INCIDENT REPORTING

1
INCIDENT REPORTING

• RISK MANAGEMENT WORKERS COMPENSATION PROGRAM

2
WHAT SHOULD BE REPORTED?

• All incidents and accidents involving employees,
  no matter how insignificant they seem.
• This documents relative facts.
• Provides a loss control tool.

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REPORTING EMPLOYEE INCIDENTS

• For injuries NOT requiring Medical Treatment
  (minor injuries that do not require immediate
  medical treatment other than first aid), the
  Employee needs to
• Notify your agency Workers Compensation Contact
• Assist the Contact in completion of an on-line
  incident report and file with Risk Management
• Completing and filing this form with Risk
  Management Workers Compensation serves as a
  record of notification to your employer in the
  event you require medical treatment in the future
  (up to one year).
• An on-line incident report should be submitted to
  Risk Management Workers Compensation within 24
  hours of receiving the report of injury.

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REPORTING EMPLOYEE INCIDENTS

• For injuries that do require Medical Treatment,
  the Employees Supervisor/Workers Compensation
  Contact needs to
• ? Complete First Report of Injury Form, (SFN
  2828) and file it with Workforce Safety
  Insurance (WSI) within 24 hours after learning
  of the injury. Traumatic Injuries require
• Supervisor to immediately file the SFN 2828 and
  notify Risk Management by phone [phone]), fax
  (328-7585) or email (drwaliser_at_nd.gov) and
• Employee must complete SFN 2828 as soon as
  possible thereafter.

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REPORTING EMPLOYEE INCIDENTS

• For injuries that do require Medical Treatment,
  the Employee needs to
• Notify your agency Workers Compensation Contact
• Assist the Contact in completion of an on-line
  incident report and file with Risk Management
• Complete SFN 2828 Sections 1 and 2 and file it
  with Workforce Safety Insurance
• Obtain initial treatment from the pre-selected
  designated medical provider
• Have care provider complete C-3
• Return C-3 to supervisor or Workers Compensation
  Contact as soon as possible, but no longer than
  24 hours after treatment.

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REPORTING EMPLOYEE INCIDENTS

• I filed a Workers Comp Claim - NOW WHAT
• You will be contacted by a Claims Adjuster from
  Workforce Safety Insurance and if the claim
  results in lost work time you will be contacted
  by a Nurse Case Manager.
• These professionals will assist you with your
  claim and help answer any questions that you may
  have.

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REPORTING EMPLOYEE INCIDENTS

• You will also receive in the mail a letter from
  Workforce Safety Insurance notifying you that
  your claim has been accepted or denied.
• If your claim is denied the letter will also
  explain what steps you can take to have your
  claim reviewed.
• AT ALL TIMES YOU ARE REQUIRED TO FOLLOW THE
  REQUIREMENTS SET FORTH BY YOUR MEDICAL PROVIDER
  AND WORKFORCE SAFETY INSURANCE.

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REPORTING EMPLOYEE INCIDENTS

• What if my injury wont allow me to return to
  my regular job for a while?
• You will be placed in Transitional Duty until you
  can do your regular job.
• Transitional Duty is work that is modified to
  meet the restrictions placed on you by your
  medical provider.
• All attempts will be made to find Transitional
  Duty in your agency - however if this is not
  possible you may be placed with another agency.

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REPORTING EMPLOYEE INCIDENTS

• QUESTIONS ON TRANSITIONAL DUTY
• How long will I be on Transitional Duty?
• Will my assignments change?
• How will my pay be affected?
• Where will my assignment be located?
• What are the benefits of Transitional Duty?
• Can I elect not to participate?

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WHEN WILL TRANSITIONAL DUTY END?

• 90 days after starting of the assignment
• You are released to your pre-injury position
• The assignment is no longer available
• The workers compensation claim is denied
• Transitional work with the employing agency is
  available
• The restrictions become permanent

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ABOUT TRANSITIONAL DUTY

• This is a temporary position
• The job duties will change as medical
  restrictions and limitations change
• The work will be meaningful
• The work will be within 25 miles of your regular
  job

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HOW WILL I BE PAID?

• You will remain in your regular classification
  and position
• Wages and benefits will be prorated for hours
  worked
• Wages are supplemented up to 66.6 by NDWC
• You can use leave benefits to keep pay at regular
  level

13
COMMUNICATION

• The Worker, Supervisor, RMWCP, and WSI must be
  kept informed about
• Benefit information
• Medical Treatments
• Concerns of the worker

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BENEFITS OF TRANSITIONAL DUTY

• Speeds up recovery
• Keeps employees working
• Reduces compensation costs
• Prevents abuse

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IS TRANSITIONAL DUTY MY CHOICE?

• You can elect not to participate in your
  transitional duty assignment- however, it may
  affect the benefits you receive from Workforce
  Safety Insurance.