Workers' Compensation

1
State of ConnecticutCore-CT Project Workers
Compensation 8 Hours
Updated 09/26/2003
2
Getting Started
Welcome

• Welcome to the Workers Compensation Course!
• Introductions
• Training Facility Orientation
• Parking Lot Issues to be addressed at a later
  point in time.
• To participate in this course, you should have
  already completed the following training
• PeopleSoft Navigation Tutorial
• HOV100 HRMS Business Process Overview

3
Ground Rules
Welcome

• Be back from breaks and lunch on time
• Listen and follow along avoid jumping ahead
• The only stupid question is the one left unasked
• Helping each other is encouraged
• All Parking lot issues will be answered quickly
• Honor training site guidelines in regards to food
  and drink
• Please do not use the Internet for anything but
  accessing Core-CT
• Instructor is not responsible for spelling errors

4
Objectives
Welcome

• In this training, you will learn to
• Apply the new Workers Compensation processes
  that you learned about in the HRMS Overview
  course. We will specifically focus on the
  following processes
• Incident Details
• Injury Details
• Claims Management
• Updating Employee Data
• Reconciling Paycheck and Adjusting Time and Labor
• View Employee Injury Summary
• Reports
• Use Core-CT as a tool in supporting the processes
• Utilize PeopleSoft functionality to maximize your
  efficiency

5
Agenda
6
Agenda
7
Training Tools
Welcome

• In this training session, we use tools created
  specifically for this course.
• Presentation
• We use a PowerPoint presentation to guide us
  through our discussion of processes and key
  points related to using Core-CT
• Exercises
• We developed exercises that enable you to
  practice the skills you learn in each module
• Training Database
• The functionality in our database mirrors the
  Core-CT production environment closely, though
  changes may be made prior to go-live
• Significant changes made after training will be
  communicated to you
• Data is loaded into the Core-CT training database
  to help you learn how to use Core-CT, not to
  reflect a specific agencys transactions
• You can make mistakes and experiment without
  consequence

8
Training Tools
Welcome

• We also use a web-based help system during this
  class. This tool is available to you after
  go-live.
• Web Learning Assistant
• Web-based tool that provides help and detailed
  information for specific Core-CT job functions
• Contains concepts, procedures, flows, and a
  glossary
• The WLA is your primary reference tool (now and
  once Core-CT goes live)
• The WLA will evolve with Core-CT. As
  functionality changes, so will the content in the
  WLA
• Lets walk-through the tool together now
• WLA Browse Path Core-CT Human Resources gt
  Monitor Health Safety gt Data Entry Procedures gt
  Entering Claims Management

9
Training Tools
Welcome

• Job Aids are available to reinforce the
  information introduced in this course. Job Aids
  summarize key information and outline critical
  processes in Core-CT.
• General Job Aids
• Module Specific Job Aids
• Reporting Job Aids

10
Core-CT Navigation
Welcome

• Together we will practice the skills you learned
  in the Core-CT Navigation Tutorial.
• Universal Navigation Header
• Activity Log in and use the Universal Navigation
  Header to sign off Core-CT
• Left-Hand Navigation Menu
• Activity Use the Left-Hand Navigation Menu to
  step through the various levels of the directory
  structure

11
Agenda
12
Overview
Incident Details

• The first step in the workers compensation
  process is logging the incident in Core-CT. The
  TPA (third party administrator) is responsible
  for initially entering the incident in Core-CT.
• Once the TPA records an incident, agency
  personnel can access the incident to view or
  update some of the information
• It is important to track incidents when they
  occur

13
Process Flow
Incident Details
Employee is Placed on Workers Compensation
Accident Reported to TPA Agency
TPA Enters Injury Details Agency Updates (if
necessary)
TPA Enters Incident Details Agency Updates (if
necessary)
Employee / Supervisor files appropriate forms
Report only
Stop
Medical Only
Stop
Lost Time
Salary Prgm Executed Interfaces to/from TPA
Core-CT
Interfaces to/from TPA Core-CT (disability
date info)
TPA Enters Claim Details Agency Enters
Claim Rate Info
TPA Begins WC Check Process
A
14
Key Points
Incident Details

