General Information

Contact Dept

  • Phone:
    (559) 600-1800
  • Fax:
    (559) 455-4788
  • Address:
    2220 Tulare Street, 14th Floor
    Fresno, CA 93721

Workers' Compensation

Welcome to the Workers' Compensation section of Risk Management's Website.  Included in this section are printed materials explaining Workers' Compensation. The materials explain how to file a claim if you are injured or contract an illness in the course of, and as a result of, your employment with the County. You will also find forms needed for reporting an injury. 

What is Workers' Compensation?

Workers' Compensation coverage guarantees automatic benefits to employees injured on the job or who incur a job-related illness. Potential benefits include medical, temporary and permanent disability payments, and job displacement benefits. Immediate benefits are in the form of medical care. You may also be entitled to temporary disability payments if you have an accepted claim and if an authorized physician takes you off work for more than three days.

The County of Fresno is self-insured for its Workers' Compensation Program. The County contracts with a Third Party Administrator (TPA) to help administer the program for us.

Our current TPA is:
Risico Claims Management, Inc.
P.O. Box 9783
Fresno, CA 93794-9783
(559) 277-4960

For questions regarding your claim, please contact Risico and/or the claim examiner at (559) 277-4960. If you have additional questions regarding medical concerns such as treatment plan, medications prescribed, utilization review denials, etc., contact the Nurse Advocate, Shawna Reberry, RN, (559) 256-4450 ext. 464.

As a county employee, if you have any questions regarding your Workers' Compensation claim, please read the Workers' Compensation Handbook and Frequently Asked Questions (FAQ) provided below.  This may help answer questions you have.  You may also secure a copy of this Handbook by contacting the Workers' Compensation Coordinator in your Department.  You should also read "How To File A Workers' Compensation Claim".  This document is included in the forms below. 

It is important all steps are followed when filing a claim.   If the reporting process is not complete, the County's Workers' Compensation Administrators cannot make decisions, approve extended medical treatment, or approve payment of benefits.  

FAQ's 

If you have questions regarding reporting a claim, please contact your supervisor, your Department's WC Coordinator, or Fresno County Risk Management, 600-1850.

The Claim Reporting Process

If you sustain a work related injury, immediately report the incident to your supervisor.  If you require medical attention, your supervisor will provide you a packet of information.  You must use the forms in the packet to appropriately report your claim.

The packet contains the following items:

Workers' Compensation Handbook for County Employees
How to File a Workers' Compensation Claim
Important Information Regarding the Intergration Program
Employee Claim Form
Receipt of Workers' Compensation Claim Information
Option to Decline Integration Form
Medical Treatment Authorization Form*

     Forms to be completed by employee and/or supervisor:  

  • Workers' Compensation Claim Form (DWC-1)
  • Receipt of Workers' Compensation Claim Information
  • Option to Decline Integration Form (Reverse side: Important Information Regarding the Integration Program)
  • Medical Treatment Authorization Form
  • First Fill Prescription Form

You may complete the necessary forms on line, print them, and provide them immediately to your supervisor. (Please do not e-mail the completed forms as we need printed copies.)

Step 1Begin by reading:

 Workers' Compensation Handbook for County Employees
How to File a Workers' Compensation Claim
Important Information Regarding the Integration Program   

Step 2:  Complete the appropriate forms:

Employee Claim Form (DWC-1) (Top Portion Only)  
Receipt of Workers' Compensation Claim Information  (Top Portion Only)
Option to Decline Integration Form 

* Note:  Your supervisor needs to sign and give you back the Medical Treatment Authorization Form.  Your supervisor should retain a copy of the treatment authorization form.

Additional Packet Items

Medical Provider Network Pamphlet
Medical Provider Network Pamphlet (Spanish)
Medical Provider Network Provider Directory* 
Disability Retirement Process    
False or Fraudulent Claim Warning 

First Fill Prescription

The attached form shall be used immediately after an injury to fill a prescription if perscribed

First Fill Prescription Form 

Bloodborne Pathogens and Tuberculosis Exposures

In the event of an exposure to blood or other potentially infectious material, the Communicable Disease Exposure Report shall be used to document the exposure. If the employee seeks medical treatment, the completed report shall be sent with the employee to the designated medical facility. See the form below for further instructions on completing the report. 

Communicable Disease Exposure Report


For Supervisors

To ensure that a work related injury or illness is being handled appropriately, the "Procedures for Supervisors" guide below will assist you in making sure that you have completed the correct steps.  Keep in mind that regardless of whether the employee needs medical attention or not, you need to complete the Supervisors Investigation Report (see below).  Complete recordation of the events helps you and your workers' compensation coordinator as they need this information to complete the Employers First Report of Occupational Injury Report (5020 form).

Procedures for Supervisors
Supervisors Investigation Report 
Medical Treatment Authorization Form 

Safety and Workers' Comp Coordinator List    
Accident Investigation Report for Inmate Workers

For Workers' Compensation Coordinators

Employers First Report of Occupational Injury (5020 form)  
Role of the Workers' Compensation Coordinator 
Workers' Compensation Coordinator OJI Checklist

Workers' Compensation Fraud  

Fraud Hotline   

The Hotline provides County employees and citizens a way to report fraudulent workers compensation activity by County of Fresno government employees. Callers are not required to identify themselves.  

County of Fresno Fraud Hotline Page

Useful Links

Useful Links Page