Policy Text
Policy
1022Garden Grove Police Department
Policy Manual
Copyright Lexipol, LLC 2025/09/11, All Rights Reserved.
Published with permission by Garden Grove Police
DepartmentOccupational Disease and Work-Related Injury
Reporting - 1Occupational Disease and Work-Related Injury
Reporting
1022.1 PURPOSE AND SCOPE
The purpose of this policy is to provide guidance regarding the timely reporting of occupational
diseases, mental health issues, and work-related injuries.
1022.1.1 DEFINITIONS
Definitions related to this policy include:
Occupational disease or work-related injury - An injury, disease, or mental health issue arising
out of employment (Labor Code § 3208; Labor Code § 3208.3; Labor Code § 3212 et seq.).
1022.2 POLICY
The Garden Grove Police Department will address occupational diseases and work-related
injuries appropriately, and will comply with applicable state workers’ compensation requirements
(Labor Code § 3200 et seq.).
1022.3 RESPONSIBILITIES
1022.3.1 MEMBER RESPONSIBILITIES
Any member sustaining any occupational disease or work-related injury shall report such event
as soon as practicable, but within 24 hours, to a supervisor, and shall seek medical care when
appropriate (8 CCR 14300.35).
1022.3.2 SUPERVISOR RESPONSIBILITIES
A supervisor learning of any occupational disease or work-related injury should ensure the
member receives medical care as appropriate.
Supervisors shall ensure that required documents regarding workers’ compensation are
completed and forwarded promptly. Any related Citywide disease- or injury-reporting protocol shall
also be followed.
Supervisors shall determine whether the Major Incident Notification and Illness and Injury
Prevention policies apply and take additional action as required.
The supervisor shall provide the employee with the following:
(a)Garden Grove Accident Reporting form.
(b)The “Employee’s Claim for Worker’s Compensation Benefits” form.
(c)A Garden Grove Hospital Treatment Authorization Form or Coastal Occupational
Medical Group Treatment Authorization form, if medical treatment is required.
(d)Garden Grove Supervisor Accident Reporting Form
Garden Grove Police Department
Policy Manual
Occupational Disease and Work-Related Injury Reporting
Copyright Lexipol, LLC 2025/09/11, All Rights Reserved.
Published with permission by Garden Grove Police
DepartmentOccupational Disease and Work-Related Injury
Reporting - 2All required forms above can be found in the Records Division or downloaded from the City of
Garden Grove’s Intranet under the Human Resources section.
The supervisor must log the fact that the paperwork was given to the employee. This information
will be placed on the Injury on Duty log, located on the “P” drive of the Department’s computer
system.
It is the employee's responsibility to complete the forms and return them to a supervisor for
processing. The employee has the option of not completing the forms, thus not reporting the injury.
If returned, the supervisor shall immediately:
(a)Provide the employee with the temporary copy of the Employee’s Claim for Workers’
Compensation Benefits form.
(b)Send the original forms to the Division Commander or Watch Commander for review
and signature. The Division Commander or Watch Commander shall then forward the
original forms to the City’s Benefits Coordinator in the Human Resources Department
at City Hall.
(c)If the employee's injury requires medical treatment, then the employee shall obtain
medical care at the Garden Grove Hospital or Coastal Occupational Medical Group in
Tustin, unless prior authorization is obtained to be treated at another facility.
1022.3.3 BUREAU COMMANDER RESPONSIBILITIES
The Bureau Commander who receives a report of an occupational disease or work-related injury
should review the report for accuracy and determine what additional action should be taken. The
report shall then be forwarded to the Chief of Police, the City’s risk management entity, and
the Administrative Services Bureau Commander to ensure any required Division of Occupational
Health and Safety Administration (Cal/OSHA) reporting is made as required in the illness and
injury prevention plan identified in the Illness and Injury Prevention Policy.
1022.3.4 CHIEF OF POLICE RESPONSIBILITIES
The Chief of Police shall review and forward copies of the report to the Human Resources. Copies
of the report and related documents retained by the Department shall be filed in the member’s
confidential medical file.
1022.4 OTHER DISEASE OR INJURY
Diseases and injuries caused or occurring on-duty that do not qualify for workers’ compensation
reporting shall be documented on the designated report of injury form, which shall be signed
by a supervisor. A copy of the completed form shall be forwarded to the appropriate Bureau
Commander through the chain of command and a copy sent to the Administrative Services
Bureau Commander.
Unless the injury is extremely minor, this report shall be signed by the affected member, indicating
that he/she desired no medical attention at the time of the report. By signing, the member does
not preclude his/her ability to later seek medical attention.
Garden Grove Police Department
Policy Manual
Occupational Disease and Work-Related Injury Reporting
Copyright Lexipol, LLC 2025/09/11, All Rights Reserved.
Published with permission by Garden Grove Police
DepartmentOccupational Disease and Work-Related Injury
Reporting - 31022.5 SETTLEMENT OFFERS
When a member sustains an occupational disease or work-related injury that is caused by another
person and is subsequently contacted by that person, his/her agent, insurance company or
attorney and offered a settlement, the member shall take no action other than to submit a written
report of this contact to his/her supervisor as soon