IMPORTANT TERMS. See Slide 20 for Contact Information

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2 IMPORTANT TERMS Workers Compensation Law F.S. 440 Self-Insured vs. Insurance Company We re Self-Insured to $200K Third Party Claims Administrator (TPA) Johns Eastern Company, Inc. Lost Time Adjuster: Medical Only Adjuster: Medical Case Manager Injury Leave Full pay during first days off from work Wage Loss (Indemnity) Benefits 66 2/3 % of 13 WK AWW Supplemental Pay Optional - up to 33 1/3 % Sick or Vacation Pay Alternate Duty Return to work with physical restrictions See Slide 20 for Contact Information 2

3 EFFECTIVE MAY 1, 2014 Do not send injured employees to the nurse at City Hall. 3

4 STEP 1 REPORTING INJURY Employee reports injury/occupational disease to Supervisor immediately. 4

5 STEP 2 EMERGENCY OR ROUTINE? For an emergency requiring immediate medical treatment, Supervisor calls 911 Chest Pains Shortness of Breath Unconsciousness Seizures Fractures Stroke Loss of Vision Loss of Hearing Paralysis Severe Bleeding Injuries Involving Multiple Body Parts For a serious injury, but not serious enough to require an ambulance, Supervisor calls ahead and transports employee directly to the pre-designated medical care provider. For a non-emergency injury, Supervisor transports or sends injured employee to his administrative office for processing. 5

6 STEP 3 ON-LINE FIRST REPORT INTAKE SYSTEM Supervisor or other designated administrative employee enters Notice of Injury (DWC-1) by entering the employee number and completing the questionnaire on the Johns Eastern Website. Specialized training provided! 6

7 STEP 4 - FORMS GENERATED FOR PRINTING Completed First Report of Injury (DWC -1) Authorization For Release Of Medical Information Form Temporary Pharmacy Card 7

8 STEP 5 SIGN FORMS & SEND TO DOCTOR Employee signs DWC-1 First Report of Injury Form and the Authorization For Release Of Medical Information Form, is given copies of the DWC-1 and Authorization For Release Of Medical Information Forms and the original Temporary Pharmacy Card, and is then sent (or transported, if appropriate) to the City s pre-designated medical care provider. Note: The Workers Compensation Payroll And Injury Leave Form, where the injured worker elects to or not to supplement workers compensation leave with their sick or vacation leave, should also be completed and signed at this time. Copies of the signed DWC-1 and Release Of Medical Information Forms are E- mailed to Johns Eastern wcfax@johnseastern.com Example Forms on Slides 9, 10, 11, & 12 Authorized Providers on Slide 13 8

9 DWC-1 Form If the on-line system is unavailable, the DWC-1 Form can be completed by hand and faxed to Johns Eastern at (813)

10 Authorization for Release of Medical Information Form 10

11 Temporary Pharmacy Card 11

12 12

13 PRE-DESIGNATED MEDICAL CARE PROVIDERS For General Non-Life Threatening Injuries: Dr. Steven Badolato at Premier Urgent Care 6300 N. Wickham Rd, Melbourne, FL Monday thru Friday 8:00 AM to 7:00 PM and Saturday Sunday 8:00 AM to 5:00 PM. Supervisor must call ahead to their Work Comp Coordinator, Wendy at , or, if she is not available, to their Office Manager, Cristina at Dr. Krishna Kris Vara, M.D., M.P.H. at Melbourne Urgent Care 395 South Wickham Road, (Next to McDonalds) Melbourne, FL Use this doctor only Monday thru Thursday 8:00 AM 6:00 PM. Phone No need to call ahead, but the injured employee should have the treatment authorization form or Melbourne employee ID. For Eye Injuries: Florida Eye Associates, 502 E. New Haven Ave., Melbourne, FL Supervisor must call ahead to After Hours: Holmes Regional Medical Center Emergency Room, 1350 S. Hickory Street, Melbourne, FL 32901; Phone

14 WHAT TO SAY TO MEDICAL CARE PROVIDER I am a supervisor with the City of Melbourne and one of my employees has a Workers Compensation injury. He (sprained his back; cut his hand; injured his leg; got debris in his eye; etc.) and he needs to see the doctor as soon as possible. 14

15 STEP 6 - INVESTIGATION Supervisor conducts accident investigation and completes Supervisor s Investigation of Accident report using the National Safety Council s Guide for Identifying Causal Factors and Corrective Actions Supervisor sends a copy of the completed report to Risk Management. Supervisor addresses all corrective actions. 15

16 STEP 7 EMPLOYEE REPORTS BACK Employee receives initial medical treatment and brings brings b back his doctor s note (DWC- 25 Form) to his Supervisor, who reviews the employee s work status, s a copy of the doctor s note to Johns Eastern at wcfax@johnseastern.com and Risk Mgr. at jim.gallagher@mlbfl.org See DWC-25 Form on Slide 17 16

17 DWC-25 Form 17

18 STEP 8 - RETURN TO WORK OR ALTERNATE DUTY? If employee returns to work with no restrictions, Supervisor assigns regular duty work. If employee returns to work with restrictions, the Supervisor assigns temporary alternate duty within the injured employee s work restrictions. If alternate duty placement within the work restrictions is not available, Department Director notifies Risk Management. 18

19 STEP 9 CASE MANAGEMENT Johns Eastern Company s claims adjuster and medical case manager take over and communicate directly with the injured employee, the medical care providers, the employee s supervisor, Risk Management, and the City s defense attorney when claims are litigated. See Slide 20 for Adjusters & Medical Case Manager Contact Information 19

