Safety and Workers’ Compensation

The Claremont Colleges Services (TCCS)

Short-Term Disability and Paid Family Leave Benefits:
(909) 607-7946, [email protected]
Workers’ Compensation Benefits:
(909) 607-9493, [email protected]

Safety Information and Reports

Workers’ Compensation Reports & Forms

Staff, Faculty and Student Employees: If you have an injury or illness that you believe is related to your work for Pitzer College, you are required to report it to your supervisor or the Human Resources Office as soon as it occurs. You are required to complete the Employee Report of Injury regarding the accident/incident causing your injury/illness:

Accident Reports for Work-Related Injuries and Illnesses: (required within 48 hours of the accident/injury or discovery of illness): Employee Report of Injury | Supervisor Report of Injury
Workers’ Compensation Claim Form (optional; required if receiving medical attention)
MPN (Medical Provider Network) Notice to Employees
- Aviso de la Red de Proveedores (MPN, por sus siglas en ingles)
Predesignation of Personal Physician (for work injuries/illnesses)
- Designacion Previa de Medico Particular (para lesiones/enfermedades laborales)
Your Worker’s Compensation Benefits
- Sus Beneficios de Compensacion Laboral
On-the-Job Injuries and Illnesses: What To Do

For questions regarding our workers’ compensation benefits or assistance in completing forms, please contact the Workers’ Compensation Administrator at TCCS, Elizabeth Torres, at (909) 607-9493, [email protected]