• Keep in mind the following key points for
  tracking incident details
• In addition to incident information being tracked
  through Core-CT, you can also track reports filed
  with OSHA
• WC207 Accident Report should continue to be
  used to track incidents related to workers
  compensation (physical form stays with the
  agency)
• The incident number is assigned once you save the
  information on the incident pages
• New incidents must be reported on the
  1-800-828-2717 injury hotline
• Reoccurring must be reported on the
  1-866-220-6534 recurrent hotline

15
Walk-through and Exercise
Incident Details

• Lets log-in to Core-CT.
• Exercise 1 Enter Incident Details
• Scenario An employee at the Department of
  Transportation dropped a heavy object on his toe
  while working in the garage. Record the incident
  details as if you were the TPA.
• WLA Path Core-CT HR gt Monitor Health Safety gt
  Data Entry Procedures gt Entering Incident Details
• Exercise 2 Updating Incident Details
• Scenario The TPA entered the incident details
  for an employee at the Department of Public
  Health. You need to add details to the
  description that was entered.
• WLA Path Core-CT HR gt Monitor Health Safety gt
  Data Entry Procedures gt Entering Incident Details

16
Agenda
17
Overview
Injury Details

• After entering the incident details, the TPA must
  enter the injury details.
• Once the TPA records the injury details, agency
  personnel can access the injury to view or update
  some of the information
• Tracking work-related accidents and injuries
  enables you to implement corrective and
  preventative actions and document Workers Comp
  Claims
• The State has set-up accident types based on
  information from the Department of Administrative
  Services Workers Compensation Unit
• The accident types are available to complete the
  details of an injury resulting from an accident

18
Process Flow
Injury Details
Employee is Placed on Workers Compensation
TPA Enters Injury Details Agency Updates (if
necessary)
Accident Reported to TPA Agency
TPA Enters Incident Details Agency Updates (if
necessary)
Employee / Supervisor files appropriate forms
Report only
Stop
Medical Only
Stop
Lost Time
Salary Prgm Executed Interfaces to/from TPA
Core-CT
Interfaces to/from TPA Core-CT (disability
date info)
TPA Enters Claim Details Agency Enters
Claim Rate Info
TPA Begins WC Check Process
A
19
Key Points
Injury Details

• Keep in mind the following key points when
  tracking injury details
• Once you have established that a person has
  experienced a work related injury or illness, the
  State and TPA need to discuss the case regarding
  time off from work and medical issues, if
  necessary
• The agency and the TPA determine the type of
  compensation benefit the person receives, if any
• A 52-week wage history must be obtained for any
  Lost time injury
• You can track more detailed Incident and Injury
  reporting by using the Incident and Accident Type
  fields
• In order to capture details for OSHA reporting,
  agencies must enter the appropriate OSHA Type on
  the Injury Details, Reporting page

20
Walk-through and Exercise
Injury Details

• Lets log-in to Core-CT.
• Exercise 3 Enter Injury Details
• Scenario In the first topic we entered incident
  details for James Joseph, an employee at DOT. Now
  we will enter the injury details for the same
  employee while we are logged in as the TPA.
• WLA Path Core-CT HR gt Monitor Health Safety gt
  Data Entry Procedures gt Entering Injury Details
• Exercise 4 Updating Injury Details
• Scenario In the second exercise, we asked you to
  update incident details for Jill Smart, an
  employee at the Department of Public Health. Now
  we must also update some of her injury details.
• WLA Path Core-CT HR gt Monitor Health Safety gt
  Data Entry Procedures gt Entering Injury Details

21
Agenda
22
Agenda
23
Overview
Claims Management

• Once the incident and injury details are logged,
  the TPA and agency complete the claims management
  pages.
• Details include the employees individual status,
  assessment of the employees ability to work, and
  direct and indirect costs of the claim
• Your tracking provides the information you need
  to report a claim to the TPA and OSHA

24
Process Flow
Claims Management
Employee is Placed on Workers Compensation
Accident Reported to TPA Agency
TPA Enters Injury Details Agency Updates (if
necessary)
TPA Enters Incident Details Agency Updates (if
necessary)
Employee / Supervisor files appropriate forms
Lost Time
Salary Prgm Executed Interfaces to/from TPA
Core-CT
Interfaces to/from TPA Core-CT (disability
date info)
TPA Enters Claim Details Agency Enters
Claim Rate Info
TPA Begins WC Check Process
A
25
Key Points
Claims Management

