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