021-10741 | WC | 12/22/21 | 12/22/21 | Closed | When the employee went home from work he was notified that he had been exposed to COVID-19 by a family member. He has a runny nose. He has placed himself in isolation. | 0.00 | 0.00 | 150.00 | 150.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 150.00 | 150.00 | 2021 | |
| WC-2021-10743 | WC | 12/22/21 | 12/22/21 | Closed | Employee tested positive for covid 19, he was exposed in his work. | 0.00 | 0.00 | 168.00 | 168.00 | 3,557.72 | 3,557.72 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 3,725.72 | 3,725.72 | 2021 | |
| WC-2021-10745 | WC | 12/22/21 | 12/22/21 | Closed | The employee tested positive with a home test on 12/20. The employee tested positive with a PCR test 12/22. The employee is on quarantine. The employee is not working. The employee will probably be back to work on 12/31. | 0.00 | 0.00 | 168.00 | 168.00 | 3,978.26 | 3,978.26 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 4,146.26 | 4,146.26 | 2021 | |
| WC-2021-10936 | WC | 12/23/21 | 12/23/21 | Closed | The injured worker was working in the field. He tested positive for COVID. | 0.00 | 0.00 | 168.00 | 168.00 | 5,424.90 | 5,424.90 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 5,592.90 | 5,592.90 | 2021 | |
| WC-2021-10738 | WC | 12/24/21 | 12/24/21 | Closed | Covid-19 exposure. | 0.00 | 0.00 | 175.50 | 175.50 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 175.50 | 175.50 | 2021 | |
| WC-2021-10739 | WC | 12/24/21 | 12/24/21 | Closed | Employee states he was opening a water valve. He accidentally touched the hot water pipe with his left forearm and burned his forearm. | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 2021 | |
| WC-2021-10760 | WC | 12/24/21 | 12/24/21 | Closed | The employee stated, he was working and started feeling symptoms of COVID-19. He then tested positive on a home test on 12/25/2021. He went to a kiosk and tested positive on 123/26/2021. He was put on quarantine on 12/24/2021 for ten days. | 0.00 | 0.00 | 168.00 | 168.00 | 3,365.73 | 3,365.73 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 3,533.73 | 3,533.73 | 2021 | |
| WC-2021-10779 | WC | 12/22/21 | 12/24/21 | Closed | The employee was positively exposed to Covid on 12/22. The employee took a rapid test on the 12/22 that was negative. The employee took a rapid test on 12/24 that was positive. The employee tested positive for Covid on 12/27 at the lab. The results came back positive on 12/27. The employee is on quarantine for 10 days. The employee can go back to work on 1/4. | 0.00 | 0.00 | 168.00 | 168.00 | 1,326.50 | 1,326.50 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 1,494.50 | 1,494.50 | 2021 | |
| WC-2021-10802 | WC | 12/24/21 | 12/24/21 | Closed | The employee is experiencing symptoms of co-vid- body aches, sore throat, cough, loss of taste and smell. The employee was exposed on 12/14/21- Got tested 12/28/21 tested positive. The employee was placed on quarantine 12/28/21- Got tested at: |
Healthvana
344 Tully Road
San Jose, CA 95111
For questions, please go to www.Healthvana.com/FAQ
| 0.00 | 0.00 | 150.00 | 150.00 | 2,526.81 | 2,526.81 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 2,676.81 | 2,676.81 | 2021 | ||||||
| WC-2021-10796 | WC | 12/25/21 | 12/25/21 | Closed | The employee has tested positive for Covid. | 0.00 | 0.00 | 168.00 | 168.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 168.00 | 168.00 | 2021 |
| WC-2021-10765 | WC | 12/26/21 | 12/26/21 | Closed | The employee started to have COVID -19 symptoms. He took a test and tested positive. | 759.76 | 759.76 | 1,375.78 | 1,375.78 | 3,612.90 | 3,612.90 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 5,748.44 | 5,748.44 | 2021 |
| WC-2021-10785 | WC | 12/26/21 | 12/26/21 | Closed | The employee stated, he was working and started feeling symptoms of COVID-19. He tested positive on 12/28/2021. He started quarantine on 12/28/2021, he has no return date yet. | 0.00 | 0.00 | 168.00 | 168.00 | 3,234.90 | 3,234.90 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 3,402.90 | 3,402.90 | 2021 |
