Understanding Workers Compensation

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Understanding Workers Compensation

• Presented by
• Human Resource Services
• Kayla Devereaux
• December 2007

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What is Workers Compensation Insurance (WCI) ?

• Workers compensation insurance is an insurance
  plan provided by PSU and the State of Kansas to
  pay certain benefits to employees who are injured
  in accidents that arise out of and in the course
  of employment.
• In Kansas, WCI is a no-fault system.

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• Employees who sustain compensable injuries from
  an accident injury or occupational disease may be
  entitled to
• Reasonable and necessary medical treatment
  expenses to treat the job related injury or
  illness
• Disability compensation to replace part of the
  wages lost due to a disability and
• Survivors benefits if death results from an on
  the job injury.

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What is not covered by WCI?

• An employer is not liable for worker compensation
  benefits if an employee is impaired due to the
  use of alcohol or drugs and the impairment
  contributed to injury or death. This includes
  the use of prescription or non-prescription
  medications.
• The law does not provide compensation for
  coronary or coronary artery or cerebrovascular
  injury (e. g. , stroke) unless it is shown that
  the exertion of the work that caused the injury
  was beyond that required by the employees usual
  job duties.

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Who is covered by WCI and when does that coverage
begin?

• All classified and unclassified employees,
  graduate assistants and student employees are
  covered by workers compensation insurance.
  Volunteers may also be eligible for workers
  compensation benefits if injured on the job.
• Coverage begins on the first day of work.

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Who administers WCI for State of Kansas
Employees?

• The Division of Workers Compensation, Kansas
  Department of Labor, administers the Workers
  Compensation Act. The State Self-Insurance Fund
  (SSIF) was established by the Kansas legislature
  to administer workers compensation claims on
  behalf of State of Kansas employees.
• The SSIF can be reached in Topeka at 785-296-2364
  or website - http//www.khpa.ks.gov/subject/workco
  mp.htm

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What if an accident occurs?

• All accidents should be reported to the employer
  (usually a supervisor) immediately so the injured
  worker can seek medical attention if needed and
  to investigate the accident to prevent
  recurrence.
• The employee must complete the Incident Report
  form (even if work was not missed or medical
  treatment needed). If the employee does not
  complete the report within 10 days of the
  incident, he/she could be denied workers
  compensation benefits. If an employee is unable
  to complete the incident report because of their
  injuries, the supervisor should complete the
  report for them and note that the employee is
  unable to complete it because of injuries. The
  employee should immediately notify the supervisor
  if work is missed or medical treatment sought at
  a later date.

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What if an accident occurs?

• The supervisor must complete the Employers
  Report of Accident form (K-WC 1101-A)
  immediately.

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What if an accident occurs?

• Both the Incident Report and Employers Report of
  Accident must be sent to HRS immediately. HRS
  will submit both forms to SSIF. Submission of the
  Employers Report of Accident does not mean that
  the employee has been approved for Workers
  Compensation. The SSIF will investigate the
  claim once they have received the Employers
  Report of Accident and determine compensability.

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Where do injured workers go for medical treatment?

• An employee injured at work is entitled to all
  reasonable and necessary medical treatment needed
  to cure or relieve the effects of the injury.

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Where do injured workers go for medical treatment?

• Minor/Non-life-threatening injuries would be seen
  at the Student Health Clinic.
• Serious/Life-threatening injuries would be seen
  at the Emergency Department at Mt. Carmel
  Regional Medical Center.
• Incidents that would occur after hours or
  weekends would be treated at the Emergency
  Department at Mt. Carmel Regional Center if
  immediate care is required.

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Where do injured workers go for medical treatment?

• PSU employees working in the Kansas City area
  must receive medical treatment for work-related
  accidents at KU Medical Center.

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Where do injured workers go for medical treatment?

