Archdiocese of Kansas City S ummer Camp 2019
Kansas WC Overview Benefits are paid at the employer’s expense Coverage begins on first day on the j ob Benefits include medical expenses and income benefits An employee cannot be fired, demoted, or discriminated against for filing a claim in good faith. Employees can obtain free assistance by contacting the WC Ombudsman’s office at 800-332-0353 or 785-296-4000. The law provides for penalties for employee fraud
What determines if a claim is accepted? An inj ury is deemed to arise out of the employment if: There is a “ causal connection” between the work conditions and the resulting accident, and… . The accident is the prevailing factor causing the inj ury or condition. “ Arising out of and in the course of employment” doesn’ t include: Natural aging process by normal daily activities Inj uries from a “ neutral risk” Inj uries due to a risk personal to the worker Inj uries due to idiopathic causes
Details of obligations Y ou must have a posted notice K-WC 40-A advising employees of what do in case of an inj ury Y ou must provide employee assistance in form of form K-WC 27-A or K-WC 270-A (S panish) Must be reported within 28 days of notice by the employer (if the inj ury incapacitates the employee for more than the remainder of the day, shift, or turn on which the inj ury occurred. A claim may be denied if employee fails to notify employer within 20 days of the accident inj ury, or within 20 days from date of medical treatment, or within 10 days of the last day worked (if employee no longer works for employer) Church Mutual files the FROI with the state Weekly benefits includes a one week waiting period. If disability exceeds 3 weeks, the employee is paid for the waiting period. Permanent partial benefits are “ scheduled” when possible
Guidelines for Medical Treatment Employers are entitled to choose the treating physician. If an employee self- selects a physician who is not authorized or agreed upon by the employer/ carrier, the employer is responsible for only the first $500 in medical bills from such self selected physicians. An employee shall submit to any reasonable physical examination order by the employer. A fee schedule is in place, it is revised annually, to ensure health care cost containment, yet insured the availability of necessary treatment and care.
Report a an Injury Y ou can also report your claim online Let's get started Other Methods include: Phone • (800) 554-2642 ext . 2 Fax • 715-539-4651 Email • claimsint ake@ churchmut ual.com
Nurse Hotline – Preferred 24/ 7 Why? For one, it’s free! Faster, more appropriate treatment of inj ury, if needed • Ability to capture and recall facts of accident • Avoidance of ER / Reduction in time away from work • Reduction in percentage of cases with costs – Ex Mod • Employee’s like the quick communication with an expert • Recommendation of proper level of care • Options for specific providers if treatment needed/ sought • Medcor initiates the First Report for the Employer, sends to Church Mutual •
Other Methods of Reporting Phone, Fax, On-Line • Please don’ t “ snail mail” – prevents early intervention and case management • Alternative methods most appropriate instead of Nurse Hot Line if/ when: • Employee reports to mgmt late, and has already secured outside medical care Employee is not available to discuss with nurse at the time of call No matter how reported, key is to have employees report all work inj uries/ conditions to you immediately, and then to involve the Nurse Hotline or Church Mutual immediately.
What Happens Next? S omeone from Church Mutual will reach out to whoever is noted as the employer contact, based on the initial loss information. Or, can over-ride this with a singular employer contact, for all losses, regardless of location. Notice Only - EE/ ER receives letter indicating who is assigned, and that no formal claim is being pursued. Med Only – EE/ ER receives letter, ER and Med Provider called (in some cases, EE called, too) Lost Time – EE/ ER receives both letters, and calls, Med Provider also called
New Claim -Initial Discussions Fill in any gaps in Nurse Hotline FROI • Confirm mechanism of inj ury / Witnesses • Determine if any concerns re: legitimacy of inj ury, ulterior motives, j ob • satisfaction/ performance. EE remain at work, or back to work? Days Off? • Last Date paid through / Average Weekly Wage (if needed) • Medical Provider Info (if known) • Modified/ Restricted Work Duty availability (if needed) • Church Mut ual will at t empt t his cont act wit hin 24 hours of not ificat ion of loss, if not a Not ice Only case.
