WELCOME TO WORKERS COMP 101

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Eric Sims
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1 WELCOME TO WORKERS COMP 101

2 Risk Management Risk Management consists of five programs: Occupational Health Loss Prevention Insurance Liability Workers Compensation The City has self-insured and self-administered the Workers Compensation program since 1978

3 Self-Insured and Self- Administered The City is self-insured for workers compensation. Than means the City pays for the costs of on-the-job injuries. There is excess insurance coverage. And, the City is self-administered. That means all claims for workers compensation benefits are handled by city employees on the City Risk Workers Compensation Team

4 Workers Compensation Staff *Susan Cline-Quinones Workers Compensation Manager *Viki Bisby, AIC Senior Workers Compensation Disability Analyst *Debbie Lytle Senior Workers Compensation Disability Analyst *Melissa Schnell, ARM Workers Compensation Disability Analyst; Return to Work Specialist *Elizabeth Brandenburg Claims Technician

5 The Injured Worker Packet The packet contains: An 801 form to complete Injured Worker Guide Managed Care Organization (MCO) choice form Incident report form Employee responsibilities letter MCO information/locations Envelope for Attending Physician Access the injured worker packet at: Or obtain WC packets by calling option 2

6 What s an 801? This is the claim form required by the State of Workers Compensation regulator Oregon If medical treatment is sought for something that happened on-the-job, the 801 form needs to be completed right away. ONLY IF MEDICAL TREATMENT IS SOUGHT. The injured worker fills in information.. The worker s supervisor completes the form and turns it in to the City Risk Workers Compensation team

7 Supervisor Responsibilities Complete the Incident Report and 801 with employee (NOTE: 801 FORM IS ONLY REQUIRED IF THERE IS MEDICAL TREATMENT BEYOND FIRST AID) Timely report to Safety Manager AND City Risk- within 12 hours of notice. Fax to Risk (503) , If OSHA reportable, Safety Manager or designee MUST report to OR-OSHA within 24 hours. Document witness names and statements TAKE PICTURES, if possible. Report third party liability concerns with City Risk Call City Risk if you have would like to report concerns verbally

8 Employee Responsibilities Report Injury or Illness to Supervisor immediately! If seeking medical treatment, provide physician with envelope in the claim packet, or if not available, inform the medical provider that the City has a return to work program with the possibility of transitional duty Cooperate with the claim investigation and ongoing claim process Obtain a work status from the medical provider after each appointment noting any restrictions. Provide to supervisor AND Risk Management. If offered medically approved transitional duty, return to work Actively discuss claim questions/concerns with the claim analyst Follow Bureau policy regarding absences while on transitional duty assignment

9 City of Portland HR Admin Rule 7.08 Transitional duty assignments are generally up to 90 calendar days, except they may be extended by mutual documented agreement between the Bureau and City Risk. The injured worker is paid at the same rate as job at injury while on transitional work

10 City of Portland Early Return-to-Work Program Assist injured workers who are temporarily unable to perform all the essential functions of their job at injury to return to suitable transitional work as soon as possible Studies show that an early return to transitional work decreases claim costs and increases the likelihood of a full release and return to regular work

11 Benefits of an Early Return to Work Program The State of Oregon Workers Compensation Employer at Injury Program has reimbursed the City of Portland more than $325,000 annually for wages, tools, equipment and training The Bureaus reap the benefits of the tools, equipment and training, and may reduce claim frequency in the future

12 Employer At Injury Program (EAIP) WCD Reimbursements for: Wage Subsidy Worksite Modifications Tools, Equipment and Consumables Clothing Training

13 Employer At Injury Program Eligibility The worker must have an accepted or deferred Oregon Workers Compensation injury or occupational disease claim at the time of the Employer-At-Injury Program All Worksite Modifications and Employer at Injury Purchases must be ordered while the worker is performing their transitional duty assignment

14 Employer At Injury Program Benefits Wage Reimbursement: 50% of gross wages 45% of gross wages post 7/1/2013 Maximum 66 transitional work days and must be completed within a 24 consecutive month period Worksite Modification: This is altering a work site by renting, purchasing, modifying, or supplementing equipment to enable a worker to perform the transitional work within their limitations

15 Employer At Injury Program MORE Benefits EAIP Purchases: Tools and equipment required for the worker to perform transitional work Consumables means purchases required to support the functioning of tools or equipment utilized during transitional work Additional EAIP Purchases: Tuition, Books and Fees: to enhance the worker s existing skill or develop a new skill. Maximum expenditure is $1, Clothing required for the transitional duty except what the employer normally provides. Maximum reimbursement is $400.00

16 Job Analysis Pursuant to (5)(d) the attending physician will need an accurate description of the physical requirements of the worker s job held at the time of injury to evaluate the injured workers claim for closure. City Risk will determine if a job analysis is needed. Scheduling of the date/place and time needs to be a priority for the Bureau. Please note the job classifications specifications are not sufficient for this requirement.

17 Best Practices Identify and create a bank of transitional duty job assignments with physical description of tasks Return employees to transitional duty following employee injury or illness as soon as possible. Supervise employee to ensure compliance with medical restrictions and expectations of transitional work assignment Report immediately to City Risk any change in work status Identify tools and equipment that may be beneficial for the worker and employer in returning a worker to transitional duty

18 FREQUENTLY ASKED QUESTIONS For supervisors, managers and employees: GO TO: omf/wcprogram

Integrating Resources for Return to Work After Industrial Injuries

Integrating Resources for Return to Work After Industrial Injuries Bob Williams, MSIR Worksite Modification Consultant Oregon Preferred Worker Program Why look for strategic ways to restore our economy