Workers' Compensation

Secure Workers' Compensation Submission Form

Submit forms via our Secure Workers’ Compensation Submission Form (an OnBase/PolyDoc form).  Do not email or fax any documents that contain Social Security numbers or any other personally identifiable information.

Whether you are submitting the documents as the manager/designee or the injured worker, please log in using your Cal Poly Pomona credentials (BroncoName and password). Once you have logged in please complete the form and upload the proper documentation as prompted.