Workers Compensation 101. Laura Romaine WC Claims Program Consultant (800) ext. 8406

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1 Workers Compensation 101 Laura Romaine WC Claims Program Consultant (800) ext. 8406

2 Today s Objective Employer Responsibilities in WC Posting and Reporting State Required WC Forms Other Necessary WC Forms Real-life Samples and Questions

3 Required WC Postings Notice 6 - Notice of Coverage Ombudsman Notice Office of Employee Counsel Political Subdivision Medical Alliance or other Network Notice Notice 9 Only if Police or Security Guards are employed Notice 8 Required if there is an active construction site

4 Real Life Question 1 We require every employee speak and read fluent English, do I have to post in Spanish?

5 WC Postings Required in English and Spanish Must be in HR and every building Don t change size or wording

6 Real Life Question 2 We have each campus or department keep record of the injuries reported, is this a problem?

7 Record of Injuries Consists of a First Report of Injury (FROI) on all incidents and injuries reported or of which the Employer has knowledge Must include all FROI s for the last 5 years from the last day of the current month Upon request from the State must be produced within 10 days

8 When is an Injury Reported? An employee or someone acting in their behalf notifies a person in management, or in a position they are expected to report (ie secretary or nurse) If anyone in management or report position sees an incident or injury

9 The First Report of Injury Complete on every incident or injury reported or of which an Employer has knowledge Complete regardless of whether employee cooperates Employer form and should not be completed by injured employee Use Carrier FROI Online, DWC 1, IA-1, or DWC approved form

10 The First Report of Injury Must be completed in full and signed A copy of the FROI must be given to Employee with a copy of the Rights and Responsibilities

11 When to File with Your Carrier State Law requires the FROI be filed by the eighth day of: Employee loses one day of time due to an injury Occupational Disease Death of an Employee due to an work related injury or illness

12 Temporary Income Benefits TIBS are due when an employee is medically unable to work due to a compensable on the job injury. The first 7 calendar days of lost time is a mandatory waiting period. An employee is NOT paid under Workers Compensation for these days unless they miss 14 or more calendar days of time.

13 Temporary Income Benefits Workers Compensation pays: 70% of Average Weekly Wage for employees who make $8.50 or more an hour 75% of Average Weekly Wage for employees who make less than $8.50 an hour. (There is a 26 week maximum then it reduces to 70%.)

14 Election of Benefits If an Employee is missing time due to an injury on the job, he/she must be given a choice to use available leave. Assault leave must be coordinated with WC Claims Adjuster

15 Offsetting or Non-Offsetting Employee may elect to use all or none of available leave First 5-7 days of elected leave days will apply to waiting period Once waiting period is paid, TIBS pay 70(75)% and remaining leave is used to bring employee to 100% AWW Employee may elect to use all or none of available leave Once elected leave is exhausted TIBS pays 70(75)% AWW

16 Other FROI Papers Alliance Acknowledgement or other Medical Network Form First Fill/Progressive Medical Form

17 DWC 6 Supplemental Report Must be filed by the 3 rd day after Employee returns to work Employee starts losing additional lost time Must be filed by the 10 th day of Use of elected leave Earning more or less than pre-injury wage due to injury (modified duty) Employee resigns or is terminated

18 DWC 6 Supplemental Report Multipurpose form complete the areas applicable to reason you are filing The Injured Employee must receive a copy of every completed DWC 6 The DWC 6 is available to file online with convenient PIE worksheet

19 Wage Statement A Wage Statement must be filed with the carrier within 30 days of the earliest of: The employee s 8 th day of disability The date the employer is notified that the employee is entitled to income benefits The date of the employee s death as a result of a compensable injury A copy of the wage statement must be given to the employee

20 DWC 3 Wage Statement Non-School District Employers must file a standard DWC-3 Wage Statement. Report all gross pecuniary wages earned in 13 weeks prior to injury. Pecuniary are paid wages such as salary, piecework, allowances, bonuses or commissions Non-pecuniary are wages paid in forms other than money such as health insurance premiums, uniforms, laundry, housing, meals, etc

21 DWC 3 SD Wage Statement for School Districts Report the wages EARNED in a week rather than paid in a week. Determine average daily rate, i.e. the amount that would be deducted from salary if an employee was absent from work for and did not have any leave time available. Contract Employees include total value of contract, including any stipends the employee was earning or scheduled to receive, and any amount of TRS supplement the employee received in his paycheck. Be sure to include the number of days for the current school year. Non-Contract Employees include only wages earned 13 weeks prior to date of injury. Do not include any wages earned on or after date of injury.

22 DWC 3SD Continued REMEMBER: Only pecuniary wages are reportable. Fringe benefits such as health insurance are not included for school district employees. The Annual Wage Information must be completed for all employees, both Contract and Non-Contract. If not employed during any of the preceding 12 months insert NE (Not Employed) in the corresponding box. If no wages were earned during a month, insert 0

23 Review Post File FROI on every injury and incident Rights & Responsibilities Leave Election Form Medical Alliance Acknowledgement First Fill/Progressive Medical Update with DWC6 Supplemental Wage Statement either DWC 3 or DWC 3SD Employee must be copied on every FROI s, DWC 6, DWC 3SD

24 For More Information To file online, forms, reports and information Division of Workers Comp x.html

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