• Keep in mind the following key points for claims
  management
• Core-CT assigns the claim number automatically
  once you save the information on the claims
  management pages
• Core-CT assigns a reoccurrence claim number
  automatically that links back to the original
  incident number for each reoccurrence processed

26
Walk-through and Exercise
Claims Management

• Lets log-in to Core-CT.
• Exercise 5 Enter Claims Management
• Scenario Bill Williams is an employee at the
  Department of Revenue Services. He currently has
  a workers compensation claim pending and you are
  the TPA who must enter the claims management
  details in Core-CT.
• WLA Path Core-CT HR gt Monitor Health Safety gt
  Data Entry Procedures gt Entering Claims
  Management

27
Agenda
28
Overview
Salary Program Executed

• In order to complete the claims management
  information, agency personnel must enter the
  employees average salary for the previous 52
  weeks starting with one week prior to the date of
  injury or reoccurrence date on the Claim Rate
  page.
• Initially agencies will need to run two queries
  to calculate the average salary
• One query retrieves historical payroll data that
  has been converted into EPM (Enterprise
  Performance Management) from the legacy system
• One query retrieves Core-CT historical payroll
  data
• Agencies should download these queries to Excel
  and use the information extracted to calculate
  the average salary to enter on the Workers
  Compensation Rate page

29
Process Flow
Salary Program Executed
Accident Reported to TPA Agency
TPA Enters Injury Details Agency Updates (if
necessary)
TPA Enters Incident Details Agency Updates (if
necessary)
Employee / Supervisor files appropriate forms
Lost Time
Salary Prgm Executed Interfaces to/from TPA
Core-CT
Interfaces to/from TPA Core-CT (disability
date info)
TPA Enters Claim Details Agency Enters
Claim Rate Info
TPA Begins WC Check Process
A
30
Workers Compensation Rates
Salary Program Executed

• 75 CGS - Chapter 568
• Determined by taking Average Weekly wage(Salary
  query)plus Filing status(WCC-1a) and lookup in
  rate table
• New rate table every Oct.1st
• Weekly rate divided by 7 Daily rate
• No increase with CBI

• 100 Statute 5-142
• Only certain job classifications qualify
• Full weekly salary
• Weekly salary divided by 5 Daily rate
• Increases with CBI even if out on workers
  compensation leave

31
Key Points on CORE-CT Calculations OF TRC Codes
Salary Program Executed

• 75 Claims
• 3 day waiting period, 6 days or less
• If total disability period is 7 days or greater
  waiting period is waived
• All calculations are based upon a 14 Calendar day
  basis

• 100 Claims
• No waiting period
• 10 minus R rule for spilt biweekly pay periods
• All calculations are based upon a 10 Paid day
  basis
• Exception - Single biweekly disabilities will not
  be subject to the 10 minus R rule

32
Key Points
Salary Program Executed

• Keep in mind the following key points
• Agency personnel need to determine if there is 52
  weeks of salary history in Core-CT to determine
  where to run the query from
• If 52 weeks do not exist in Core-CT, agencies
  must use EPM and converted data
• If 52 weeks exist, agencies can use Core-CT
  historical payroll data
• Once the query is downloaded to Excel, agencies
  must review the gross earnings amounts and codes,
  adjust any necessary amounts (e.g., remove
  awards, bonuses, etc.), total the 52 pay periods
  and derive a weekly average that will be used for
  the Workers Compensation calculation
• This amount should be entered in the 52 Week
  Average Salary field and will be included in the
  work done by the TPA to process the employees
  claim
• Agencies should also include the total gross and
  total weeks used to calculate the 52 Week Average

33
Walk-through and Exercise
Salary Program Executed

• Lets log-in to Core-CT.
• Exercise 6 Execute Review Query for 52 Week
  Average Weekly Wage
• Scenario The TPA notifies you that they have
  assigned Bill Williams from DRS a claim number
  and approved his claim. You must run a query to
  calculate his average salary for the previous 52
  weeks (may not run in class depending on
  processing capacity).
• WLA Path Core-CT HR gt Monitor Health Safety gt
  Data Entry Procedures gt Entering Claims
  Management
• Exercise 7 Enter 52 Week Average Salary on
  Claim Rate page
• Scenario Now that we have calculated the
  average salary, we must enter it along with the
  total gross on the Claim Rate page. Enter the
  average salary for the Bill Williams.
• WLA Path Core-CT HR gt Monitor Health Safety gt
  Data Entry Procedures gt Entering Claims Management