| WC-2021-10761 | WC | 12/27/21 | 12/27/21 | Closed | Employee states that the hospital had changed equipment to get blood out. The equipment got jammed and as she was trying to remove it, the plastic cap came out and the needle that had just been used to draw blood out from a patient poked her on her right middle finger. | 253.32 | 253.32 | 772.50 | 772.50 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 1,025.82 | 1,025.82 | 2021 |
| WC-2021-10778 | WC | 12/27/21 | 12/27/21 | Closed | The employee was talking to the customers. As she turned around to continue the inspection and start walking, she stepped in a pot hole in the asphalt. She lost her balance and fell forward, landing on her left knee. | 206.34 | 206.34 | 22.50 | 22.50 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 228.84 | 228.84 | 2021 |
| WC-2022-10891 | WC | 12/27/21 | 12/27/21 | Open | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 2021 | |
| WC-2021-10776 | WC | 12/28/21 | 12/28/21 | Closed | The employee stated he was working around a coworkers that tested positive for covid 19. The employee decide to get a rapid test at work and tested positive for Covid 19. The employee plan on getting tested again. | 0.00 | 0.00 | 168.00 | 168.00 | 3,234.90 | 3,234.90 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 3,402.90 | 3,402.90 | 2021 |
| WC-2021-10777 | WC | 12/28/21 | 12/28/21 | Closed | The employee was attending training , possibly exposed to Covid-19 during this time. Other coworkers are also positive. Today he woke up with chills and body aches and performed an at-home test on 12/28/21. The test came back positive. Employee last day of work was 12/27/21. | 0.00 | 0.00 | 168.00 | 168.00 | 3,189.13 | 3,189.13 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 3,357.13 | 3,357.13 | 2021 |
| WC-2021-10780 | WC | 12/23/21 | 12/28/21 | Closed | The employee was reaching into the dishwasher. He felt a tweak in his lower back when bending over. | 20,141.25 | 20,141.25 | 208.00 | 208.00 | 2,610.00 | 2,610.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 22,959.25 | 22,959.25 | 2021 |
| WC-2021-10797 | WC | 12/28/21 | 12/28/21 | Closed | The employee believes he was exposed at work because many people around him at work have been getting sick. He was asymptomatic but decided to get tested as a preventative measure. His symptoms started on Tuesday night. He called out of work on Wednesday with worsening symptoms. While waiting for results, he went to Stanford Hospital to get a test with more rapid results. Both tests came back with positive results. |
| 0.00 | 0.00 | 168.00 | 168.00 | 3,422.52 | 3,422.52 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 3,590.52 | 3,590.52 | 2021 | ||||||
| WC-2021-10937 | WC | 12/28/21 | 12/28/21 | Closed | The injured employee tested positive for COVID-19 on January 07. | 0.00 | 0.00 | 168.00 | 168.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 168.00 | 168.00 | 2021 |
| WC-2021-10794 | WC | 12/29/21 | 12/29/21 | Closed | The employee started having symptoms of COVID19 on 12/29/2021. He took the COVID19 test on 12/31/2021 and test results came out positive on 01/02/2022. He was placed on quarantine on 01/02/2021. | 0.00 | 0.00 | 168.00 | 168.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 168.00 | 168.00 | 2021 |
| WC-2021-10800 | WC | 12/29/21 | 12/29/21 | Closed | The employee was exposed to COVID19 at the workplace. She took the COVID19 test on 12/29/2021 and test results came out positive on the same day. She was placed on quarantine on 12/30/2021. | 0.00 | 0.00 | 168.00 | 168.00 | 1,155.40 | 1,155.40 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 1,323.40 | 1,323.40 | 2021 |
| WC-2021-10801 | WC | 12/29/21 | 12/29/21 | Closed | The injured employee was working, and he was exposed to multiple people who were covid19 positive. | 0.00 | 0.00 | 150.00 | 150.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 150.00 | 150.00 | 2021 |
| WC-2021-10791 | WC | 12/30/21 | 12/30/21 | Closed | The employee was working and did not feel well. She had a cough and a cold. She took COVID-19 home tests and they were negative. She had a PCR test at the county and tested positive. She has been in isolation since 12/26/2021 and will return to work on 01/07/2021. | 0.00 | 0.00 | 168.00 | 168.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 168.00 | 168.00 | 2021 |
