What We Do

1. What We Do Program Description: The Workers’ Compensation Program Office was developed in response to legislative and regulatory requirements directed towards providing medical services and related monetary benefits for TSA federal employees. The office is responsible for overall program management, administration and compliance. Provide technical advice, guidance and program support to supervisors, managers and Workers Compensation Coordinators regarding program requirements and compliance to federal laws and regulations. Plan, develop and implement programs and initiatives to control injury related costs with the intended focus to increase work-force readiness to support the TSA mission.

2. In the Beginning • 2002 – 2004 Old way of Doing Business • TSO performing Screening functions • Nov/Dec started screening bags • Claims filed increased substantially on yearly basis • All injuries required completion of Claim Forms • Automatic 45 days COP • 2005 New Initiatives • Electronic filing of Claim Forms • Creation of Optimization and Safety Teams • Identified Safety issues • Instituted Nurse Case Manager Program Pilot • Chargeback cost reached high of $58 M

3. TSA Workers Compensation/Medical Case Management Program • Brought private industry Best Practices to the federal sphere: • 24/7 Hotline • Early intervention • Ongoing case management to facilitate care and RTW • Provide limited duty • National roll-out 12/1/05

4. TSA Claims to DOL Trend Data * Includes Federal Air Marshal Service claims ** Through April 30, 1213 claims filing is down 296 claim when compared to SPLY.

5. TSA HISTORICAL COSTS OF INJURIES *45.4M is the projected End of Year OWCP Chargeback cost for FY13

6. The Facts

7. Claims Filing Process Overview

8. Workers’ Compensation Program Highlights • Theodore Roosevelt Award • TSA was awarded the 2009 Theodore Roosevelt Workers’ Compensation and Disability Management Award by Specialty Risk Services, LLC. Specialty Risk Services presents the award to companies, both government and non-profit, for their work to reduce the cost of injuries to employees while on the job. • Nurse Case Manager Program • The national nurse case management program was implemented to provide focus and direction for early medical intervention for injured employees. • Within 24 hours of notification of injury, a nurse case manager will contact the employee to offer support and assistance. • Through on-going contact, the nurse monitors the employee’s medical condition to ensure quality medical care to facilitate their medical progress and return to duty. • When implemented in 2005, the NCM decreased the average COP absence from an average of 45 days to an average of 12 days. • FYHSP Goals • Traumatic Injury Leave is authorized when an employee sustains a work-related traumatic injury and the injured worker’s physician certifies that the employee is unable to work or TSA fails to provide limited duty work during the first forty-five (45) days following the injury. The percent decrease represents salary compensation paid to employees for lost time associated with traumatic injuries.

9. Program Initiatives • Prescription Network (Pharmacy Benefit Management or PBM) • Benefits provided by the prescription network will include: • A proven first fill program with no out-of-pocket expense for the injured employees; • Point-of-Sale Drug Utilization Review; • Provides two (2) levels of clinical review to protect the agency and the injured staff member;  and • In addition, the program assesses proper dosing, frequency, drug interactions, and medication use related to the identified injury.   • The PBM will provide prescription medication through the network provider for reduced costs to the agency. Express Scripts is the prescription network provider. Prescriptions may be obtained by staff from local retailers nationwide such as CVS, Wal-Mart, Walgreen’s, Rite Aid or Giant. • Currently 80% of airports with open workers’ compensation claims utilize PBM services

10. Program Initiatives • Workers’ Compensation Coordinator Training • Conducted monthly “Best Practice” training teleconferences with Workers’ Compensation Coordinators (WCC) to review current medical case management strategies i.e., Role of the Nurse Case Manager, Understanding Shoulder Injuries, Optimizing the use of local Occupational Health Clinics, Interventional Pain Management and host of other case management topics. • Since April 2007, monthly conference calls are conducted with an average attendance of 47 WCCs, HR Representatives and Field Counsels per month. • Ongoing training is also provided through visits to Headquarters and Airports • Program office conduct on-site Manager and Supervisor training at airports. The training covers the following topics; • Federal Employees Compensation Act (FECA) overview • Timely reporting injuries to the Injury Hotline • Completing workers’ compensation forms properly • Creating limited duty assignments • Properly recording Time and Attendance records

