/10-+ NEW MEXICO DEPARTMENT OF TRANSPORTATION AD 805 12/08/11 WORKERS COMPENSATION INJURY MANAGEMENT Alvin C. Dominguez, P.E., Cabinet Secretary Supersedes Administrative Directive No. 805 dated December 04, 2006 AUTHORITY: 1.00 Americans with Disabilities Act; Chapter 52, Workers Compensation Act, NMSA 1978; Risk Management, Section 1.6.4 NMAC, and Chapter 7 of Title 1, the New Mexico State Personnel Board Rules. PURPOSE: 2.00 To provide policy and guidance for the administration concerning the Workers Compensation Act. DEFINITIONS: 3.00 Compensable claim means a claim that is filed by, or on behalf of, an employee with the Risk Management Bureau (RMB) for an injury that is compensable under the Workers Compensation Act, the injury of which is otherwise known as a compensable injury. 3.01 Modified Work Assignment means a temporary restriction of, or change in, the performance of the employee s normal work duties, or other alternative worksite accommodation, including but not limited to, a combination of duties from a variety of positions, that is implemented by the Department to accommodate the employee s medical restrictions that are expected to last less than one year. 3.02 SHARE Compensable Claim Codes means those codes that are to be used in the Department s Statewide Human Resources Accounting and Management Reporting System (SHARE) for tracking time and attendance for which an employee s pay is subject to the Workers Compensation Act, i.e., compensable claim hours, and includes: 3.02a WCMED: Workers Compensation Medical records those hours for an employee, who with a compensable injury, seeks
medical attention in accordance with the Workers Compensation Act. 3.02b WKRCP: Workers Compensation Paid records those hours an employee is paid in accordance with the Workers Compensation Act. 3.03 Workers Compensation Act means the law that is the exclusive remedy for any compensable claim. DIRECTIVE: 4.00 The Department shall comply with the Workers Compensation Act to provide necessary benefits and support for its employees, whose health and safety is of the utmost importance. PROCEDURES: 4.01 For purposes of promoting the return to work of an employee with a compensable injury, employees and supervisors are directed to Administrative Directive (AD) 631, Modified Work Assignments, provided that reference to AD 631 herein pertains to only compensable injuries. 4.02 In coordination with the respective Risk Management Section, an employee with a compensable injury for which he or she is claiming hours using SHARE Compensable Claim Codes, and the employee s supervisor who is responsible for approving such SHARE Compensable Claim Codes, are to do so pursuant to Administrative Directive (AD) 305, Employee Time and Attendance Reporting. 4.03 Employees with a compensable claim must report their compensable claim hours (exception(s)) accurately using SHARE Compensable Claim Codes. An employee who fails to accurately report compensable claim hours has falsified time records. A supervisor who fails to verify, authorize or approve compensable claim hours accurately has falsified time records. Falsification of time records is a fourth degree felony in the State of New Mexico. General 5.00 The injury management process begins by following the hiring procedures outlined in Administrative Directives 617, Filling Vacant Positions and extends on through an employee s employment with the Department as further outlined below. Immediate Supervisor 5.01 Becomes familiar and complies with directives and procedures used for managing employees with compensable injuries, including those cross-referenced below. 5.02 Provides continuous reinforcement of training on work-related topics and procedures to follow in the event of a work-related accident or compensable injury. 5.03 Responds to and handles a compensable injury case using relevant procedures as set forth in Administrative Directive 631, Modified Work Assignments and Administrative Directive 601, Pre-Existing and Post-Employment Impairments, in coordination AD 805 2