| WC-2021-10798 | WC | 12/30/21 | 12/30/21 | Closed | The employee was helping the patient with a glucometer when the needle poked her right middle finger. | 636.29 | 636.29 | 180.00 | 180.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 816.29 | 816.29 | 2021 |
| WC-2021-10934 | WC | 12/29/21 | 12/30/21 | Closed | The employee was exposed to COVID-19 on 12/29/21. Tested positive on 12/30/21. | 0.00 | 0.00 | 150.00 | 150.00 | 5,262.90 | 5,262.90 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 5,412.90 | 5,412.90 | 2021 |
| WC-2021-10935 | WC | 12/26/21 | 12/30/21 | Closed | The employee had been working with a coworker that has tested positive for Covid. He was notified on the 25th that he had been exposed. The employee started feeling ill on 10/30/201. | 0.00 | 0.00 | 157.50 | 157.50 | 6,378.40 | 6,378.40 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 6,535.90 | 6,535.90 | 2021 |
| WC-2021-10942 | WC | 12/30/21 | 12/30/21 | Closed | The employee is experiencing co-vid related symptoms- runny nose, body aches, chills, congested, sore throat, headache. Rapid test positive and tested again at dr's office tested positive again. | 0.00 | 0.00 | 168.00 | 168.00 | 5,063.20 | 5,063.20 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 5,231.20 | 5,231.20 | 2021 |
| WC-2021-10933 | WC | 12/31/21 | 12/31/21 | Closed | The employee began to feel ill on 12/31/21. She tested positive for COVID-19 on 01/3/22. | 0.00 | 0.00 | 168.00 | 168.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 168.00 | 168.00 | 2021 |
| WC-2021-10946 | WC | 12/31/21 | 12/31/21 | Closed | Covid-19 exposure. | 0.00 | 0.00 | 168.00 | 168.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 168.00 | 168.00 | 2021 |
| WC-2021-11881 | WC | 12/31/21 | 12/31/21 | Closed | The injured employee is stressed because of the Supervisor's behavior, expectation, interaction and amount of work. | 177.49 | 177.49 | 200.50 | 200.50 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 377.99 | 377.99 | 2021 |
| WC-2021-10257 | WC | 9/30/21 | 9/30/21 | Closed | The employee tested positive for Coronavirus and has been advised by employer to quarantine. He is not sure as to where he got exposed but he took the test on 9/30/2021; he does not have any symptoms at the moment. | 0.00 | 0.00 | 150.00 | 150.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 150.00 | 150.00 | 2021 |
| WC-2021-10255 | WC | 10/1/21 | 10/1/21 | Closed | The employee had to walk up a steep hill. The employee felt chest pains while walking up the hill. | 0.00 | 0.00 | 150.00 | 150.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 150.00 | 150.00 | 2021 |
| WC-2021-10256 | WC | 10/1/21 | 10/1/21 | Closed | The injured worker states that she was diagnosed eight years ago with tendonitis. Recently she had a flare-up in her work due to her daily work routine. | 690.72 | 690.72 | 7.50 | 7.50 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 698.22 | 698.22 | 2021 |
| WC-2021-10493 | WC | 10/1/21 | 10/1/21 | Closed | The employee uses the computer which has caused her right wrist, elbow and left wrist to hurt. She states she has to use her left hand and arm to perform daily tasks as it hurts too much to use her right side. | 19,783.73 | 19,783.73 | 1,248.01 | 1,248.01 | 3,480.00 | 3,480.00 | 972.10 | 972.10 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 25,483.84 | 25,483.84 | 2021 |
| WC-2021-10258 | WC | 10/4/21 | 10/4/21 | Closed | The employee was driving northbound on Bay road. His light turned green and proceeded through the intersection. The car to his left went through the red light,and the employee started to stop. He hit the other vehicle on the side and the other vehicle kept driving. The employee's cruiser had completely turned off. The other car continued to drive away. The employee hit his head on the roof of his cruiser. The air bags did not deploy. | 1,094.20 | 1,094.20 | 780.00 | 780.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 1,874.20 | 1,874.20 | 2021 |