Nurse Hotline Results
Catholic Mutual Group Claim Advocacy Catholic Mutual Group and Church Mutual became S trategic Alliance Partners to provide Workers Compensation and Auto Insurance in 2016. The Catholic Mutual Claim Advocacy Program was developed to assist Church Mutual in providing outstanding claim service to our Members. Claim Advocates assist Members with claim issues, adj uster contact information, coordinate Claim Reviews and facilitate communication with Church Mutual adj usters. Holli S ampson is the Claim Advocate for the Archdiocese of Kansas City. S he can be reached at 402- 514-2439 or hsampson@ catholicmutual.org. Jen Wentworth is the Claims Relationship Manager. S he can be reached at 402-514-2393 or j wentworth@ catholicmutual.org Ken Freudenburg is the Loss Control Representative. He can be reached at 402-514-2384 or kfreudenburg@ catholicmutual.org.
Work Comp by the Numbers CMIC Program Total 188 Claims $1,377,565 Total Incurred Top Causes of Loss Fall, S lip/ Trip 76 claims $ 728,708 S train 41 claims $ 302,921 Total Top 2 Causes 117 claims $1,031,629 Top Claims by Occupation Teachers 62 claims $764,227 Maintenance 30 claims $102,559 Total Top 2 Occupations 92 claims $866,786
By the Numbers continued Claims at or over $50,000 1329365 Teacher Fall, S lip/ Trip, skull $ 68,461 1338307 Teacher S train, ankle $202,892 1377587 Admin. Fall, S lip/ Trip, wrist $ 49,497 1308504 Clergy S triking against, head $126,577 1296803 Teacher Fall, S lip/ Trip, thigh $292,825 Total Top 5 Losses $623,977
Work Comp by the Y ear 2016 Totals 72 Claims Total Incurred $710,853 Top Cause of Loss Fall S lip/ Trip 30 claims $412,142 S train 16 claims $ 39,454 Total Top 2 Causes 46 claims $451,596 Top Claims by Occupation Teachers 27 claims $355,000 Food S ervice 8 claims $ 86,241 Maintenance 8 claims $ 51,444 Total Top 3 Occupations 3 claims $415,068
By the Y ear continued 2017 72 Claims Total Incurred $498,387 Top Cause of Loss Fall, S lip/ Trip 30 claims $173,899 S train 13 claims $290,970 Top 2 Causes 43 claims $464,869 Top Claims by Occupation Teachers 27 claims $370,166 Maintenance 11 claims $ 34,687 Total Top 2 Occupations 38 claims $404,853
By the Y ear continued 2018 44 Claims Total Incurred $168,324 Top Cause of Loss Fall, S lip/ Trip 16 claims $142,667 S train 12 claims $ 8,006 Top 2 Causes 28 claims $150,673 Top Claims by Occupation Maintenance 11 claims $16,428 Teachers 8 claims $39,061 Top 2 Occupations 19 claims $55,489
CMG Connect Online Learning Management System
Available Training Resources: Transpor ortation on Busi usiness of of the the Chur Church ch Be Smart – Drive Safe II New! Best Practices for Financial Management and Cash Handling Church Transportation – Is it Necessary and Ministry Based? Best Practices in HR Management 11-15 Passenger Van Policy Best Practices for Facilities Usage Management “CAR ARES” S” Best Practices Libr brar ary Sc Schoo ool Safet Safety Yout outh M h Mini nist stry Defeating a Violent Intruder Youth Ministry – Everything Matters and Everyone Has a Getting Ready to Defeat a Violent Intruder Role Bloodborne Pathogen Training Safe Safe Env Environment Playground Safety eLearning video New! Safe Haven – It’s Up to You is a 60-minute USCCB School Top Safety Hazards eLearning video New! compliant training video Anti-Bullying Training New! A Safe Haven Starts at Home is a 20-minute internet Cyb yber er Liab ability ty eLearn arning ng Series es education video for parents and teachers Malware and Phishing video A Safe Side of the Line is a 20-minute video dedicated to boundary issues when working or volunteering with Safet Safety children. Fire Safety Vulnerable Adults eLearning Training Preventing Slips, Trips & Falls Parish sh Festi tiva vals Preventative Maintenance Safe and Successful Parish Festivals
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