34
Agenda
35
Agenda
36
Overview
Updating Employee Data

• Once the workers compensation claim is
  processed, agency personnel must update employee
  data to ensure the employee is placed on a leave
  of absence and their time is reported correctly.
• Agency personnel must update the job data to
  place the employee on leave of absence.
• If the employee is assigned a schedule, agency
  personnel must change their schedule to a zero
  hour schedule
• Agency personnel need to report the employees
  time in Time and Labor with the applicable
  Workers Compensation codes (must be
  substantiated by medical documentation)
• Finally, agency personnel must update any
  additional pay or general deduction settings that
  are in place

37
Updating Employee Data
Agency Enters PY Data
Agency Enters HR Data
Agency Enters TL Data
TPA Generates First Check
A
Agency Reconciles First Check
Timekeeper Adjusts Attendance (if necessary)
Central PY Performs Adjustments (if necessary)
Agency Cuts Petty Cash Check
Central WC Generates Queries for Audit
Employee Receives Check from TPA while Out
38
Key Points
Updating Employee Data

• Keep in mind the following key points when
  updating employee data for an employee who is
  placed on workers compensation
• Agency HR must put the employee on leave and
  update their employee type once the agency
  receives the first WC check from the TPA
• Agency Time Labor must update the employees
  schedule
• Agency Payroll must ensure any general deduction
  or additional pay information is stopped as
  appropriate
• It is important to remember that for workers
  compensation you must place the employee on a
  paid leave of absence so you dont affect their
  employee status
• Action should be paid leave of absence
• Reason can be workers compensation with or
  without pay
• Leaves continues to accrue for 1 year per claim

39
Time and Labor TRC Rules
Updating Employee Data

• IWSD (Informational Workers Compensation Start
  Date) - For new claims and recurrent claims where
  the employee reports to work before leaving IWSD
  cannot equal the date or injury or recurrence. It
  must be at least one day greater
• ILPD (Informational Last Pay Date) Cannot
  precede IWSD
• IWED (Informational Workers Compensation End
  Date) Cannot precede ILPD or IWSD. It must be
  the last day of disability

40
Walk-through and Exercise
Updating Employee Data

• Lets log-in to Core-CT.
• Exercise 8 Update HR Data
• Scenario Sara Bent, an employee at the
  Department of Public Safety, is going out on
  Workers Compensation effective July 1st. Update
  her employee status to be leave due to workers
  compensation.
• WLA Path Core-CT HR gt Monitor Health Safety gt
  Data Entry Procedures gt Entering Job Data
• Exercise 9 Update TL Data
• Scenario Since Sara will be out for 3 months,
  you must also assign her to a Zero hour schedule
  and enter her time for the past two weeks.
• WLA Path Core-CT HR gt Monitor Health Safety gt
  Data Entry Procedures gt Entering Time
• Exercise 10 Update PY Data
• Scenario Sara also has a general deduction that
  must be stopped while she is on workers
  compensation.
• WLA Path Core-CT HR gt Monitor Health Safety gt
  Data Entry Procedures gt Entering General
  Deductions

41
Agenda
42
Overview
Reconciling Paycheck and Adjusting Time and Labor

• The TPA can only issue workers compensation
  checks after all required forms are processed
  which can delay the issuing of checks from the
  regular employee pay schedule. As a result, most
  State employees are paid from the agencys
  payroll account while awaiting payment from the
  TPA.
• Agency calculates difference between the
  reimbursement amount and the amount paid to the
  employee during the interim period based on the
  days the employee was out since the incident and
  the rate of pay on the claim type
• Agency Business Office deposits the check from
  the TPA and sends payroll adjustment forms to the
  Comptrollers Office who in turn balances the
  employees payroll information
• Employee may be owed money due to taxes (agency
  will cut a petty cash check)
• Employee may owe money due to the amount of the
  claim (employee must repay any money through a
  payroll deduction once they return from workers
  compensation or a personal check)

