Worker s Compensation. What to do when an employee is injured at work.

Transcription

1 Worker s Compensation What to do when an employee is injured at work.

2 OCM BOCES is subject to New York State Worker s Compensation Law If an injury requires treatment by a medical provider, The BOCES must submit an Employer s Report of a Work Related Injury of Illness (Form C-2F)to our insurance carrier for that bill to be paid. No bill can be paid by our carrier unless this claim is on file. If treatment beyond the initial evaluation is required, our carrier must pre-approve the treatment. New York State has identified the 5 most common injuries and has specific guidelines on how those injuries must be treated. Our carrier is obligated by law to follow those guidelines.

3 The type and the severity of the injury dictate the documents required for reporting. All injuries require completion of a Worker s Compensation/Accident /Injury/Occupational Illness Report. This form can be found on our website under Personnel/Forms and under OCM BOCES Only/Forms. This is a fill in form that can be completed, saved and printed for signature. It is preferable that the form be typed as handwritten forms can be difficult to read. Throw out any old copies of forms and use only the form currently posted on the web. It has the most current required information and includes instructions for completion. The web form requires a sign off by the employee not only on the Accident/Injury Report, but also the accompanying instructions for completion.

4 If the injury requires medical treatment at a doctor s office, urgent care, emergency room, or any facility that will require payment of a billing, the employee must notify the treatment provider that this is a Worker s Compensation injury and billing should be made to our administrator: NCAComp, Inc. 14 Lafayette Square, Suite 700 Buffalo, NY Under no circumstances should the employee go for treatment and not notify us. If the situation allows, it is preferable that we are advised before treatment is rendered, but if the employee decides outside of work hours to pursue treatment, then we should be notified on the next business day after treatment is rendered. If any professional treatment is rendered (x-rays, prescription, stitches, referral to a specialist, etc) paperwork from the doctor s office, urgent care or ER must be provided to Donna Robillard in the Personnel Office. There are no exceptions. The type of treatment provided directly affects how the claim is reported to the Worker s Comp Board, our carrier and PESH (Public Employees Safety and Health Bureau) so specific details of treatment are absolutely necessary.

5 If the injury requires time away from work (other than the day of the injury) Personnel ( ) must be notified on the first day the employee is away from work and should be notified immediately when the employee returns to work. The employee must have a doctor s note removing them from work in order to be eligible for payment under the BOCES Worker s Compensation Salary Continuance policy. The employee cannot take themselves out of work. The employee s return to work requires authorization from their treating physician. Light duty return to work will be reviewed on a case by case basis based on the responsibilities of the employee and the restrictions placed by their doctor. No employee shall be allowed return to work light duty unless their supervisor and the Director of Personnel have reviewed their restrictions with regard to their responsibilities and our ability to provide them with work that does not violate those restrictions.

6 What to do when an injury occurs. First and foremost, get treatment if needed. If the injury does not require emergency treatment, the school nurse, if available, should evaluate the injury. The employee needs to complete the Worker s Comp Accident/Injury/Occupational Illness report and submit it to their supervisor for signature. If the employee is unable to complete the report the nurse or supervisor can do it for them. The supervisor will then submit the report to Personnel. If emergency treatment is necessary, notify Personnel ( ) immediately that the employee has been injured and is being transported for treatment.

7 How to complete the Accident Report The Worker s Comp Accident/Injury/Occupational Illness Report form includes instructions for completion. All fields must be completed as per the instructions. The employee must sign and date both page 1 and page 2 of the report. Both must be submitted to Personnel with any associated back-up. Under current reporting requirements all of these forms must be submitted to our carrier for reporting to other Federal and State agencies, even if treatment is not required, so accurate completion of all fields in critical.

8 How to complete the Accident Report When describing the injury be specific. Is the injury a bruise, contusion, abrasion, sprain, strain, etc. Be very specific about what body part is affected. Left knee, right elbow, left side of neck, upper thigh, etc. Were there any witnesses? If so, list complete names. The Worker s Compensation carrier may need to speak with them, depending on the severity of the injury. Be sure to give the name and physical address of the building where the injury occurred. We have staff in 80 buildings and are now required to report our injuries based on the location where the injury occurred.

9 How to complete the Accident Report If the employee seeks medical attention, be sure that is stated on the accident report and include the location and provider of treatment. (Any paperwork received from treatment should be attached to the accident report if treatment immediately follows the injury.) If the employee seeks treatment after the injury report has been submitted then they must notify Personnel immediately and supply copies of any paperwork related to the injury Personnel should receive copies of any ER/Urgent Care/Doctor s instructions, evaluations or follow-up requirements. The type of treatment received drives how the injury is reported to PESH, our carrier and the Worker s Comp Board. Specific information about the type of treatment received is critical.

10 A completed accident report Timely submission of accident reports is very important. We are required, by law, to report accidents that result in any type of treatment or lost time within 10 days of the injury. Failure to do so could result in fines for noncompliance of up to $2000 per incident. Please note that the employee must sign and date both the instruction page and the accident report. Both pages must be submitted to Personnel.

11 How to Report Time Lost Any follow up medical appointments for Worker s Comp should be reported on an Employee Leave Request and must have the appointment card or a script from the doctor, to verify the appointment. These leave requests must be forwarded to Personnel for entry into WinCap. Only the Personnel Office can enter Worker s Comp absences in WinCap. Based on the backup given, the appointment will be charged as either ½ day or one full day and applied to the available time for Worker s Compensation injuries per Board policy.

12 How to Report Time Lost When an employee is taken out of work due to the injury, Personnel ( ) should be notified on the first full day they are out. A phone call or from the supervisor s office is adequate. If the supervisor has a note from the employee it should be forwarded to Personnel immediately. The backup for the absence should be received no more than 3 days after the doctor has taken the employee out of work and should include the first date they are unable to work and an estimated return to work date or date of next follow up appointment. The employee or their doctor can mail, or fax the note to Personnel. If a medical provider s note is not on file, the absence days will be charged against the employee s sick time, until such time as a note is provided. The employee cannot take themselves out of work for a comp injury. They must have a doctor s note or the absence time will be charged to their personal sick time. The employee has a responsibility to maintain contact with their supervisor or the Personnel Dept with regard to their work status. Doctor s notes should be provided minimally every 2 months that indicate prognosis and estimated return to work date or date of next follow up appointment.

13 Documentation for Worker s Compensation Injuries can be mailed: OCM BOCES Personnel Henry Administration P O Box 4754 Syracuse, NY ed: drobillard@ocmboces.org faxed:

14 Summary In the case of any work related injury our focus should be to get the individual the treatment needed and get them back to work as quickly as possible. In order to accomplish this, accident reports must be filed with our carrier on a timely basis so that we can get them directly involved in the individual s treatment and recovery. For injuries that result in a one-time evaluation or short term treatment, filing the paperwork as quickly as possible allows our carrier to pay the bills associated with treatment. In either case prompt, accurate, and complete information is necessary to complete the process.