State of Nebraska Workers’ Compensation

1. State of NebraskaWorkers’ Compensation Laura Peterson State Risk Manager General Counsel, Admin. Services

2. Session Goals and Objectives • Interactive • Workers’ Compensation Overview • Unique Rules for State Agencies • How the State Covers Work Comp • Discussion • Answer Your Questions

3. Work Comp Overview What is Work Comp? • Compensates employees for work injury • Exclusive Remedy • Avoid Litigation between employer & employee • No-fault • Faster resolution • Each party (employer/employee) give and get something

4. Work Comp Overview Who is Covered? • Almost All Employees • Employee: a person who is in the service of the state, whether elected, appointed, or hired, whose duties require them to work for the state and who is paid from state funds. • Includes “duly appointed members of boards or commissions when they are acting in their official capacity.”

5. Work Comp Overview Who is Generally Not Covered? • Employees of an Interlocal or Joint Public Agency • Independent Contractors • Volunteers • Persons covered by federal work comp • Clients, patients or wards of a state agency

6. Work Comp Overview When is an Employee Entitled to Comp? • The injury was caused by an accident or occupational disease • The accident or disease arose out of and in the course of employment • The employee was not willfully negligent

7. Work Comp Overview What Does Work Comp Provide? After 7 calendar day waiting period: • Indemnity (Lost Wage) Benefits • Death Benefits • Medical Services • Prescriptions

8. Work Comp Overview Recent Developments • Going and Coming Rule • Fee Schedule & Payment Terms • Mental Claims without Physical Injury

9. Specific Rules for the State Relevant Statutes • Work Comp Statutes Generally • 48-101 to 48-1,117 • State Specific Work Comp Statutes • 48-192 to 48-1,109 • Other Statutes • 81-8,233 to 81-8,239.09

10. State Work Comp Program • Self-Insured • Agency Assessments • Exposures - FTE & Payroll • Losses – claims (number & severity) • Future rebate program • Lag time • Safety • RTW

11. State Work Comp ProgramInjured Employee Responsibilities • Obtain Necessary Emergency Medical • Report all Incidents & Injuries • Physician Selection/Physician Visits • Report Time • Communicate with Agency & TPA

12. State Work Comp Program Agency Requirements • General • Designate AWCC • Report Injury • Report Claim Information (continued on next page)

13. State Work Comp Program Agency Requirements (continued) • Report Time & Wage Information • Health & Safety • Return to Work • Evaluate Claim Information • Maintain Contact with Employee

14. State Work Comp ProgramRisk Management Responsibilities • Investigate • Determine Compensability • Pay Required Benefits (medical, indemnity, voc rehab, etc.) • Review for Settlement • Manage Litigation

15. State Work Comp ProgramTPA Responsibilities • Act on behalf of Risk Management to the extent authorized • Receive claims • Investigate Claims • Manage claims • Reserves • Payments • Settlement, subrogation & litigation

16. State Work Comp ProgramAttorney General Responsibilities • Advise Risk as necessary • Litigation • Settlement • Medicare Set-Aside

17. Discussion/Questions

18. Conclusion Risk Management’s workers’ compensation goals are to have as few injuries as possible, to compensate injured employees fairly within the statutory requirements if they are injured, to eliminate abuse of the system, and to return employees to work as quickly and fully as possible after an injury. We need all employees to help us obtain these goals.