WELCOME TO WORKERS COMP 101

WELCOME TO

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

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’

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

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:

http://www.portlandonline.com/omf/WCProgram

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 …..

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) 823-6120, email:

[email protected]

• 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

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

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.

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

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

Employer At Injury Program (EAIP)

– Wage Subsidy

– Worksite Modifications

– Tools, Equipment and Consumables – Clothing

Employer At Injury Program Eligibility

Oregon Workers’ Compensation injury or occupational disease claim at the time of the Employer-At-Injury

Program

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:

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 $1,000.00

• Clothing required for the transitional duty except what the employer normally provides. Maximum

Job Analysis

Pursuant to 436-030-0015 (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

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

FREQUENTLY ASKED QUESTIONS

For supervisors, managers and employees:

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