What’s New With CSU’s Workers’ Compensation CSU OFFICE OF RISK MANAGEMENT & INSURANCE NOVEMBER 2015
The purpose of today’s presentation Introduce our new Website & Introduce Origami, our new claims system We will be providing training outside of this presentation on WC Basics and Advance Workers’ Compensation Please watch our website for dates and to register or contact me at Kweigang@colostate.edu The next training for WC Basics is November 19th
Risk Management & Insurance Which includes the Workers’ Compensation Program has A New Website and Workers’ Compensation Process Risk Management - http://rmi.prep.colostate.edu/ Workers Compensation http://rmi.prep.colostate.edu/workers-compensation/
WHAT YOU’LL FIND ON OUR NEW SITE
What Does The Change Mean for Departments WE’RE MOVING FORWARD ALONG THE INFORMATION HIGHWAY
THE PROs – A GREAT RESOURCE SITE Information that will assist departments and employees through the stages of a WC claim Up to date Forms and Postings Authorized Treating Physician’s that can be sorted by County Easy Access to reporting Missed Time Ease of reporting injuries Q&A for common questions that arise during the course of a WC claim Up to date Training information and Power Points
The Cons Current forms, postings and information in circulation at CSU don’t have the new website information and need to be replaced Employee Notifications that should be posted throughout department Authorized Treating Physician forms Employee Guide Departmental website’s or documents that reference the Workers’ Compensation website
The Origami Vision A One Stop Data Base System for reporting Currently you can go to the RMI website http://rmi.prep.colostate.edu/insurance/incident- reporting/ and report Incident, Injury, Illness, Exposure Damage to CSU Property Damage to CSU Vehicle Safety Concern/Near Miss Reporting Damage to Non-CSU Property Damage to Non-CSU Vehicle The goal is to gather information that can provide reports, data and assist in developing a collaborative effort between staff and departments Increase knowledge so that we can better handle our risk and improve the health and safety of CSU employees
At this point, if 1. File a Workers’ Compensation 2. Upon submission, employee 3. If medical is sought, the 4. Once in claim medical is not sought, Incident and DDP will receive: incident is escalated to claim status, employee the incident remains http://rmi.prep.colostate.edu/ a. Incident Letter status by Workers’ Compensation and DDP will as record only. workers-compensation/ b. Copy of Report receive: Claim staff. No further action Packet (including file-an-incident/ c. ATP Guide is required. Introduction Letter, ATP Guide, Action Needed! Employee Guide, 6. Claim is transmitted to Third Party Administrator 5. Once in claim status, the Forward information to employee’s and Injury (TPA), CCMSI. Claim Number will be assigned, employee DDP will also receive, the DDP supervisor, provide Workers’ Timesheet) and a will be contacted via phone by TPA adjuster, and Checklist, Supervisor Checklist Compensation with employee’s copy of report. employee will receive packet via mail from CCMSI. If signed documents and and Investigative Questions. claim is put on Notice of Contest (NOC), employee and DDP/Supervisor responses to DDP will receive email notice investigative questions. Action Needed! 8. Following employee’s visit(s) 7. Employee and DDP will receive emails every two weeks Please note: Employee should respond to requests The first 24 hours is requesting updates to missed time. To enter authorized to the ATP, CSU Workers’ from CCMSI or CSU in a timely personal time, but missed time, please visit: http://rmi.prep.colostate.edu/ Compensation will distribute manner and should contact adjuster still needs to be workers-compensation/lost-time/. copies of medical status report(s) at CCMSI with any questions regarding reported. Please remember that no compensation or wage to DDP and will request updates to claim status. replacement is granted without report of lost/missed time. employee’s work status. Action Needed! 9. As claim progresses, notices will be sent to employee 10. Employee is released from care. Email Changes in work status include: and/or DDP at key events: will be sent to employee and DDP working (no restrictions), in need of a. Lost time reaches 24 hours, 80 hours and regarding claim closure, reason(s) why and modified duty within or outside of exhaustion of injury leave any departmental actions needed. department, not working, etc. b. Notice of Contest Please respond in a timely manner to c. Release from Medical Care/MMI all requests for updates. d. Claim Closure
