MONTGOMERY COUNTY SELF-INSURANCE PROGRAM WORKERS' COMPENSATION

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1 MONTGOMERY COUNTY SELF-INSURANCE PROGRAM WORKERS' COMPENSATION INSTRUCTIONS FOR REPORTING WORK-RELATED INJURIES/ ILLNESSES SUPERVISOR'S The following steps should be followed by the supervisor when an employee work-related injury /illness occurs: 1. Arrange for immediate medical attention. To offer a PPO Physician you can: 0 Check the website at and click on PPO Network, or 0 Contact the Nurse Case Manager at , or 0 Locate an Immediate Care facility at click on Downloads and choose the Immediate Care listing. EMPLOYEES The Claims Management Process The following is a brief description of the flow process of a workers' compensation claim. 1. Injured employee or supervisor reports work injury to Security. Security faxes incident report to Rowena D'Souza, Risk Management. She then reports the injury to a claim reporting service and a claim number is generated. 2. The employee is free to seek treatment with a provider of their choice. It can be a walk-in clinic, emergency room or a personal physician. The first visit is covered by workers' compensation if the injury occurred while the employee was at work. 3. After the initial visit the employee should contact "CorVel" at ( ) to discuss future treatment. Use of managed care through "CorVel" ensures the college will reimburse the employee for lost time associated with the work injury at 100% of pay if the claim is deemed a compensable injury by "CorVel". 4. If the employee chooses not to utilize managed care and the claim is deemed compensable by "CorVel" the employee will be compensated for lost time at 66 2/3 % of pay in accordance with State law and reasonable medical bills associated with the injury will be paid.

2 KEY INFORMATION Rowena D'Souza, Risk manager at Montgomery College- Contact her at (240) to discuss any aspect of your workers' compensation claim. CorVel assigned to handle Montgomery College claims. Contact them at ( ) with questions about your claim. Address: Telephone: CORVEL CORPORATION P.O. BOX BALTIMORE, MD Fax: WC7157- State of Maryland Workers'Compensation ID number MCSIP Montgomery Comity Self- Insurance Program

3 WORKERS' COMPENSATION INFORMATION PACKAGE The Risk Management Office has received notification of your recent injury/illness. This letter provides information on what to expect in terms of the benefits you may be entitled to receive, and the procedures used to process your worker's compensation claim. It is important to us that your claim be processed promptly and efficiently. If you wish to discuss any aspect of your workers' compensation claim, call Rowena D'Souza, Risk Manager at (240) Montgomery College Office of Business Services WORKERS' COMPENSATION INFORMATION FOR INJURED EMPLOYEES Every employer in Maryland, with more than two employees, is required to provide Workers' Compensation coverage. Workers' Compensation benefits provide payment for lost wages as well as reasonable medical expenses incurred as a result of a work-related injury or illness. Maryland State Law requires payment of 66 2/3% of the average weekly wage during the period of incapacity. However, Montgomery College provides full wage protection for up to 12 months of documented disability for employees that work at least half-time with regular status (as opposed to temporary status) in a budgeted position on a continuing basis if they participate in the Managed Care Program The Risk Management Office administers the County's Workers' Compensation Program through a contracted claims service (CorVel). It is our goal to ensure that each injured employee receives high quality medical care, and prompt payment of benefits. When an employee sustains a non-life threatening injury at work they can be treated at any walk-in clinic and most minor injuries can be attended to at these clinics. In the case of serious injury the employee should be transported to the nearest emergency room. The individual should identify themselves as a Montgomery College employee and inform the clinic/hospital that they have sustained an injury at work. The employee should provide the clinic/hospital with the information in this packet thereby ensuring the clinic has adequate information to facilitate appropriate billing. Under the Workers' Compensation Law of Maryland you may choose your treating physician. Indicate to your physician that your injury is workrelated. If the claim is found to be compensable you will receive the State mandated benefit of 66 2/3% of your average weekly wage for time lost as well as reasonable medical expenses incurred as a resu lt of the work-injury or illness.