| WC-2021-10267 | WC | 10/4/21 | 10/4/21 | Closed | The employee was attempting to speak to a patient who was trying to elope when the patient swiped at his left arm, causing his arm to lift up and his shoulder to be hyper-extended. | 722.93 | 722.93 | 187.50 | 187.50 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 910.43 | 910.43 | 2021 |
| WC-2021-10272 | WC | 9/23/21 | 10/4/21 | Closed | The employee was getting out of the shower before a training class. He slipped and fell in the shower. He landed on his back. His left shoulder and neck is now hurting. | 6,039.57 | 6,039.57 | 1,779.33 | 1,779.33 | 28,369.98 | 28,369.98 | 13,015.76 | 13,015.76 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 49,204.64 | 49,204.64 | 2021 |
| WC-2021-10291 | WC | 10/5/21 | 10/5/21 | Closed | The employee was positioning a difficult patient for a mammogram when she felt pain in her right shoulder down to her right arm. | 589.27 | 589.27 | 808.00 | 808.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 1,397.27 | 1,397.27 | 2021 |
| WC-2021-10292 | WC | 10/6/21 | 10/6/21 | Closed | The injured worker was working at her desk and a coworker wanted her to take material down from the window. She stated that a coworker took the material down. Injured worker reports that the coworker is harassing her and talking really loudly. She stated that she is making a lot of mistakes. | 174.25 | 174.25 | 175.50 | 175.50 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 349.75 | 349.75 | 2021 |
| WC-2021-10296 | WC | 10/6/21 | 10/6/21 | Closed | The employee was driving from one school to another school. The driver in front of her made an abrupt stop and the employee hit the car. The employee has pain in her neck and she has a headache. She was wearing a seatbelt. Possibly hit the back of her head on the headrest. Airbags did not deploy. | 316.77 | 316.77 | 183.00 | 183.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 499.77 | 499.77 | 2021 |
| WC-2021-10301 | WC | 10/6/21 | 10/6/21 | Closed | The injured employee was using a box cutter when he cut his right hand. | 1,783.03 | 1,783.03 | 865.71 | 865.71 | 7,110.65 | 7,110.65 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 9,759.39 | 9,759.39 | 2021 |
| WC-2021-10319 | WC | 10/6/21 | 10/6/21 | Closed | The employee was at physical therapy appointment for a different injury on her left hand. The physical therapist asked her to close both hands. The employee's right middle finger locked and she could not straighten it. The employee was not treated for the injury to her right middle finger. | 6,072.00 | 6,072.00 | 3,661.90 | 3,661.90 | 11,059.20 | 11,059.20 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 20,793.10 | 20,793.10 | 2021 |
| WC-2021-10408 | WC | 10/6/21 | 10/6/21 | Closed | The Supervisor called in the report. The employee states that she has pain in her neck and lower back pain when working in the office. An ergonomic check was done and she had adjustments made at her work station and she got a new keyboard. | 0.00 | 0.00 | 168.00 | 168.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 168.00 | 168.00 | 2021 |
| WC-2021-10302 | WC | 10/8/21 | 10/8/21 | Closed | Employee states he was unloading carts and separating chemicals. He suddenly felt pain to his kidneys. He also says he urinates more than usual. | 174.25 | 174.25 | 157.50 | 157.50 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 331.75 | 331.75 | 2021 |
| WC-2021-10500 | WC | 10/8/21 | 10/8/21 | Closed | The injured employee was working with a patient who needs a lot of assistance. She was helping to move her legs and started to become sore. Later she had lower back pain. | 10,106.85 | 10,106.85 | 1,622.81 | 1,622.81 | 0.00 | 0.00 | 1,065.24 | 1,065.24 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 12,794.90 | 12,794.90 | 2021 |
| WC-2021-10307 | WC | 10/12/21 | 10/12/21 | Reopen | The employee walking out of the lobby when she slipped. She fell on her left shoulder and left leg. Did not hit her head. | 12,808.39 | 34,681.98 | 6,531.97 | 6,531.97 | 27,061.93 | 44,606.93 | 21,214.62 | 27,224.32 | 0.00 | 11,764.43 | 0.00 | 0.00 | 0.00 | 0.00 | 124,809.63 | 67,616.91 | 2021 |
