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1 Workers’ Compensation Office of Police and Risk Management
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2 Workers’ Compensation What is workers’ compensation? Workers’ compensation is a state-regulated program that pays your medical bills and provides payments to replace some of your lost wages if you are injured at work or have a work-related disease or illness. Workers’ compensation payments will begin when there is more than seven (7) calendar days of lost time. Texas Department of Insurance Texas Department of Insurance (TDI) is a state agency that ensures proper delivery of benefits to injured workers; helps resolve disputes about claims; and provides workplace health and safety services. TDI develops rules to administer the workers’ compensation system and monitor the activities of system participants. TDI does not pay benefits. Benefits are paid by insurance companies or third-party administrators. Your responsibility as an employee Tell your employer about your injury or illness within 24-hours. Tell your supervisor anytime your injury causes you to miss work. Notify your department when released to return to work (limited or regular duty).
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3 Your Responsibility - Complete the First Report of Accident/Incident form. Employee and Supervisor submit accident form. -Submit the completed First Report of Accident/Incident to OPRM within 48 hours. -Supervisor/Manager responsible for conducting the initial incident investigation. -State only the facts about the injury. Do not be opinionated -Communicate with OPRM about a work injury.
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4 Injury Investigation Conduct an initial investigation at the accident scene. Should be done by the Supervisor/Manager. Secure some basic information about the accident Supervisor shall: Ensure Report of Accident/Incident form is completed and sent to OPRM. Have all witnesses to the accident complete the witness statement Get a written statement of what happened from the employee involved in the accident or injury.
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5 OPRM Role Conduct the claim investigation Manage the SMU Return to Work program We do not deny/accept claims. Facilitate/explain the workers’ compensation program Identify injury trends and conduct training to mitigate work injuries Conduct ergonomic assessment (if applicable)
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6 Return to Work Program Southern Methodist University has created and implemented a program that will assist employee’s return to work after a work-related injury. The goal of the program: Retain the on-site experience of valuable, trained employees Reduce replacement and training costs for hiring new employees Reduce overall medical costs Increase employee morale and maintain productive employees If an employee is released to modified duty: Send the doctor’s medical release to OPRM OPRM will work with the department manager to return the employee to work in a temporary, modified duty status. OPRM will have employee and supervisor sign Modified Duty Agreement OPRM will present bona fide offer employment letter to employee
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7 Modified Duty- Your Responsibilities Employee’s Responsibilities Maintain contact with your supervisor/manager Provide weekly updates on your condition Provide medical documentation Manager’s Responsibilities Communicate with injured employee and OPRM Develop work duties within medical limitations Sign Modified Duty Agreement Examples of Modified Duty Regular job with some tasks removed Inventory supplies, administrative tasks, inspections, etc Revise work schedule
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What is Ergonomics Relationship between workers and their environment especially the equipment they use. Goal is to minimize work injuries. OPRM conducts ergonomic assessments at individual work stations. Partner with our workers’ compensation carrier, Travelers, to conduct/complete the assessment. Provide recommendations to worker/manager. Coordinate equipment resources with individual department & Purchasing Not all assessments will require new equipment/furniture!!
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9 Do’s DO…. Immediately complete the First Report of Accident/Incident form when notified of an injury. Investigate the accident area so that you can properly determine if the accident was preventable or non-preventable. State only the facts about the injury. Do not be opinionated. Communicate with OPRM about your injured employee/claim. Assist the employee in returning to modified duty, when possible, to facilitate the transition to full duty. Ask questions when you are not sure about the procedures or paperwork to complete on a work injury.
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10 Don'ts DON’T… Do not tell the employee that he/she is not injured and did not sustain the injury while in the course and scope of employment. Do not refuse to complete the First Report of Accident/Incident form when notified of an injury. Do not let your personal feelings and/or views get in the way of your professionalism.
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11 Questions Juan M. Azcarate III, CRM Assistant Director Workers' Compensation and Risk Analyst Southern Methodist University Office of Police and Risk Management 3050 Dyer Court, P.O. Box 750231 Dallas, TX 75275 Work: 214.768.3737 Cell: 214.280.2742 Fax: 214.768.4850 Refer to OPRM web page- Workers’ Compensation
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