CLM-2026-0038
ApprovedEmployee lower back strain while lifting concrete forms at Lennar residential site, Lot 47. Employee transported to Sutter Medical, diagnosed with L4-L5 disc herniation.
$18,700
total incurred
Jan 15, 2026
Jan 16, 2026
Workers Compensation
WC-2026-005678
Workers Comp — Back Injury
Financial Summary
Location of Loss
Lennar Natomas Meadows, Lot 47 — 2847 Meadow Park Dr, Sacramento, CA
Activity Timeline
Injury occurred
Jan 15, 2026 at 10:20 AMEmployee Carlos Medina strained lower back lifting concrete forms (~85 lbs). Immediate sharp pain, unable to continue working.
Medical treatment
Jan 15, 2026 at 12:00 PMTransported to Sutter Medical Center. Diagnosed with L4-L5 disc herniation. Prescribed pain management and physical therapy.
Claim filed
Jan 16, 2026 at 8:00 AMDWC-1 form submitted. SCIF notified of workplace injury.
Adjuster assigned
Jan 18, 2026 at 2:00 PMRobert Hernandez assigned. Initial phone interview with employee completed.
Claim approved
Jan 22, 2026 at 9:00 AMClaim accepted. Temporary disability and medical benefits authorized.
TD payment issued
Jan 29, 2026 at 12:00 AMFirst temporary disability payment: $1,868.67 (2 weeks). Direct deposit to employee.
MRI results received
Feb 5, 2026 at 10:00 AMMRI confirms L4-L5 disc herniation. Neurosurgeon consultation recommended.
Medical payment
Feb 10, 2026 at 2:30 PMSutter Medical invoice paid: $4,280. Physical therapy authorized for 12 sessions.
TD payment issued
Feb 12, 2026 at 12:00 AMSecond temporary disability payment: $1,868.67 (2 weeks).
Claims Adjuster
Robert Hernandez
State Compensation Insurance Fund
Related Policy
Policy #: WC-2026-005678
Effective: Jan 1, 2026 — Jan 1, 2027
Premium: $34,200/yr
activeDocuments
Claim Report - CLM-2026-0038.pdf
957 KB
Medical Records - CLM-2026-0038.pdf
2051 KB