| WC-2021-10308 | WC | 10/11/21 | 10/12/21 | Open | The injured employee was putting inmate food in an oven and leaning over when he pulled a muscle to his neck area. | 18,136.09 | 58,147.87 | 12,306.62 | 12,306.62 | 255,970.97 | 255,970.97 | 12,113.67 | 15,000.00 | 0.00 | 66,502.28 | 0.00 | 0.00 | 0.00 | 0.00 | 407,927.74 | 298,527.35 | 2021 |
| WC-2021-10315 | WC | 10/13/21 | 10/13/21 | Closed | The injured employee was walking between tables and he slipped on some grease. He caught himself before he fell but tweaked his lower back. He also hit his left elbow. | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 2021 |
| WC-2021-10332 | WC | 10/12/21 | 10/13/21 | Closed | The employee began to feel ill on 10/13/21. He tested positive for COVID-19 on 10/13 and got the results on 10/16/21. | 0.00 | 0.00 | 150.00 | 150.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 150.00 | 150.00 | 2021 |
| WC-2021-10336 | WC | 10/13/21 | 10/13/21 | Closed | Employee states he works at home. Due to long times of sitting down working, he has developed lower back pain. | 1,338.96 | 1,338.96 | 321.09 | 321.09 | 0.00 | 0.00 | 258.39 | 258.39 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 1,918.44 | 1,918.44 | 2021 |
| WC-2021-10325 | WC | 10/14/21 | 10/14/21 | Closed | The employee tested positive for COVID19 while at work. | 0.00 | 0.00 | 150.00 | 150.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 150.00 | 150.00 | 2021 |
| WC-2021-10334 | WC | 10/17/21 | 10/17/21 | Closed | The employee tested positive for COVID-19 rapid test. He got tested today 10/18/2021 and results came positive the same day. | 2,088.21 | 2,088.21 | 1,375.50 | 1,375.50 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 3,463.71 | 3,463.71 | 2021 |
| WC-2021-10335 | WC | 10/19/21 | 10/19/21 | Closed | The injured employee was walking down the stairs and the employee fell. She fell forward down the stairs, injuring both knees and hip areas. | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 2021 |
| WC-2021-10337 | WC | 10/20/21 | 10/20/21 | Closed | The injured employee was responding to a call on a suspicious subject. The subject struggled while being detained and the employee injured both of his elbows. The employee's coworker also accidentally hit the employee with a baton on the right knee. | 874.96 | 874.96 | 780.00 | 780.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 1,654.96 | 1,654.96 | 2021 |
| WC-2021-10338 | WC | 10/18/21 | 10/20/21 | Closed | The employee was lifting empty book bins. The employee later felt pain in her shoulders, neck, lower back and chest. | 0.00 | 0.00 | 168.00 | 168.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 168.00 | 168.00 | 2021 |
| WC-2021-10348 | WC | 10/20/21 | 10/20/21 | Closed | The employee was notified that he was exposed to Covid. He tested positive for Covid. | 0.00 | 0.00 | 168.00 | 168.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 168.00 | 168.00 | 2021 |
| WC-2021-10350 | WC | 10/20/21 | 10/20/21 | Closed | The employee was arresting an individual who was fighting with them. During the struggle he scraped his knuckles against the ground. The following day he had lower back pain. | 0.00 | 0.00 | 150.00 | 150.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 150.00 | 150.00 | 2021 |
| WC-2021-10346 | WC | 10/21/21 | 10/21/21 | Closed | The employee was restraining an aggressive inmate when that inmate pushed him upwards against a bench. | 345.06 | 345.06 | 757.50 | 757.50 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 1,102.56 | 1,102.56 | 2021 |
| WC-2021-10347 | WC | 10/21/21 | 10/21/21 | Closed | The employee stated he was responding to an altercation. He was trying to get a combatant into custody. He felt a pop in his left shoulder. | 885.43 | 885.43 | 845.50 | 845.50 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 1,730.93 | 1,730.93 | 2021 |
| WC-2021-10349 | WC | 10/21/21 | 10/21/21 | Closed | The employee stated that she was attempting to get in the car, it was raining, the ground was wet, her foot slipped and her right knee popped, she also cut her right ring finger with the car door. | 5,467.35 | 5,467.35 | 3,482.93 | 3,482.93 | 435.00 | 435.00 | 3,843.02 | 3,843.02 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 13,228.30 | 13,228.30 | 2021 |
