| How To File A Claim | |
| To file a claim for benefits, an employee should first notify his or her supervisor and home department coordinator of the disability. There are two ways to file a claim. | |
| 1) | Currently the online reporting is not available. |
| 2) | Call the university's disability administrator Sedgwick CMS at (800) 495-2315. |
| A Claims Intake Specialist will require the following information: | |
| 1. | Social Security Number |
| 2. | Employee Number |
| 3. | Name |
| 4. | Home Address |
| 5. | Telephone Number |
| 6. | Date of Hire |
| 7. | Employment Status (Full or Part-time) |
| 8. | Occupation/Job Title |
| 9. | Last Day Worked |
| 10. | Last Day Worked |
| 11. | Have You Returned to Work? |
| 12. | Description of Disability |
| 13. | Is the Disability Work-Related? |
| 14. | Have You Filed for Workers' Compensation? |
| 15. | Has a Previous Claim for the Same Disability Been Made? |
| 16. | If You are Confined to a Hospital, Name and Address |
| 17. | Dates of Confinement |
| 18. | Doctor's Name, Address, Phone & Fax Number |
| In addition, the employee's doctor will be required to call (800) 495-2315 to authorize the disability. While disabled, an employee will receive benefits on his/her usual university pay date. If the employee has arranged for direct deposit it will continue. | |
Disability 851 Downey Way HSH Los Angeles, California 90089-1058 Mail Code 1058 (213)740-5875