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Published byMadeline Agatha Cross Modified over 8 years ago
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Child Support Directors Association of California in partnership with California Department of Child Support Services Workers’ Compensation: Issues and Incidents October 6, 2010 | 3:30 – 5:00 1
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Workers’ Compensation: Speakers San Diego County – Department of Human Resources Jan Mazone - Deputy Director Susan Eldridge - Senior Risk and Insurance Analyst Jim Lery - Senior Human Resources Analyst Moderator Mark Mandel - Senior Departmental Personnel Officer San Diego County - DCSS 2
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The Life and Times of a Workers’ Compensation Claim The convoluted workflow when processing a claim for an injured worker according to the complicated and scary laws of the State of California Department of Industrial Relations – Department of Workers’ Compensation. Anonymous Workers’ Compensation: Issues and Incidents 3
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The Official Flowchart 4
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California Labor Code Every California employer is required to secure payment of workers’ compensation benefits through either 1. Carrying insurance with a company authorized to write such insurance in California, or 2. Securing from the Director of Industrial Relations a certificate of consent to self-insure. 5
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AND NOW IN TERMS WE CAN ALL UNDERSTAND…. Workers’ Compensation: Issues and Incidents 6
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THE INJURY HAPPENS Workers’ Compensation: Issues and Incidents 7
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Report incident Workers’ Compensation: Issues and Incidents 8
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Fill out the Dreaded Paperwork Workers’ Compensation: Issues and Incidents 9
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Should we Delay, Deny or Accept? Do you think he really slipped on the banana peel and rolled himself into a tape ball? Workers’ Compensation: Issues and Incidents 10
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Communication is important Workers’ Compensation: Issues and Incidents 11
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1 St 90 days to determine if accept or deny Workers’ Compensation: Issues and Incidents 12
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Investigating can lead to a denied claim Workers’ Compensation: Issues and Incidents 13
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Claim or No Claim 14
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Most Claims are Accepted Workers’ Compensation: Issues and Incidents 15
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A claim can be for medical treatment Workers’ Compensation: Issues and Incidents 16
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Or severe enough to need intense treatment & lost time Workers’ Compensation: Issues and Incidents 17
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All claims cost a little or a lot of these 18
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Injured worker is under managed care Workers’ Compensation: Issues and Incidents 19
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There could be a temporary disability Workers’ Compensation: Issues and Incidents 20
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So finding transitional work is important Workers’ Compensation: Issues and Incidents 21
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Once they are Permanent & Stationary Workers’ Compensation: Issues and Incidents 22
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Accommodate with permanent modified duty Workers’ Compensation: Issues and Incidents 23
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If not, Service Connected Disability Retirement Workers’ Compensation: Issues and Incidents 24
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Some claims will need Future Medical Workers’ Compensation: Issues and Incidents 25
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And some will be Permanently Disabled Workers’ Compensation: Issues and Incidents 26
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Who Wants to be a Claims Adjuster? 27
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But regardless of the outcome one thing is for sure…… Workers’ Compensation: Issues and Incidents 28
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Our Office It takes Our Office to get the job done! Workers’ Compensation: Issues and Incidents 29
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Contact Information Jan Mazone Deputy Director (619) 531-6470 or janice.mazone@sdcounty.ca.govjanice.mazone@sdcounty.ca.gov Susan Eldridge Senior Risk and Insurance Analyst (619) 578-5787 or susan.eldridge@sdcounty.ca.govsusan.eldridge@sdcounty.ca.gov Jim Lery Senior HR Analyst (619) 578-5745 or james.lery@sdcounty.ca.govjames.lery@sdcounty.ca.gov 30
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QUESTIONS 31
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