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10/26/2017
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The role of the HR representative in Georgia Workers’ Compensation Claims
What does Georgia's Workers’ Compensation Act expect of me as the HR representative for my employer?
The law expects you to educate all employees with emphasis on supervisors.
Why the emphasis on educating supervisors?
Because the supervisor is the quarterback of the Worker’s
Compensation Team.
The HR rep is the receiver on the WC team
What do I need to do to educate the employees of the company? Get the employee’s signature on a document acknowledging he has been informed and understands his rights under Georgia’s Workers Compensation Act, has seen the panel and the Bill of Rights.
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What rights do I include in the document?
That the employee has :*seen the panel of physicians*knows what to do if injury occurs and to whom to report it*understands how the panel works*has seen the Bill of rights*knows HR will assist him in getting medical treatment
What must I tell supervisors?
*Report all injuries to HR*Keep records of all reported injuries*Interview witnesses and keep records of statements given*Escort the employee to HR/nurse*Take all reported work injuries seriously
How do I instruct supervisors?
Don’t tell the employee to shake it off
Don’t tell employee to go to HRDon’t Tell employee to get back to
workDon’t Tell employee “you ain’t hurt”
Don’t Tell employee to put Biofreezeon his injury
Don’t tell the employee he is firedDon’t Tell employee to go home and
rest and come to work next dayDon’t Tell employee to continue to
work until shift overDon’t Tell employee to call his wife to
come take him to a doctorDon’t Tell a co worker to take
employee to HR or nurse’s station
Hold regular meetings with supervisors
When do I educate employees about workers’ compensation?
TWO TIMES : (1) at the time of hire and (2) at the time of injury!
How do I create a panel of physicans?
List 6 OR MORE doctors on the panel.One must be an orthopedic surgeon and one must be a minority
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Where do I post this panel of physicians?
In many places that are seen by the employee such as break room, time clock, whereeveremployee’s gather.
How do I pick the doctors to put on the panel?
*Interview docs before putting them on the panel that they know WC law.*Make sure the doctors know what your company does*Make sure you have the name of the person at the doctor’s office to contact for immediate response
Once the panel of physicians is posted in several places, does the law require me to do anything further with it?
YES ! You must constantly monitor the panel for accuracy because doctors move, die and retire !KEEP OLD PANELS !!!
Once I offer an employee a job, is there anything I need to do before he goes to work?Get the worker to complete a POST OFFER MEDICAL QUESTIONAIRE.
What does the law require me to do when an employee reports a work injury to me or to his supervisor?
Make sure ALL supervisors know that everyone who reports an injury must contact HR ! This is where the ball is usually dropped!
I have received notice from an employee that he has injured himself at work. Now what?
*Get a statement from him of how injury occurred.*Let him choose a doctor from the panel.Get a signed 207 form.*Let him circle and initial his choice*Get a Dr’s appointment for him.*Offer transportation if he has none.
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SEND EMPLOYEE FOR AN IMMEDIATE DRUG SCREEN !!
Does an employee verbally have to report a work injury?
NO !!
This is NOTICE of a work injury !
The employee has gone to the doctor, now what does the law require me to do?Call the doctor’s office , fax her a signed 207 form and have her fax you her medical report !Ask the doctor if the employee can return to regular duty work. If not, why not?Offer the employee light duty workAsk the doctor when is she to see the employee again and keep track of this!Ask the doctor what the employee stated was his method of injury.
Employer needs to know the Treatment plan of every injured worker. Send this to adjuster !
Test results ?Physical therapy needed ?Medications prescribed ?Conservative treatment?Surgery proposed ?
What does the law want me to do next?
*CONTACT THE INSURANCE ADJUSTER.*SEND ADJUSTER SIGNED 207 AND ALL MEDICAL REPORTS *STAY IN CONSTANT COMMUNICATION WITH THE ADJUSTER. YOU TWO ARE A TEAM !!!
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Why are you leaving the management of your workers’ comp claims completely in the hands of your adjuster?
I RECEIVED THE MEDICAL REPORT FROM THE
DOCTOR. DOES THE LAW HAVE SPECIFIC REQUIREMENTS OF HOW I HANDLE MEDICAL
REPORTS? YES !!!! HIPAA REQUIREMENTS.
All medical records of employees
in the possession of the employer MUST be kept in a LOCKED filing
cabinet and not co-mingled with
personnel or workers’ compensation files.
Access to the filing cabinet containing employee medical
records MUST be restricted.
Any time medical records are
under review by the employer,
access to the reviewing personnel MUST be restricted.
Tip: work injuries are not short term disability claims
What do I do when employees have non work injuries?
If the employee is out of work receiving worker’s comp, do I need to be doing anything? YES!!
Employee loves to hunt and posted this on facebook, twitter and instagram
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Supervisors must be the street committee !!!
You should report all Non work related accidents to treating Dr.
The law requires HR rep, not the adjuster, to keep track of the injured worker ! Report this to Dr.
Does the law expect me to tell the doctor about the employee’s activities away from work? YES !!
SPORTS
GYM JUNKIES
Does HIPAA prevent me from talking to the treating physician? NO !!
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What do I do if the panel doctor wants to refer the employee to another doctor?
Make sure the panel doctors know you must approve ALL referrals before she makes a referral !
What does the law say about a panel doctor making a referral?
If the case goes to court, what will the judge
expect from me?
Proof of posted panel
Proof that employee selected his own choice and a second choice
Accident report signed by employeeProof employee was assisted in getting medical
appointmentMedical records that document prompt and
appropriate treatment was provided for employeeMedical records show history, diagnosis, treatment
and return to work dateMedical records that show CAUSATION or LACK
THEREOFCredible testimony from knowledgeable supervisor
and witnessesOffer of light duty work if appropriate
Detailed , convincing medical opinionsProof that employee was engaged in activities which
show ability to work
*Errors made by HR rep that impact the cost of a workers compensation
Failure to interview doctors before putting them on panel
Failure to keep panel up to dateFailure to keep old panels for older dates of accident
Failure to allow injured worker to select physician from panel
Failure to allow injured worker to make a second choice from the panel
Failure to assist injured worker in making appointment
Failure in providing transportation if neededFailure to get the injured worker back to panel
physician if he strays from itFailure to provide doctor with information about job
duties and specifics of the injury Failure to correct inaccurate information in medical
recordsFailure to provide doctor with light duty job
descriptionFailure to educate supervisorsFAILURE OF HR rep TO MANAGE THE MEDICAL CARE OF THE
INJURED WORKER
Does the law expect me to know the defenses to a workers comp claim? YES! Report all to the adjuster !
Willful misconductHorseplayIdiopathic injuriesIntoxication by drugs/alcoholNon work related injuries
Aggravation of a preexisting condition
The employer is only liable for workers compensation benefits for an aggravation of a preexisting injury as long as the aggravation by work exists. Once the aggravation is over, the employer is no longer obligated to pay worker’s compensation benefits.
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Behind every favorable decision for the employer is a knowledgeable , competent work comp HR representative
Knowledgeable, competent workers’ comp HR representative
Website
www.sbwc.georgia.gov