Worker’s Comp. Claims Reporting
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Worker’s Comp. Claims Reporting

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Timely injury reporting is a must! This webinar will cover the steps to follow in the event of a work place injury including an overview of the forms in your AlphaStaff Risk Kit. A few of the......

Timely injury reporting is a must! This webinar will cover the steps to follow in the event of a work place injury including an overview of the forms in your AlphaStaff Risk Kit. A few of the topics that will be covered are:

How to report the injury to AlphaStaff.
How to complete the necessary paperwork.
Understanding the claims handling process.

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  • 1. 800 Corporate Drive, Ste 600 Ft. Lauderdale, FL 33334 | 888.335.9545 Toll-Free | alphastaff.com2013 Webinar SeriesWorkers Compensation ClaimsThursday: May 16, 2013Presented by Norma Lango, ACASenior Claims SpecialistAlphaStaff
  • 2. Simplifying business. Benefiting people.AGENDA• AlphaStaff Risk Kit• State Posting Requirements• What To Do Prior To An Injury• What To Do In The Event Of An Injury• Initial Treatment Form And Chain Of Custody Form• Reporting The Injury• Employer’s Report of Work-Related Injury/Illness(“ERI”) Form• After A Claim Is Filed• Workers’ Compensation Pharmacy Program• Returning To Work• Other Notifications• Summary• Contacts2
  • 3. Simplifying business. Benefiting people.THE RISK KIT• Step-By-Step Claims Reporting Instructions• Employer’s Report Of Work-Related Injury/Illness(“ERI”) Form• Employer Authorization for Initial Medical Treatment Form• Workers’ Compensation Pharmacy Form• State Workers’ Compensation Poster• Medical Provider Panel• Certificate of Insurance Request Form• Safety & OSHA Packet3
  • 4. Simplifying business. Benefiting people.STATE POSTING REQUIREMENTSPost the State Workers’ Compensation poster and the medical panel (list ofmedical facilities) in a conspicuous place where all employees can see it.4
  • 5. Simplifying business. Benefiting people.WHAT TO DO PRIOR TO AN INJURYInform Your Employees About Workers’ CompensationAdvise your employees:• That an injury is covered under workers’ compensation if theinjury is job related.• Job related means - the injury must arise out of employment oroccur during the course of employment.• The workers’ compensation adjuster will determine if the injury iscompensable or not.• Who they need to report injuries too.• That work injuries must be reported immediately.• That initial medical treatment must be sought at a designatedurgent care facility or hospital emergency department (dependingupon the severity).5
  • 6. Simplifying business. Benefiting people.WHAT TO DO IN THE EVENT OF AN INJURY• Offer medical care/first aide to the injured employee.• Direct the employee to a medical facility listed on your medicalpanel.• Give the injured employee an Employer Authorization forInitial Treatment form and a Chain of Custody (“COC”) form.• In the event of an acute injury call 911.6
  • 7. Simplifying business. Benefiting people.INITIAL TREATMENT FORM & CHAIN OF CUSTODY FORM• The Employer Authorization For Initial Treatment form must be given to theinjured employee to present at the medial facility (if possible).• A Chain Of Custody form must be given to the injured employee to presentat the medical facility (if possible).7
  • 8. Simplifying business. Benefiting people.REPORTING THE INJURY• The employee’s supervisor/manager or other authorized personnelmust report all injuries/incidents to AlphaStaff’s Risk Department,via the Employer’s Report of Injury/Illness (“ERI”), within 24 hoursof knowledge of an injury/incident.• The supervisor/manager gathers facts about the incident and theemployee’s injuries then completes the ERI.• Include as many details as possible including names of witnesses.• Any doubts/questions regarding the injury should be documentedon the ERI.• Once the ERI is completed the supervisor/manager can fax or emailit to AlphaStaff’s Risk Department. Fax: 866-632-6423 or Email:wcclaims@alphastaff.com• The supervisor/manager must report injuries/incidents even if theemployee refuses medical care; and/or does not want to file a workers’compensation claim.• Once the ERI is received, AlphaStaff promptly reports the injury/incidentto the workers’ compensation insurance carrier. Therefore Filing a claim.Prompt reporting helps keep the overall claims cost down.8
  • 9. Simplifying business. Benefiting people.EMPLOYER’S REPORT OF INJURY/ILLNESS (“ERI”)9
