1. UMD Procedures April 2010 9/7/20151

2.  Promptly Notify UMD Workers’ Compensation Coordinator (Cathy Rackliffe) ◦ All reported incidents ◦ When employee begins to lose time from work ◦ Sustains a re-injury ◦ Can’t work within restrictions ◦ All medical reports (retained in UMD HR) 9/7/20152

3.  Consult with UMD UReturn Program (Shelly Frohrip) ◦ Incidents involving lost time ◦ Incidents involving accommodations ◦ If a QRC, NCM, or other professional assigned 9/7/20153

4.  FMLA Coordinator (Betsy Behning) ◦ Notify of all leaves  Consecutive days  Overnight hospital stay  Intermittent leaves 9/7/20154

5.  Same designated medical providers  UMD Quick Care (for minor injuries) – new for 2009  UMD Health Services  St. Luke’s Occupational Health  Duluth Clinic Occupational Medicine  Special locations for NRRI, CMRL and burns  Emergencies: nearest hospital 9/7/20155

6. What does this mean for you? Changes ◦ New policy  Affects all campuses  Fewer policy/procedural pages  Number of required forms reduced  Emphasis on early reporting  Complete FROI for ALL claims ◦ New procedures  Develop UMD procedures  Unique to our campus  Complies with the policy  Modeled after University procedures 9/7/20156

7. What does this mean for you? New Supervisory Responsibilities  First Report of Injury (FROI) form Completed by supervisor within 8 hours (1 work day) FROI automated in the future Provide to injured employee MN W.C. Info Sheet List of Designated Providers Temporary Prescription Drug ID Card 9/7/20157

8. What does this mean for you? Enhancements ◦ Express Scripts  Temporary Prescription Drug ID Card  First Fill (7-day prescription, 25 tablets, up to $125)  Express Scripts absorbs cost if claim not accepted  Permanent card for accepted claims  Target, Walgreens, Duluth Clinic, etc. 9/7/20158

9. Link to Express Scripts 9/7/20159

10. EmployeeSupervisor  Employee Responsibilities ◦ Immediately notify supervisor of an on-the- job injury, accident, or illness ◦ Seek medical attention. ◦ Promptly cooperate with Supervisor and Sedgwick (Claims Administrator)  Supervisor Responsibilities ◦ Assess incident and assist Employee with seeking medical attention. ◦ Dial 911 if injury is potentially life threatening ◦ Contact UMD Workers’ Compensation Coordinator or UMD UReturn Program if unable to accommodate restrictions. 9/7/201510

11. Supervisor First Report of Injury  Complete for ALL incidents, except incidents such as paper cuts  Within 8 business HOURS (1 day)  Forward to UMD Workers’ Compensation Coordinator same day completed 9/7/201511

12.  Supervisor ◦ Supervisor Incident Investigation Report  Complete within 24 business HOURS (3 days)  Forward to UMD Workers’ Compensation Coordinator same day completed  Contact Sedgwick with questions about claim compensability 9/7/201512

13.  Supervisor ◦ Lost Time Report  Coincides with biweekly payroll  Forward to UMD Workers’ Compensation Coordinator same day completed 9/7/201513

14.  Employee Employee Incident Report Complete as soon as possible following the incident Forward to Supervisor Supervisor forwards to UMD W.C. Coordinator 9/7/201514

15.  Documents completed by Supervisor ◦ First Report of Injury ◦ Supervisor Incident Investigation Report ◦ Lost Time Reports 9/7/201515

16.  Document completed by Employee ◦ Employee Incident Report 9/7/201516

17.  Documents Supervisor sends to UMD W.C. Coordinator ◦ First Report of Injury ◦ Supervisor Incident Investigation Report ◦ Employee Incident Report ◦ Medical Reports ◦ Lost Time Reports UMD W.C. Coordinator FAX documents to Sedgwick 9/7/201517

18. Supervisor gives employee MN W.C. Info Sheet List of Designated Providers Temporary Prescription Drug ID Card 9/7/201518

19. New Responsibility for Supervisors  First Report of Injury ◦ http://www.d.umn.edu/umdhr/WorkComp/firstreport.pdf http://www.d.umn.edu/umdhr/WorkComp/firstreport.pdf  Supervisory training  Schedule a time for more in depth training/  Call Cathy Rackliffe at 726-6827 9/7/201519

20. Cathy Rackliffe Area Claims Reporting Help UMD Workers’ Compensation Coordinator 269 Darland Administration Building Tel. 726-6827 FAX: 726-7505 cracklif@d.umn.edu Shelly Frohrip, M.V.R., C.R.C. UMD Director, UReturn – Employee Services 278 Darland Administration Building Tel. 726-7725 FAX: 726-8083 9/7/201520

21. Betsy Behning FMLA Coordinator 255 Darland Administration Building Tel. 726-6520 FAX: 726-7505 jericks1@d.umn.edu Rhonda Bosworth, Claims Supervisor Sedgwick Claims Management Insurance, Inc. P. O. Box 46999 Eden Prairie, Minnesota 55344 Tel. 1-800-231-0165, Extension 63764 FAX: 952-826-3785 Rhonda.Bosworth@sedgwickcms.com 9/7/201521

22.  Thank you for your time! 9/7/201522