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Workers’ Compensation: Protecting our Workforce While Promoting Safety

DIVISION OF FINANCE. Workers’ Compensation: Protecting our Workforce While Promoting Safety. Texas A&M University, Human Resources. February 29, 2012. Today’s Topics. Brief history of Workers’ Compensation Cost of injuries to the University How a claim is processed Forms and more forms

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Workers’ Compensation: Protecting our Workforce While Promoting Safety

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  1. DIVISION OF FINANCE Workers’ Compensation:Protecting our Workforce While Promoting Safety Texas A&M University, Human Resources February 29, 2012

  2. Today’s Topics • Brief history of Workers’ Compensation • Cost of injuries to the University • How a claim is processed • Forms and more forms • Proper accident follow-up • Return to Work Program

  3. Workers’ Compensation Defined “Workers’ Compensation is a form of insurance specifically designed to provide medical payments and/or financial payments to employees on the payroll of the TAMU System who suffer work-related injuries, illnesses or death in the course and scope of their employment.”

  4. WCI Historical Overview • Germany: Developed world’s first true Workers’ Compensation Insurance system in 1884. • Prior to 1917: Most injured employees in the Unites States could pursue claims only through civil or tort law • Employee must prove employer malice or negligence resulted in injury • Employee burden difficult to prove in most cases, resulting in high number of judgments for employers • 1917 and later: States developed WCI System of compensation as a result of Supreme Court ruling • Today: WCI is administered on a state-by-state basis

  5. Office of Risk Management and Safety • Operates as a bona fide insurance agency • Adjusters – evaluate and determine whether or not an injury is compensable • Legal assistance – participates in appeal hearings, legal procedures, fraudulent investigations, and other proceedings where necessary • Injuries are referred to as “claims” • A documented accident at work does not necessarily mean the injury will be compensable

  6. Workers’ Compensation Process @ TAMU Department Department Department Department

  7. Communication is Important! Human Resources HR LIAISON 862-4971 Supervisor A Supervisor B Supervisor C Supervisor D

  8. TAMU System Components WCI Cost Per $100 of Payroll* Component FY 2008 FY 2010 Texas Forest Service (TFS) $ .90 .75* Commerce .50 .50 Corpus Christi .45 .25 Texas A&M University (TAMU) .25 .15* Kingsville .25 .15 Prairie View .20 .15 TEES .15 .05* Texarkana .10 .05 Texas Transportation Inst. .10 .05 *Example: $30K yearly TAMU employee = WCI premium of $3.75/month $30K yearly TFS employee = WCI premium of $18.75/month $30K yearly TEES employee = WCI premium of $1.25/month

  9. Claims and Lost Time @ Texas A&M University

  10. Environmental Health & Safety Mission • Provides services that promote a healthy and safe environment • Establishes safety procedures that apply to University and TAMUS employees

  11. Texas A&M University “Top 5” • Body Part Injuries: • Finger 11% • Arm 10% • Hand 10% • Back 9% • Knee 7% • Nature of injury: • Bruise/contusion 26% • Cut 15% • Strain 14% • Exposure 11% • Sprain 6%

  12. Safe Practices Are a Job Requirement! Safety is a job evaluation factor in performance evaluations – Uses best practices to assist in ensuring the safety and security of self and others. Competes safety training as necessary and follows applicable safety standards in the performance of his/her job duties. • Exemplary • Exceeds Expectations • Achieves • In Development or Needs Improvement • Unsatisfactory

  13. WCI Best Practices • Reduce medical costs and lost time accidents by implementing thorough training and safety programs • Following the Return to Work (RTW) Program to assist in returning the employee to his or her original position at full duty as soon an as safely as possible

  14. Safety Must Be a Priority! Workplace “Accident”: DINING http://www.youtube.com/watch?v=noFCekWiUGE&feature=related

  15. What are the benefits of WCI? • Reasonable medical costs paid if you are injured on the job • Income benefits replace part of your lost wages • Income benefits paid for permanent impairment from an on-the-job injury • Death benefits provided to your legal beneficiaries

  16. Workers’ Compensation Forms • First Report of Injury • Witness Statement • Request for Paid Leave • Supplemental • Wage Statement http://employees.tamu.edu/employees/benefits/leave/WorkersCompensation.aspx

  17. WCI Forms: Deadlines for Reporting • First Report of Injury Within 24 hours of accident • Witness Statements None; as soon as possible • Request for Paid Leave Form As soon as the injured employee begins to lose work time (“lost time” is defined as any period of lost time, minus the initial day of injury and the next scheduled shift). • Supplemental • Subsequent lost time (intermittent): within 24 hours of lost time • Resigns/terminates, salary change: within 24 hours of event • Wage Statement Immediately after 7th cumulative WCI missed day

  18. WCI Accident Follow-up • Administrative (paperwork) • First report of injury • Witness statement(s) (if applicable) • Request for Paid Leave (if applicable) • Supplemental (if applicable) • Wage statement (if applicable) • Incident Analysis (investigation) If Necessary • Gather facts • Analyze facts • Corrective action • Follow-up

  19. Incident Analysis: Gather Facts Example 1

  20. Incident Analysis: Gather Facts Example 2

  21. Incident Analysis: Gather Facts Example 3

  22. Incident Analysis: Gather Facts Example 4

  23. Early Return to Work Program • Objective: to return employees to safe and productive employment as soon as is medically possible • Department must make good-faith effort to identify meaningful work when employees have restrictions • Employer does not have to “create” work • Work identified should be consistent with the employee’s knowledge, skill level, and within Dr.’s restrictions • Designed to be temporary assignment and last no longer than 45 calendar days

  24. Early Return to Work Program • Initiated when employee has work restrictions which are recommended by his/her physician • Is designed as a temporary measure to facilitate a return to work and will not exceed 45 calendar days in duration per injury/illness • Program includes physician’s restrictions for both work and non-work related injuries/illnesses

  25. Your takeaways… • Safe work practices are everyone’s responsibility. • Accidents are costly. • WCI forms administration must be timely. • Accidents must be analyzed where necessary for prevention. • Forms URL http://employees.tamu.edu/employees/benefits/leave/WorkersCompensation.aspx

  26. Contact Information • Workers’ Compensation Jim R. Kuhlmann Leave Specialist Phone: (979) 862-4971 Email: jkuhlmann@tamu.edu • Environmental Health and Safety Phone: (979) 845-2132 Web: http://ehsd-online.tamu.edu/

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