| WC-2021-10407 | WC | 10/21/21 | 10/21/21 | Closed | The injured worker was working with coworker and inmate when he tested positive of COVID. | 0.00 | 0.00 | 168.00 | 168.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 168.00 | 168.00 | 2021 |
| WC-2021-10344 | WC | 10/22/21 | 10/22/21 | Closed | The employee was talking to a student who became upset and struck her in the arm and upper right side area. The student also began to throw things at her. | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 2021 |
| WC-2021-10345 | WC | 10/22/21 | 10/25/21 | Closed | The employee came in to work today and didn't feel well. He felt like he had a head cold with body aches and chills. He took a rapid test and it came back Positive. He made an appointment with his doctor to take a lab test this afternoon. He was sent home and is on quarantine for 10 days. | 0.00 | 0.00 | 168.00 | 168.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 168.00 | 168.00 | 2021 |
| WC-2021-10351 | WC | 10/4/21 | 10/25/21 | Closed | Employee reported to Kaiser with a needle stick injury. | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 2021 |
| WC-2021-10456 | WC | 10/25/21 | 10/25/21 | Closed | The employee was walking into a housing unit. A coworker opened the sliding door. As the employee was walking through the door, the coworker accidentally hit the close button on the slider causing the door to close on her and squish her. The employee was able to jump out. This caused pain to the back. | 1,888.63 | 1,888.63 | 298.25 | 298.25 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 2,186.88 | 2,186.88 | 2021 |
| WC-2021-10406 | WC | 10/27/21 | 10/27/21 | Closed | The employee states that she was walking on the sidewalk. She was run over by a man on a bicycle and was knocked unconscious. | 140.00 | 140.00 | 200.50 | 200.50 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 340.50 | 340.50 | 2021 |
| WC-2021-10538 | WC | 10/4/21 | 10/27/21 | Closed | The employee stated, she works as payroll coordinator. She does a lot of computer work. She does a lot of keyboard and mouse work. Due to the repetitive motion, she feels pain in her right hand, both wrists, upper arms and shoulders. | 5,943.71 | 5,943.71 | 473.63 | 473.63 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 6,417.34 | 6,417.34 | 2021 |
| WC-2021-10659 | WC | 10/27/21 | 10/27/21 | Closed | The employee was dispatching when she felt a sharp pain in her left ear, followed by a popping sound. | 2,250.96 | 2,250.96 | 188.90 | 188.90 | 0.00 | 0.00 | 460.17 | 460.17 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 2,900.03 | 2,900.03 | 2021 |
| WC-2021-10436 | WC | 10/28/21 | 10/28/21 | Closed | Employee states she was transferring a patient that was very weak. She tried to help him to get up 3 times as he was holding the bed rail. She and a coworker were able to move the patient from the commode to his bed. After that she felt that her spine got misaligned from the middle back. | 5,739.87 | 5,739.87 | 2,003.57 | 2,003.57 | 3,204.05 | 3,204.05 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 10,947.49 | 10,947.49 | 2021 |
| WC-2021-10492 | WC | 10/28/21 | 10/28/21 | Closed | The injured employee was pulling out the debris from the culvert after a rain. He was doing it for a week and his lower back starting hurting. | 1,119.28 | 1,119.28 | 321.23 | 321.23 | 7,773.26 | 7,773.26 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 9,213.77 | 9,213.77 | 2021 |
| WC-2021-10594 | WC | 10/29/21 | 10/30/21 | Closed | The employee was pulling a person's equipment into the boat. The employee felt a pain in his right elbow. | 1,584.54 | 1,584.54 | 325.72 | 325.72 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 1,910.26 | 1,910.26 | 2021 |
| WC-2021-10403 | WC | 10/31/21 | 10/31/21 | Closed | The injured employee was responding to a fight that happened in the intake area. She stated someone accidentally stepped onto her right ankle. | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 2021 |
| WC-2021-10405 | WC | 10/31/21 | 10/31/21 | Closed | The injured employee was trying to gain control of a resistant inmate and he injured his right hand in the process. | 2,203.30 | 2,203.30 | 276.43 | 276.43 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 2,479.73 | 2,479.73 | 2021 |