20 JOHNS EASTERN ADJUSTER & MEDICAL CASE MANAGER CONTACT INFORMATION Lost Time Claims Adjuster: Main Phone Number (800) Medical Only Claims Adjuster: Medical Case Manager: 20

21 STEP 10 OFF WORK / CODING TIME SHEET If employee is off from work, the Supervisor, or the department s pay clerk, completes the employee s time sheet using the appropriate pay codes for hours of injury leave, Workers Compensation indemnity pay, or supplemental sick or vacation leave and completes the Workers Compensation Payroll and Injury Leave Form. See special instructions on Slide s 22 thru

22 WORKERS COMPENSATION PAYROLL INFORMATION When an employee is injured the following payroll procedures apply: ALL EMPLOYEES The first day the employee is injured is considered regular pay. It doesn t matter what time of the day they were injured. This is paid at 100% regular pay. 7 CALENDAR DAYS OF INJURY LEAVE START THE DAY AFTER THE ACCIDENT DAY See Slide 22 for POLICE (PBA) See Slide 23 for FIRE (IAFF) See Slide 24 for Non Union & LIU that work 4 ten-hour days See Slide 25 for Non Union & LIU that work 5 eight-hour days See Slide 26 for FMLA and help contacts 22

23 POLICE (PBA-POLICE BENOEVOLENT ASSOCIATION) A unit member injured on the job will continue to be paid in full injury leave for subsequent missed shifts for the first seven (7) calendar days of absence. After the injured employee is out seven (7) calendar days, and is unable to return to work full or light duty, Workers Comp. starts at 66 2/3% of their salary the day after all injury leave has been dispersed. The employee may wish to supplement his/her check up to 33 1/3 % by using their sick or vacation leave. The employee may elect not to supplement their check and just receive the 66 2/3% pay. ***The exception to this rule is, if the police officer is injured by a malicious act, then the officer will get 100% pay. They would get 66 2/3 % from Workers Comp. and the other 33 1/3 % is paid as injury leave by the department any time they are out a scheduled shift. The Police Chief is the one who makes the determination in accordance with F.S (11) on whether the injury was the result of a malicious act. 23

24 FIRE (IAFF-INTERNATIONAL ASSOCIATION OF FIREFIGHTERS) A unit member injured on the job will continue to be paid in full injury leave for subsequent missed shifts for the first seven (7) calendar days of absence. After the injured employee is out seven (7) calendar days, and is unable to return to work full or light duty, Workers Comp. starts at 66 2/3% of their salary the day after all injury leave has been dispersed. The employee may wish to supplement his/her check up to 33 1/3 % by using their sick or vacation leave. The employee may elect not to supplement their check and just receive the 66 2/3% pay during the FMLA period. After the FMLA period has been exhausted the employee is required to supplement with accrued sick and vacation leave. 24

25 NON UNION & LIU (LABORERS INTERNATIONAL UNION) EMPLOYEES THAT WORK TEN OR TWELVE HOUR SHIFTS - Receive 4 work days as injury leave according to their next 4 scheduled shifts. After the injured employee is out 4 scheduled shifts, and is unable to return to work full or light duty, workers comp. starts at 66 2/3% of their salary after all injury leave has been dispersed. The employee may wish to supplement his/her check up to 33 1/3 % by using their sick or vacation leave. The employee may elect not to supplement their check and just receive the 66 2/3% pay during the FMLA period. After the FMLA period has been exhausted the employee is required to supplement with accrued sick and vacation leave. 25

26 NON UNION & LIU (LABORERS INTERNATIONAL UNION) - EMPLOYEES THAT WORK 5 EIGHT-HOUR DAYS Receive 5 work days of injury leave according to their next 5 scheduled work days. After the injured employee is out 5 scheduled work days, and is unable to return to work full or light duty, workers comp. starts at 66 2/3% of their salary after all injury leave has been dispersed. The employee may wish to supplement his/her check for all or part of the other 33 1/3 % by using their sick or vacation leave. The employee may elect not to supplement their check and just receive the 66 2/3% pay during the FMLA period. After the FMLA period has been exhausted the employee is required to supplement with accrued sick and vacation leave. 26

27 FMLA is any absence beyond 3 days for a serious health condition. This includes a Workers Compensation injury, and subsequent absences due to the injury. The FMLA allotment is 12 weeks annually for eligible employees. NOTE - There are no partial days paid as injury leave only full days! If an employee misses only part of their allotted number of injury leave days at the beginning of the claim the rest of the days are held for later use if needed on this claim. If they are not needed they are not used. Contact Benefits Coordinator at regarding FMLA eligibility. Contact Risk Management regarding Workers Compensation

28 BENEFITS OF THE NEW PROCESS It assures supervisors become immediately aware of accidents and injuries in their work areas and don t find out second hand. Supervisors are actively involved throughout the recovery process. Employees get the medical care they need without making trips back and forth to City Hall. 28

29 KEYS TO MANAGING COSTS ASSOCIATED WITH ON THE JOB INJURIES PROMPT REPORTING PROMPT INVESTIGATION ADDRESSING HAZARDS PROVIDE ALTERNATE DUTY 29

30 WHAT DO I NEED TO DO AS A SUPERVISOR? Get the word out that: 1. Employees are to report accidents and injuries to you immediately. 2. The nurse at City Hall is no longer the contact person for on-the-job injuries and that you will assist them in processing their paperwork and directing them to medical treatment. 3. Employees are to bring back their doctor s note (DWC-25 Form) to you after each appointment. 30