1. File a Workers’ Compensation 2. Upon submission, employee Incident and DDP will receive: a. Incident Letter http://rmi.prep.colostate.edu/ b. Copy of Report workers-compensation/ c. ATP Guide file-an-incident/ At this point, if medical is not sought, the Any one can file the claim Review the report incident remains the employee a record only. respond with any supervisor No further corrections within 5 Departmental person action days Co-worker is required. Keep the Authorized Treating The Department no Physician information in case longer needs to answer medical treatment maybe a set of questions to needed at some point in the progress the report to future. the next level
4. Once in claim 3. If medical is sought, the status, the incident is escalated to claim employee and DDP status by Workers’ will receive: Claim Compensation staff. Action Needed! Packet (including a 5. Once in claim status, the DDP Forward information to employee’s will also receive, the DDP Introduction Letter, supervisor, provide Workers’ copy of injury Checklist, Supervisor Checklist Compensation with employee’s and Investigative Questions. report, ATP signed documents and Information, DDP/Supervisor responses to investigative questions. Employee Guide, and Injury Timesheet The injured work must treat with one of CSU’s Authorized Physicians.
Parties to the claim maybe 6. Claim is transmitted to Third Party We are looking contacted by a variety of CSU Administrator (TPA), CCMSI Or to assist and experts that will assist in Travelers(out of state claims) and the gathering information prevent employee will be contacted via regarding the claim and Future injuries telephone by an adjuster, and receive a circumstances surrounding packet via mail it. Action Needed! Employee and Department The claim will be either accepted, denied, should respond to requests from or placed on a Notice of Contest(NOC) for adjuster or CSU in a timely further investigation. If the claim is placed on a NOC the employee with receive manner and should contact the something from the adjuster. CSU’s WC adjuster or WC manager with will also send an email to the employee any questions regarding claim and DDP (Please pay attention to NOC status. and information provided )
Please note that 7 . Employee and DDP will receive emails the form doesn’t Please remember that no every two weeks requesting updates on play nice with all compensation or wage missed time. To enter authorized missed web browses. replacement is granted Internet Explorer time, please visit: without report of is it’s preferred http://rmi.prep.colostate.edu/ lost/missed time browser if you workers-compensation/lost-time/. want to submit it on-line
WC receives the missed time it is Once completed the timesheet reviewed and approved or denied. Currently can be printed, emailed and saved updates on The Department will receive a copy missed time of the time turned in and approvals There even is a button where it will be sent to and/or denials so that they can can be submitted directly to the the DDP on the make to appropriate adjustments WC program 10th of each for their records . month Please review the Website As the claim progresses, Please note the http://rmi.prep.colostate.edu/work notices will be sent to first 24 hours ers-compensation/lost-time/ employee and/or DDP at key missed is not For information on reporting time events: covered but and information on Lost Time needs to be Lost time reaches 24 hours, Reimbursements for Compensable reported 80 hours and Claims exhaustion of injury leave
8. Following employee’s visit(s) to the ATP, CSU Workers’ Compensation will distribute copies of medical status A modified duty letter should be report(s) to DDP and will request completed any time an employee updates to employee’s work status. The returns to work with restrictions employee also receives a report and should provide his supervisor with a copy after each visit . Contact the WC program for assistance with Modified duty and reference our website http://rmi.prep.colostate.edu/workers- compensation/tmd/
10. Employee is released from care. Email will be sent to employee and DDP regarding claim closure, reason(s) why and any departmental actions needed. Call the adjuster or the WC Employees who are release Manager regarding issues also from care with restrictions reference our website should not be returned to http://rmi.prep.colostate.edu/ work without first talking with Human Resources
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