| WC-2021-10409 | WC | 10/31/21 | 10/31/21 | Closed | The employee was clearing trails. He had finished cutting a tree. He stepped on a branch that was rolling. He felt a sharp pain in the right thigh. | 5,715.47 | 5,715.47 | 733.62 | 733.62 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 6,449.09 | 6,449.09 | 2021 |
| WC-2021-10404 | WC | 10/31/21 | 11/1/21 | Closed | The employee stated due to the repetitive motions of him climbing steep stairs 7-8 times yesterday cause pain in his right shoulder. He had to use his arms to climb the stairs, they are metal stairs that are steep and you have to use a railing. | 354.07 | 354.07 | 245.72 | 245.72 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 599.79 | 599.79 | 2021 |
| WC-2021-10419 | WC | 7/19/21 | 11/1/21 | Closed | Employee filed an application for adjudication for a CT 2/28/07-7/19/21 to the right knee citing cumulative trauma due to his heavy work activities including swat team. | 93,979.30 | 93,979.30 | 4,975.02 | 4,975.02 | 132,375.20 | 132,375.20 | 10,703.80 | 10,703.80 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 242,033.32 | 242,033.32 | 2021 |
| WC-2021-10443 | WC | 11/1/21 | 11/1/21 | Closed | The employee stated she was carrying the linen bags from the bathrooms. She started to feel pain in her lower back. | 964.66 | 964.66 | 2,624.91 | 2,624.91 | 2,773.32 | 2,773.32 | 198.69 | 198.69 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 6,561.58 | 6,561.58 | 2021 |
| WC-2021-10609 | WC | 10/29/21 | 11/1/21 | Closed | Employee completed a DWC-1 as part of contact tracing protocols. | 0.00 | 0.00 | 18.00 | 18.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 18.00 | 18.00 | 2021 |
| WC-2021-11680 | WC | 11/1/21 | 11/1/21 | Closed | The employee is reporting that she had been having pain to the back of her neck. She moves many items when completing discharges. This has caused her to strain her neck and upper back. | 2,737.57 | 2,737.57 | 1,318.00 | 1,318.00 | 9,216.00 | 9,216.00 | 1,845.15 | 1,845.15 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 15,116.72 | 15,116.72 | 2021 |
| WC-2021-11918 | WC | 11/1/21 | 11/1/21 | Closed | The injured worker states that he feels pain due to moderate disk degeneration and kidney stones. | 6,669.97 | 6,669.97 | 534.11 | 534.11 | 0.00 | 0.00 | 238.37 | 238.37 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 7,442.45 | 7,442.45 | 2021 |
| WC-2021-12304 | WC | 11/1/21 | 11/1/21 | Closed | The injured employee has had a very large work load. This work has become unmanageable. This has caused much anxiety and depression. | 6,219.81 | 6,219.81 | 447.58 | 447.58 | 4,262.72 | 4,262.72 | 208.21 | 208.21 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 11,138.32 | 11,138.32 | 2021 |
| WC-2021-10435 | WC | 11/2/21 | 11/2/21 | Closed | Employee states he was trying to take a sample from a deceased individual. Some one else was passing by with another deceased. He tried to move out of the way and poked his left middle finger. | 699.07 | 699.07 | 210.00 | 210.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 909.07 | 909.07 | 2021 |
| WC-2021-10440 | WC | 7/1/21 | 11/3/21 | Closed | Employee filed through an attorney for adjudication on 10/11/2021 of a cumulative trauma claim from 11/8/1999 to 6/30/2021 for neck, back and wrist. | 16,187.64 | 16,187.64 | 1,136.00 | 1,136.00 | 18,513.04 | 18,513.04 | 12,070.43 | 12,070.43 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 47,907.11 | 47,907.11 | 2021 |
| WC-2021-10441 | WC | 11/3/21 | 11/3/21 | Closed | The injured employee was placing a female subject under arrest and placed her at the back of a patrol car. The subject spit on him two times in the face. | 0.00 | 0.00 | 150.00 | 150.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 150.00 | 150.00 | 2021 |
| WC-2021-10442 | WC | 11/3/21 | 11/3/21 | Closed | The injured employee was trying to restrain and tackle a youth who escaped from the juvenile hall. He fell onto the concrete floor and tweaked his back. | 5,765.39 | 5,765.39 | 4,735.55 | 4,735.55 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 10,500.94 | 10,500.94 | 2021 |
