WORKERS COMPENSATION HR ADMINISTRATIVE PROCESS TRAINING NOVEMBER 2014

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1 WORKERS COMPENSATION HR ADMINISTRATIVE PROCESS TRAINING NOVEMBER 2014

2 WORKERS' DISABILITY COMPENSATION ACT Michigan's injured workers and their employers are governed by the Workers' Disability Compensation Act Provides compensation to workers who suffer an injury on the job and protects employers' liability Laws also contain anti-retaliation provisions.

3 EMPLOYER RESPONSIBILITY Provide some way of assuring that benefits are paid to its workers if they become injured while on the job. Purchase insurance policy from a private insurance company. Self-insured status Group or State Fund

4 THIRD PARTY ADMINISTRATOR (TPA) CompOne Administrators Inc. Process and pay claims Manage care of injured employees Authorize treatments Including but not limited to: PT, surgery, durable medical equipment Process work comp wages to injured employees Along with the Medical Providers determine whether injuries/illnesses qualify as WC claims

5 INJURIES ARISING OUT OF AND IN THE COURSE OF EMPLOYMENT Workers compensation laws contain a coverage formula which states that in order to be compensable, an injury must arise out of and in the course of employment Arising out of employment refers to the cause and origin of the injury In the course of employment refers to the time, place, and circumstances of the injury

6 WHAT TO DO WHEN ON-THE-JOB ACCIDENTS HAPPEN Supervisors must treat every on-the-job accident as legitimate and do the following: Promptly provide first aid and/or direct the employee to seek emergency medical treatment depending on circumstances Contact HR Obtain facts from the employee about the accident Investigate and document the accident as soon as possible -Preferably within 24 hours.

7 REPORTING AN INJURY If the injury or illness is job related it must be reported. An injury or illness that is determined to be job related will be covered by Workers Compensation Law, this includes: Medical Loss time expenses The compensation received will be determined under State law by Comp One and the Medical Providers

8 PROCESS FOR REPORTING AN INJURY Complete the Supervisor s Accident Report Form (SARF) Employee: Personal Accident Report Form (PARF) Submit completed forms to Human Resources. If possible within24hrs.

9 SUPERVISOR ACCIDENT REPORT FORM (SARF) Download Form 1. HR Homepage 2. Find HR Documents 3. Documents are arranged in alphabetical order

10 PERSONAL ACCIDENT REPORT FORM (PARF) Download Form 1. HR Homepage 2. Find HR Documents 3. Documents are arranged in alphabetical order

11 WHAT DOES HR DO? 1. SARF is received 2. Report is submitted to CompOne 3. CompOne provides a claim number 4. Provide claim number to UMS authorizing the first visit pertaining to this injury/accident

12 RECOVERY AND RETURN TO WORK Employee s speedy recovery and return to work are very important. To facilitate their return to work: -AU will attempt to make reasonable accommodations for them to continue their regular job. -If that is not possible, they may be given other responsibilities within the department or elsewhere in the University

13 REASONABLE ACCOMMODATION "A reasonable accommodation is any modification or adjustment to a job or the work environment that will enable a qualified applicant or employee with a disability to participate in the application process or to perform essential job functions. Reasonable accommodation also includes adjustments to assure that a qualified individual with a disability has rights and privileges in employment equal to those of employees without disabilities." USDOJ (Department of Justice)

14 RETURNING TO WORK When the employee returns, they must present a RTW note before beginning work! Comply with Workers Compensation Law Inform supervisor of restrictions set by physician Determine accommodation needed

15 WORKERS COMPENSATION PAYMENTS What determines payment? There is a 7-day waiting period. If an employee is off for 7 consecutive days, they are entitled to wage loss thereafter (on the 8th day) If the employee does not return to work within 14 business days they are entitled to reimbursement from the first day off of work Weekly benefits are roughly 80 percent of after-tax wages

16 WHERE CAN EMPLOYEES BE TREATED? University Medical Services Employees who sustain work related injuries or illnesses may not be treated by any other provider except University Medical Specialties, or providers they designate The law provides two exceptions to this rule: 1. Emergency medical treatment where a hospital emergency room is required 2. Ten days or more after the injury or illness was reported, an employee may seek treatment from the medical provider of his or her choice. This request for exception must be submitted in writing to the HR director prior to obtaining the desired treatment.

17 Contact Workers Compensation Extension 3886