  • 10. Simplifying business. Benefiting people.AFTER A CLAIM IS FILED• The workers’ compensation carrier assigns an adjuster and a claim numberto the claim.• In most cases the workers’ compensation adjuster will make initial contactwith the supervisor/ manager to gain additional information regarding theemployee’s work injury and return to work.• If the employee (“claimant”) is going to be off of work more than 3 days,the supervisor/manager must complete the AlphaStaff Personnel ActionForm (“PAF”) and submit it to their designated AlphaStaff Payroll Specialist,HR Account Manager, or to the HR Service Center.• The AlphaStaff Risk Specialist or Claims Specialist monitors the adjuster’shandling of the claim and assist the client and the adjuster with any issuesthat may arise relative to the claim.10
  • 11. Simplifying business. Benefiting people.PHARMACY MANAGEMENT PROGRAM• The workers’ compensation carrierprovides a pharmacy managementprogram through Carlisle MedicalPharmacy network.• A temporary Prescription Formshould be given to the claimant:– Complete the temporaryprescription card.– Carlisle’s customer servicenumber is 800-553-1783.11
  • 12. Simplifying business. Benefiting people.RETURNING TO WORKEmployee’s Responsibilities:– After each doctors visit, the claimant must provide his supervisor/ managerwith a work status report/note from the authorized treating physician. Thereport/note should specify any physical restrictions/ limitations, work status,and follow up appointments.– Keep all follow up doctor and physical therapy appointments.– Return to work when released by the physician and when the employeroffers a position within the physical restrictions/limitations.Employer’s Responsibilities:– Every effort should be made to accommodate the claimant’s light dutyrestrictions.– The benefits of accommodating light duty include:• Promotion of rehabilitation and recovery.• Gives the employer the opportunity to demonstrate concern for theclaimant’s well-being.• Improves the morale of the claimant.• Keeps workers’ compensation claims cost down.12
  • 13. Simplifying business. Benefiting people.OTHER NOTIFICATIONS• Family Medical Leave (aka FMLA)runs concurrent with workerscompensation. When an employeemisses three or more days off ofwork complete a Personnel ActionForm (PAF) and email or fax thecompleted form to your AlphaStaffHR Account Manager, PayrollSpecialist and/or to the AlphaStaffHR Service Center, email:HRSC@alphastaff.com– If you have questions regarding thisform call the HR Service Center at888-335-9545 option “8”.13
  • 14. Simplifying business. Benefiting people.SUMMARY• Advise your employee’s that work related injuries must be reported immediately totheir supervisor/manager or other authorized personnel.• Direct the employee to a medical facility.• Make sure the employee takes an Authorization for Initial Treatment form and aChain of Custody form with him/her to the medical facility.• Within 24 hours of your knowledge of an injury, gather the facts about the injuryand complete both pages of the ERI.• Fax or email the ERI to AlphaStaff’s Risk Department, fax # 866-632-6423 orwcclaims@alphastaff.com• Be sure to obtain a work status report/note from the claimant after every appointment.• Communicate with the employee during the course of their claim.• Make an effort to accommodate light duty work.• If the employee is going to be off of work more than 3 days, complete the PersonnelAction Form (“PAF”) and submit it to your designated AlphaStaff HR Account Manager,Payroll Specialist and/or to the HR Service Center.14
  • 15. Simplifying business. Benefiting people.CONTACTSAlphaStaff’s Risk Department:• Phone #: 888-335-9545 option “3” / Fax #: 866-632-6423 /Email: wcclaims@alphastaff.com• Risk Specialist: Extension 1491 (First point of contact in the Claims Department)• For Safety and OSHA questions: babdallah@alphastaff.com• For Certificate of Insurance Request: certificaterequest@alphastaff.comAlphaStaff’s HR Department:• HR Service Center Phone #: 888-335-9545 option “8” /Fax #: 866-632-8157 / Email: HRSC@alphastaff.com15
  • 16. Simplifying business. Benefiting people.ConclusionQuestions?Thoughts?Napping?16
  • 17. Simplifying business. Benefiting people.Contact Us !• .Copies of the presentationhrsc@alphstaff.com888-335-9545 (Option 8)
  • 18. Upcoming AlphaStaff WebinarsPlease mark your calendars !!!Date: Thursday, May 31, 2013Topic: Recent NLRB Rulings and TheirImpact on Non-Union EmployersDate: Thursday, June 20, 2013Topic: Employee Assistance ProgramOverview and Supervisory Awareness42
  • 19. Simplifying business. Benefiting people.Thank you for your participation!19