| WC-2021-10603 | WC | 11/3/21 | 11/3/21 | Closed | Employee has filed an application for adjudication of claim through their attorney. | 4,631.09 | 4,631.09 | 25.50 | 25.50 | 0.00 | 0.00 | 4,199.80 | 4,199.80 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 8,856.39 | 8,856.39 | 2021 |
| WC-2021-10450 | WC | 11/4/21 | 11/4/21 | Closed | The employee was changing a belt on an exhaust fan. As he did this he felt a rush of wind and three of his fingers on his right hand got stuck between the belt and the pulley. | |||||||||||||||||
| 1,304.56 | 1,304.56 | 1,451.32 | 1,451.32 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 2,755.88 | 2,755.88 | 2021 | ||||||
| WC-2021-10455 | WC | 11/4/21 | 11/4/21 | Closed | The employee states that she was assisting a patient with bed mobility. She held his legs with her back leaning over. She reports pain to her lower back. | 3,305.68 | 3,305.68 | 500.72 | 500.72 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 3,806.40 | 3,806.40 | 2021 |
| WC-2021-10526 | WC | 11/4/21 | 11/4/21 | Closed | The employee began to feel ill on 11/4/21. She tested for COVID-19 on 11/5/21. She found out she was positive on 11/6/21. | 0.00 | 0.00 | 168.00 | 168.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 168.00 | 168.00 | 2021 |
| WC-2021-11616 | WC | 11/4/21 | 11/4/21 | Closed | The employee stated that this has been on going for about 6-8 months. The employee always felt soreness and pain in his left shoulder. This is due to wear and tear of job duties. | 1,590.84 | 1,590.84 | 349.07 | 349.07 | 0.00 | 0.00 | 306.34 | 306.34 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 2,246.25 | 2,246.25 | 2021 |
| WC-2021-10454 | WC | 11/5/21 | 11/5/21 | Closed | The injured employee was using a vibrating scaler. As she picked up another tool, she cut her left index finger on the vibrating scaler. | 3,607.03 | 3,607.03 | 397.15 | 397.15 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 4,004.18 | 4,004.18 | 2021 |
| WC-2021-10862 | WC | 11/5/21 | 11/5/21 | Closed | The employee spends much time on the computer. She has had pain in her left wrist/hand for a while. It became worse on 11/5/21. | 0.00 | 0.00 | 168.00 | 168.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 168.00 | 168.00 | 2021 |
| WC-2021-10489 | WC | 11/6/21 | 11/6/21 | Closed | The employee got exposed to COVID19 on 11/06/2021; he started having symptoms of COVID19 on 11/10/2021. He took the COVID19 test on 11/10/2021 and test results came out positive on 11/11/2021. He was placed on quarantine on 11/11/2021. |
| 0.00 | 0.00 | 168.00 | 168.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 168.00 | 168.00 | 2021 | |||||||
| WC-2021-10453 | WC | 11/7/21 | 11/7/21 | Closed | The injured employee was training with extraction procedure when a shield hit his right hand. | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 2021 | |
| WC-2021-10459 | WC | 11/8/21 | 11/8/21 | Closed | The employee was standing on a step ladder to put a wall clock on the wall. The clock was too high and she twisted her upper back. She has pain to the center of the back below her shoulder blades. | 0.00 | 0.00 | 18.00 | 18.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 0.00 | 18.00 | 18.00 | 2021 | |
| WC-2021-10520 | WC | 11/9/21 | 11/9/21 | Closed | The injured worker states that her vehicle was hit by a big rig truck that was not able to stop. Her vehicle was totaled and she has multiple | ||||||||||||||||||
| cuts in her arms due to her vehicle's shattered glass. | 15,193.37 | 15,193.37 | 6,468.93 | 6,468.93 | 55,641.53 | 55,641.53 | 11,798.21 | 11,798.21 | 0.00 | 0.00 | 0.00 | 0.00 | -5,175.00 | -5,175.00 | 94,277.04 | 94,277.04 | 2021 | ||||||
| WC-2021-10476 | WC | 11/10/21 | 11/10/21 | Reopen | The employee was running after a suspect when he felt a pull in his hamstring. He also heard a pop in his quad muscle. | 9,861.47 | 18,517.21 | 2,964.46 | 2,964.46 | 88,649.72 | 88,649.74 | 343.19 | 343.19 | 0.00 | 4,113.63 | 0.00 | 0.00 | 0.00 | 0.00 | 114,588.23 | 101,818.84 | 2021 |
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