• It is important to understand that directing the
  employee to seek medical care does not mean their
  Workers Compensation claim is approved. The SSIF
  adjuster will determine compensability of the
  claim.
• If a medical provider contacts you for
  authorization of medical care, refer the provider
  to SSIF at 785-296-2364. No persons at PSU have
  authority to authorize workers compensation
  treatment.

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Where do injured workers go for medical treatment?

• The SSIF has the right to choose the treating
  physician. Should an employee seek medical care
  from a provider that is not approved by SSIF,
  payment by SSIF is limited to 500 of
  unauthorized medical payments.

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If an employee is approved for medical treatment.

• The employee will be excused from work without
  loss of pay or accrued leave in order to obtain
  medical treatment on the day of the accident or
  injury. Additionally, he/she will also be excused
  from work without loss of pay or accrued leave to
  obtain further medical treatment related to the
  injury. Absences from work must be limited to
  the time required to receive medical attention
  only. The employee may also be required to
  furnish satisfactory proof of having received
  medical treatment.

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If an employee is approved for medical treatment.

• If the employee receives medical care and is
  given work restrictions by the medical provider,
  you and your supervisor should work with HRS to
  determine if those restrictions can be
  accommodated. You should also send a copy of the
  restrictions to HRS.
• If an employee misses work due to a
  work-related injury and you havent received any
  information from the medical provider, contact
  the employee and obtain a copy of the work
  release or restrictions and send a copy to HRS.

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If an employee is approved for medical treatment.

• It is important to keep SSIF and HRS informed
  about any changes in the status of an injured
  worker. This includes changes in work
  restrictions, if they begin missing work or
  return to work.
• Employees must make every effort to return to
  transitional or permanent work within the
  physical restrictions prescribed by the attending
  health care provider. Workers compensation
  benefits and employment with PSU may be
  terminated if the employee does not cooperate
  with these efforts.

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How do employees approved for WCI get
prescriptions?

• The provider may prescribe certain drugs or other
  items during the course of treatment. Employees
  may purchase prescription drugs from any outlet
  in the area. The vendor may allow the employee to
  charge the drugs and then directly bill SSIF or
  the employee may pay for the drugs and be
  reimbursed by SSIF. SSIF usually will not pay
  for over the counter items, aspirin, band aids,
  etc. The employee should not purchase or rent
  any other medical equipment until approved by the
  SSIF claim representative.

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What does WCI pay and how does it affect
employment status?

• When a worker is injured on the job, the worker
  is entitled to certain benefits while off work
  for the injury and also medical expenses and
  vocational rehabilitation assistance, if approved
  by SSIF.
• Benefits are paid at the rate of 2/3 of the
  employees average weekly wage while the worker
  is off work up to a maximum amount based on a
  percentage of the states average weekly wage.
  This compensation is termed Temporary Totally
  Disabled or "TTD".

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What does WCI pay and how does it affect
employment status?

• All medical benefits are paid to cure and/or
  relieve the worker of the effects of the injury.
• If an employee dies as a result of a
  job-related injury, the surviving spouse or
  dependents can receive compensation based on a
  rate of 66 2/3 of the employees average weekly
  wage up to the applicable maximum amount.

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What does WCI pay and how does it affect
employment status?

• In general, the employee is not eligible for
  weekly compensation for the first 7 days unless
  totally disabled from work for 21 consecutive
  days. The SSIF will issue a separate check in the
  same time frame (biweekly) as State employees
  receive regular pay. HRS will be advised of the
  SSIF paid compensation and will make necessary
  adjustments to the time and leave balances. To
  go along with the SSIF paid compensation
  employees can use accrued leave (e.g. sick, or
  vacation) to receive a full paycheck.

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What does WCI pay and how does it affect
employment status?

• An employee cannot be fired, demoted or otherwise
  discriminated against for filing a claim in good
  faith. However, an employee cannot collect TTD
  and unemployment for the same weeks.

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Understanding Workers Compensation

• Questions