The document outlines the procedures for managing workers' compensation claims, including steps for injury reporting, initial treatment, and returning to work. It emphasizes the importance of prompt reporting to minimize costs and gives detailed instructions for submitting necessary forms to both AlphaStaff’s risk department and the insurance carrier. Additional resources and contacts for compliance and support are also provided.

1. 800 Corporate Drive, Ste 600 Ft. Lauderdale, FL 33334 | 888.335.9545 Toll-Free | alphastaff.com
2013 Webinar Series
Workers Compensation Claims
Thursday: May 16, 2013
Presented by Norma Lango, ACA
Senior Claims Specialist
AlphaStaff

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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
• Contacts
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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 Packet
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STATE POSTING REQUIREMENTS
Post the State Workers’ Compensation poster and the medical panel (list of
medical facilities) in a conspicuous place where all employees can see it.
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WHAT TO DO PRIOR TO AN INJURY
Inform Your Employees About Workers’ Compensation
Advise your employees:
• That an injury is covered under workers’ compensation if the
injury is job related.
• Job related means - the injury must arise out of employment or
occur during the course of employment.
• The workers’ compensation adjuster will determine if the injury is
compensable 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 designated
urgent care facility or hospital emergency department (depending
upon the severity).
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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 medical
panel.
• Give the injured employee an Employer Authorization for
Initial Treatment form and a Chain of Custody (“COC”) form.
• In the event of an acute injury call 911.
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INITIAL TREATMENT FORM & CHAIN OF CUSTODY FORM
• The Employer Authorization For Initial Treatment form must be given to the
injured employee to present at the medial facility (if possible).
• A Chain Of Custody form must be given to the injured employee to present
at the medical facility (if possible).
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REPORTING THE INJURY
• The employee’s supervisor/manager or other authorized personnel
must report all injuries/incidents to AlphaStaff’s Risk Department,
via the Employer’s Report of Injury/Illness (“ERI”), within 24 hours
of knowledge of an injury/incident.
• The supervisor/manager gathers facts about the incident and the
employee’s injuries then completes the ERI.
• Include as many details as possible including names of witnesses.
• Any doubts/questions regarding the injury should be documented
on the ERI.
• Once the ERI is completed the supervisor/manager can fax or email
it to AlphaStaff’s Risk Department. Fax: 866-632-6423 or Email:
wcclaims@alphastaff.com
• The supervisor/manager must report injuries/incidents even if the
employee refuses medical care; and/or does not want to file a workers’
compensation claim.
• Once the ERI is received, AlphaStaff promptly reports the injury/incident
to the workers’ compensation insurance carrier. Therefore Filing a claim.
Prompt reporting helps keep the overall claims cost down.
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EMPLOYER’S REPORT OF INJURY/ILLNESS (“ERI”)
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AFTER A CLAIM IS FILED
• The workers’ compensation carrier assigns an adjuster and a claim number
to the claim.
• In most cases the workers’ compensation adjuster will make initial contact
with the supervisor/ manager to gain additional information regarding the
employee’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 Action
Form (“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’s
handling of the claim and assist the client and the adjuster with any issues
that may arise relative to the claim.
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PHARMACY MANAGEMENT PROGRAM
• The workers’ compensation carrier
provides a pharmacy management
program through Carlisle Medical
Pharmacy network.
• A temporary Prescription Form
should be given to the claimant:
– Complete the temporary
prescription card.
– Carlisle’s customer service
number is 800-553-1783.
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RETURNING TO WORK
Employee’s Responsibilities:
– After each doctors visit, the claimant must provide his supervisor/ manager
with a work status report/note from the authorized treating physician. The
report/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 employer
offers a position within the physical restrictions/limitations.
Employer’s Responsibilities:
– Every effort should be made to accommodate the claimant’s light duty
restrictions.
– The benefits of accommodating light duty include:
• Promotion of rehabilitation and recovery.
• Gives the employer the opportunity to demonstrate concern for the
claimant’s well-being.
• Improves the morale of the claimant.
• Keeps workers’ compensation claims cost down.
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OTHER NOTIFICATIONS
• Family Medical Leave (aka FMLA)
runs concurrent with workers
compensation. When an employee
misses three or more days off of
work complete a Personnel Action
Form (PAF) and email or fax the
completed form to your AlphaStaff
HR Account Manager, Payroll
Specialist and/or to the AlphaStaff
HR Service Center, email:
HRSC@alphastaff.com
– If you have questions regarding this
form call the HR Service Center at
888-335-9545 option “8”.
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SUMMARY
• Advise your employee’s that work related injuries must be reported immediately to
their 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 a
Chain of Custody form with him/her to the medical facility.
• Within 24 hours of your knowledge of an injury, gather the facts about the injury
and complete both pages of the ERI.
• Fax or email the ERI to AlphaStaff’s Risk Department, fax # 866-632-6423 or
wcclaims@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 Personnel
Action Form (“PAF”) and submit it to your designated AlphaStaff HR Account Manager,
Payroll Specialist and/or to the HR Service Center.
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CONTACTS
AlphaStaff’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.com
AlphaStaff’s HR Department:
• HR Service Center Phone #: 888-335-9545 option “8” /
Fax #: 866-632-8157 / Email: HRSC@alphastaff.com
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Conclusion
Questions?
Thoughts?
Napping?
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Contact Us !
• .
Copies of the presentation
hrsc@alphstaff.com
888-335-9545 (Option 8)

18. Upcoming AlphaStaff Webinars
Please mark your calendars !!!
Date: Thursday, May 31, 2013
Topic: Recent NLRB Rulings and Their
Impact on Non-Union Employers
Date: Thursday, June 20, 2013
Topic: Employee Assistance Program
Overview and Supervisory Awareness
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Thank you for your participation!
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