4 WHAT INFORMATION IS COLLECTED AND HOW IS IT USED You or your supervisor must report your injury/illness to the Office of Safety and Security. They take the report and fax it to Rowena D'Souza. Rowena D'Souza reports all claims to a claims reporting service which in turn reports all claims to the "Workers' Compensation Commission" and to a contracted claims service (CarVel) for processing. The claims service may contact you to obtain details about your claim, and to obtain information such as the name of your treating physician and treatment received. Providing this information will speed the processing of your claim. The claims service will share this information with the physician, other health providers, and your supervisor(s) as it relates to your ability to recover, receive benefits, and return to work. If you have questions about the information you are requested to provide, please call Rowena D'Souza, Risk Manager at (240) If your injury incapacitates you for more than three days, the claims service will provide you with a claim form. Completion of the form (M P C 1) is necessary to preserve your claim with the Maryland Workers' Compensation Commission, and you should mail it directly to the Commission. Under College regulations, you may be charged sick leave for the initial period of disability from work. However, if your injury/illness is determined to be covered by workers' compensation, the claims service will notify the College Office to credit any sick leave used in connection with the period of incapacity. YOUR RIGHTS AND RESPONSIBILITIES Under the Workers' Compensation Law of Maryland, you may choose your treating physician or you may choose to participate in the Managed Care Program. There are several benefits associated with participation in this Program. Employees who participate in Managed Care continue to receive full salary for lost wage benefits for up to 12 months; non-participants receive the State-mandated benefit of 66 2/3% of their average weekly wage. Employees may be assured of receiving prompt, quality medical care and that the treatment is appropriate. Further, for participants CorVel will pay for the initial medical care even if the claim is denied; medical treatment is paid for until the date of denial of the claim. The College may periodically request that you be seen by another doctor for a second opinion. If you wish to change treating physicians, you must obtain permission from the claims services before seeing the new physician. The College expects you to returnjo work when you are medically able to do so. You must comply with any activity restriction your physician has ordered. If you feel the job you are performing is not within your restrictions, speak with your supervisors as soon as possible to see if further modification of the job, or additional medical care, is necessary. 2

5 If you are released for work, and feel your injury or illness prevents you from working, you must alert your supervisor and the claims service as soon as possible, and have a written medical authorization from a physician. If you have questions or problems with any aspect of the benefits you are entitled to receive, or the claims process, call Rowena D'Souza, Risk Manager at (240) WHILE AWAY FROM WORK FOR ANY PERIOD OF TIME IT IS THE RESPONSIBILITY OF THE EMPLOYEE TO COMMUNICATE WITH THEIR SUPERVISOR ON A WEEKLY BASIS TO APPRISE THEM OF THEIR STATUS. IT IS THE RESPONSIBILITY OF THE INJURED/ILL EMPLOYEE TO COMMUNICATE WITH THE CLAIMS ADJUSTER AT "CORVEL" THAT IS HANDLING THEIR CLAIM. IF UPDATED MEDICAL INFORMATION IS REQUIRED THE EMPLOYEE MUST COOPERATE WITH THE CLAIMS SERVICE TO GET THE RECOMMENDED TREATMENT. Introduction MONTGOMERY COLLEGE WORKERS' COMPENSATION PROGRAM On July 1, 2012, CorVel assumed responsibility for the management of the Montgomery College Workers' Compensation Program. Caremark is responsible for managing pharmaceutical needs related to workers' compensation claims. There are 60,000 pharmacies in the Caremark network with many located in Montgomery County and the surrounding area. Garemarks first Fill Program allows injured workers the ability to obtain his or her first prescription without notification of a compensable claim. OneNet is one of the largest PPO providers in the Mid-Atlantic Region. With the use of a thorough credentialing process, there is comfort in knowing providers are committed to quality health care. Employees are encouraged to select providers from within the network. The Claims Management Process The following is a brief description of the flow process of a workers' compensation claim. 1. Injured employee or supervisor reports work injury to Security. Security faxes incident report to Rowena D'Souza, Risk Manager. She then reports the injury to a claim reporting service and a claim number is generated. 3

6 2. The employee is free to seek treatment with a provider of their choice. It can be a walk-in clinic, emergency room or a personal physician. The first visit is covered by workers' compensation if the injury occurred while the employee was at work. 3. After the initial visit the employee should contact "CarVel" at ( ) to discuss future treatment. Use of managed care through "CarVel" ensures the college will reimburse the employee for lost time associated with the work injury at 1 00% of pay if the claim is deemed a compensable injury by "CarVel". 4. If the employee chooses not to utilize managed care and the claim is deemed compensable by "CarVel" the employee will be compensated for lost time at 66 2/3 % of pay in accordance with State law and reasonable medical bills associated with the injury will be paid. KEY INFORMATION Rowena D'Souza, Risk manager at Montgomery College- Contact her at (240) to discuss any aspect of your workers' compensation claim. CorVel assigned to handle Montgomery College claims. Contact them at ( ) with questions about your claim. Address: Telephone: WC7157- CORVEL CORPORATION P.O. BOX BALTIMORE, MD Fax: State of Maryland Workers'Compensation ID number 4