workers’ compensation: protecting our workforce while promoting safety
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WORKERS’ WORKERS’ COMPENSATION:COMPENSATION:Protecting our Workforce While Promoting Safety
Texas A&M University, Human Resources
DIVISION OF FINANCE
February 29, 2012
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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
Today’s Topics
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“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.”
Workers’ Compensation Defined
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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
WCI Historical Overview
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Operates as a bona fide insurance agencyo Adjusters – evaluate and determine whether or
not an injury is compensableo 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
Office of Risk Management and Safety
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Department DepartmentDepartmentDepartment
Workers’ Compensation Process @ TAMU
Supervisor A Supervisor B Supervisor C Supervisor D
Communication isImportant!
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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
Component FY 2008
*Example: $30K yearly TAMU employee = WCI premium of $3.75/month
FY 2010
TAMU System ComponentsWCI Cost Per $100 of Payroll*
$30K yearly TFS employee = WCI premium of $18.75/month
$30K yearly TEES employee = WCI premium of $1.25/month
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Claims and Lost Time @ Texas A&M University
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Provides services that promote a healthy and safe environment
Establishes safety procedures that apply to University and TAMUS employees
Environmental Health & SafetyMission
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Body Part Injuries:1. Finger 11%2. Arm 10%3. Hand 10%4. Back 9%5. Knee 7%
Texas A&M University “Top 5”
Nature of injury:1. Bruise/contusion 26%2. Cut 15%3. Strain 14%4. Exposure 11%5. Sprain 6%
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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
Safe Practices Are a Job Requirement!
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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
WCI Best Practices
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Workplace “Accident”: DININGhttp://www.youtube.com/watch?v=noFCekWiUGE&feature=related
Safety Must Be a Priority!
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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
What are the benefits of WCI?
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First Report of Injury Witness Statement Request for Paid Leave Supplemental Wage Statement
http://employees.tamu.edu/employees/benefits/leave/WorkersCompensation.aspx
Workers’ Compensation Forms
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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
WCI Forms: Deadlines for Reporting
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1. Administrative (paperwork) First report of injury Witness statement(s) (if applicable) Request for Paid Leave (if applicable) Supplemental (if applicable) Wage statement (if applicable)
2. Incident Analysis (investigation) If Necessary Gather facts Analyze facts Corrective action Follow-up
WCI Accident Follow-up
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Incident Analysis:Gather Facts Example 1
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Incident Analysis:Gather Facts Example 2
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Incident Analysis:Gather Facts Example 3
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Incident Analysis:Gather Facts Example 4
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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
Early Return to Work Program
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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
Early Return to Work Program
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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 URLhttp://employees.tamu.edu/employees/benefits/leave/WorkersCompensation.aspx
Your takeaways…
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Workers’ CompensationJim 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/
Contact Information
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