with the respective Risk Management Section Safety Coordinator. 5.04 Maintains Department Directives and the NMDOT Safety Handbook in a location where employees can have access, in the event that employees do not regularly have access to INTRANS, or otherwise, assists employees on an as-needed basis to access Department Directives and the NMDOT Safety Handbook through INTRANS. 5.05 In coordination with the respective Risk Management Section Safety Coordinator, makes reasonable attempts to accommodate an employee with a compensable injury through modified work assignment into a productive position within their immediate work area and within the employee s current work restrictions as relevantly outlined in Administrative Directive No. 631, Modified Work Assignments and AD 601, Pre-Existing and Post-Employment Impairments. 5.06 Ensures that the employee s time and attendance is accurately accounted for using SHARE Compensable Claim Codes, and in accordance with the policy and procedures set forth in AD 305, Employee Time and Attendance Reporting. Employee 5.07 Becomes familiar and complies with procedures used for managing injuries, including those cross-referenced below. 5.08 Cooperates with those working to mitigate the compensable injury and return the employee to work as set forth in Administrative Directive 631, Modified Work Assignments and Administrative Directive 601, Pre-Existing and Post-Employment Impairments, and including but not limited to: 5.08a Coordinates relevant communication with the State Risk Management Division, Workers Compensation Bureau, through the Risk Management Section Safety Coordinator. 5.08b Assures that all documents obtaining medical care/benefits are true and factual. Intentional falsification may subject the offender to disciplinary action and possible criminal charges. 5.08c Takes Doctor Query Form No. A-833 to all medical evaluations concerning his or her compensable injury and has the treating physician complete and sign the Form. 5.08d Reports to the Risk Management Bureau on the same day of medical evaluation or the following business day to return a completed Form No. A-833 prior to returning to duty. 5.08e Informs the Risk Management Section of all diagnosis, prognosis, work restrictions, surgeries and any other medical information relative to their claim. 5.08f Complies with all medical rules and orders noted on Doctor Query Form No. A-833 as a condition of employment while on a modified work assignment. AD 805 3
5.08g Refusing or failing to submit the completed Doctor Query Form No. A-833 will not allow him/her to return to duty until the required written information is produced. Time away from work may be considered unauthorized leave and the employee may be subject to disciplinary action. 5.09 Ensures that his or her time and attendance is accurately accounted for using SHARE Compensable Claim Codes, and in accordance with the policy and procedures set forth in AD 305, Employee Time and Attendance Reporting. 5.10 Understands that pursuant to the New Mexico Workers Compensation Act, employees are prohibited from (1) engaging in any unsanitary or injurious practice that tends to imperil, retard or impair recovery or aggravate his/her compensable injury, or (2) refusing to submit to such medical or surgical treatment as is reasonably essential to promote his/her recovery. The possible consequences for either include: (1) workers compensation benefits may be reduced or suspended, and/or (2) the employee may be found to have failed to cooperate with those working to mitigate the compensable injury in violation of this Directive. Risk Management 5.11 Provides administrative support and training on work-related Section Safety topics and procedures to follow in the event of a work-related Coordinator accident or compensable injury. 5.12 Oversees compensable injury case management using relevant procedures as set forth in Administrative Directive 631, Modified Work Assignments and Administrative Directive 601, Pre- Existing and Post-Employment Impairments in coordination with the employee with the compensable injury and the immediate supervisor, and including but not limited to: 5.12a Assures the employee with the compensable claim is given a Doctor Query/Modified Work Agreement, Form No. A-833, with instructions to report back immediately following each doctor visit or the next business day prior to reporting to their assigned work area. 5.12b Reviews the employee s work restrictions and Doctor Query Form No. A-833 with the employee and the employee s immediate supervisor. 5.12c Reviews every case to determine if the injury arose out of and in the course of employment. Risk Management 5.13 Has authority to cross organizational lines to accomplish Bureau Chief statewide duties. (or Designee) AD 805 4
CROSS REFERENCES: 6.00 Administrative Directives (AD) AD 305, Employee Time & Attendance Reporting; AD 601, Pre-Existing and Post- Employment Physical Impairment; AD 617, Filling Vacant Positions; AD 631, Modified Work Assignments; and, AD 801, Reporting Accidents, Incidents and Potential Liability Claims; NMDOT Safety Handbook FORMS: 6.01 Form No. A-000E, Authorization for Release of Medical Information; Form No. A-833, Workers Compensation Doctor Query AD 805 5