11. TSA HQ – WC Program’s Periodic Roll Review Goals and Objectives • Primary goal is to rehabilitate injured employees: • Return employees to work within TSA • If TSA cannot accommodate then refer to DOL Vocational Rehabilitation Program • Headquarters Program Manager, Workers Compensation Coordinator (WCC) and Nurse Case Manager conduct telephonic Medical Management Reviews • Utilization of all resources available to manage and document the WC file (AQS, ACS, WebOpus, SIS and WEEDS) • Conduct onsite visits with Department of Labor, Office of Workers’ Compensation District Offices • Develop ongoing working relationships with District Office Director and Personnel

12. Suggested ways to increase program effectiveness through DOL interaction • Voc Rehabilitation (Include both Federal Private Sector Job Searches in this process) • Work jointly with DOL to resolve complex clams management issues • Keep Adjudication Statistical data by agency • Prompt Job Suitability rulings

13. Contractor MCM CARE Unit • Developed In March 2011 • Evolved from the TSA Periodic Roll Initiative (PRI) and the impact of DOL visits by Ken Bates & MCA NCM (contractor) • Concentrated Action for Recovery, Employment and/or Case Resolution • Case review criteria is to be in a PR status for 9 months or longer

14. Collaborative PR Case Management Effort • Collaboration Between HQ, TSA PR Manager, Nurse Case Manager and Local WCC’s: • Conduct weekly Medical Management Meetings • Review available medical documents • Review Chargeback, ACS, AQS for current status and treatment • Identify records needed (SECOP, current medical) • review case at District office and obtain necessary documents

15. MCM CARE Unit Case Resolution

16. Visits to DOL by Periodic Roll Team • Responsibility of Care Unit Nurse and the TSA HQ PR Manager: • Obtain TSA Medical Director Review to interpret medical evidence, review for discrepancies, and provide recommendations • Thorough case review (Initial, Secondary, Final) • Develop detailed One page Case Summaries • Prepare packet for District Director (deliver NLT 2 weeks prior to visit) • Case reviews with selected personnel (i.e. DD, ADD, supervisor or CE) • 45, 60, 90 day follow up with District Director

17. Periodic Roll Reviews Results • TSA and DOL are fully engaged improving working relationships • Continue improving case management practices and RTW methodologies • 262 cases have been reviewed during 8 District office visits, resulting in the resolution of 36 PR cases (14%) • Cost Savings as of 5/10/13 (36 resolved cases): • Monthly Comp prior to claim resolution : $72,268.62 • Monthly Comp after claim resolution : $4,698.13 • Estimated avoided cost to date: $1,021,270.18 • Estimated avoided future cost: $26,287,152.11

18. Workers’ Compensation Program Success Stories A TSO injured their left arm through excessive lifting in 2006. The Nurse Case Manager was involved in the case since the date of injury. Throughout this process, the Nurse Case Manager worked with the TSO, medical provider and the WCC. The TSO had surgery and was offered limited duty in 2009 and returned to work. The TSO went out again for surgery for the other elbow. There was a delay in the recovery time and TSO was scheduled for Second Opinion through DOL-OWCP. The TSO was offered another job offer which they ultimately accepted. TSO returned to work May 27, 2010. The Lifetime Cost Savings were $875,778.80. A TSO injured their lower back while lifting a bag onto a belt in 2006. There was Nurse Case Manager involvement from the date of injury. The TSO had surgery and was progressing slowly. The Nurse Case Manager kept in contact with both the TSO and the medical provider. There was a change in the medical provider based upon the TSO’s request. The TSO expressed an interest in returning to work. The TSO returned to work on April 26, 2010, with limitations. On August 13, 2010, the TSO was released to full duty with no restrictions. The Lifetime Cost Savings were $683,931.30. A TSO injured their lower back while twisting to load passenger contents onto the x-ray machine in 2004. The TSO ran the gamut of working limited duty, full duty, or was off -work over the past several years. The Nurse Case Manager assigned worked with the TSO, medical provider and WCC in an effort to bring resolution to the workers’ compensation case and to return the employee to productive employment. The TSO had surgery in 2008 . The TSO was returned to full duty with no restrictions on July 5, 2010. The Lifetime Cost Savings were $607,412.52

19. Questions