43
Overview, cont.
Reconciling Paycheck and Adjusting Time and Labor

• The agency must also ensure that the employees
  time and labor information is coded appropriately
  for the workers compensation leave.
• Agency Time and Labor must adjust attendance
  depending on whether the employee used leave
  while the workers compensation claim was being
  settled
• In many cases these adjustments award leave back
  to the employee since time was coded to leave
  before the claim was settled
• Central payroll must perform adjustments to
  ensure taxes, benefits and deductions are all
  balanced
• While an employee is on workers compensation and
  being paid by the TPA they need to be enrolled in
  benefits billing in order to be processed by the
  agency

44
Reconciling Paycheck and Adjusting Time and Labor
Agency Enters PY Data
Agency Enters HR Data
Agency Enters TL Data
TPA Generates First Check
A
Agency Reconciles First Check
Timekeeper Adjusts Attendance (if necessary)
Central PY Performs Adjustments (if necessary)
Agency Cuts Petty Cash Check
Central WC Generates Queries for Audit
Employee Receives Check from TPA while Out
45
Agenda
46
Overview
Return from Workers Compensation

• Once an employee returns from workers
  compensation (based upon the appropriate medical
  documentation) the agency must ensure they update
  the employees information appropriately. This
  includes entering the following
• Entering a close date on the Claims Management
  page
• Updating the employees job data to be active
• Reassigning a schedule for time and labor, if
  necessary
• Restarting additional pay and general deduction
  information

47
Process Flow
Return from Workers Compensation
Return from Workers Compensation
Agency Enters Date Closed
Agency Enters HR Data
Agency TPA Notified of Employees Return
TPA Processes Last Check
Agency Enters TL Data
Enter Regular Pay in Time Labor
Agency Enters PY Data
Central or Agency WC Runs Reports
48
Key Points
Return from Workers Compensation

• Keep in mind the following key points when an
  employee returns from workers compensation
• Agency personnel can generate the Personnel
  Actions History report daily to track employee
  status
• Communication between agency personnel is key to
  ensure the employee is activated correctly in
  Core-CT

49
Walk-through and Exercise
Return from Workers Compensation

• Lets log-in to Core-CT.
• Exercise 11 Enter Close Date
• Scenario Bill Williams is returning to work and
  you must enter his close date on the Claim
  Details page.
• WLA Path Core-CT HR gt Monitor Health Safety gt
  Data Entry Procedures gt Entering Claims
  Management
• Exercise 12 Update HR Data
• Scenario Sara Bent is returning from work after
  a leave due to workers compensation, update her
  employee status to reflect her return.
• WLA Path Core-CT HR gt Monitor Health Safety gt
  Data Entry Procedures gt Entering a Return from
  Workers Compensation
• Exercise 13 Reassign schedule and enter TL Data
• Scenario Reassign Sara to her workgroup
  schedule now that she has returned to work.
• WLA Path Core-CT HR gt Monitor Health Safety gt
  Data Entry Procedures gt Entering Time

50
Agenda
51
Agenda
52
Overview
Recurrence

• A true reoccurrence is a flair up of a previous
  injury that was not precipitated by any action.
  When an employee is claiming a reoccurrence the
  TPA should always be consulted to determine if it
  is a true reoccurrence or a new injury.
• Reoccurrence processing in CORE-CT will be
  initiated by TPA staff
• An employee claiming a reoccurrence should be
  informed they need to see a doctor on each
  occasion

53
Process Flow
Recurrence

TPA Enters Reopen Date Obtains Recurrence Claim
Number
Salary Prgm Executed Interfaces to/from TPA
Core-CT
Recurrence Reported to TPA
Agency Enters Claim Rate Info
Interfaces to/from TPA Core-CT (disability
date info)
TPA Begins WC Check Process
A
54
Agency Enters PY Data
Agency Enters HR Data
Agency Enters TL Data
TPA Generates First Check
A
Agency Reconciles First Check
Timekeeper Adjusts Attendance (if necessary)
Central PY Performs Adjustments (if necessary)
Agency Cuts Petty Cash Check
Central WC Generates Queries for Audit
Employee Receives Check from TPA while Out
55
Key Points
Recurrence

• Keep in mind the following key points
• New wages, workers compensation rate and
  disability dates will need to be processed for
  all reoccurrences.
• If a claim reoccurs, you can use the Original
  Claim Number field to track the original claim
  number
• If the Original Claim Number field is populated
  with a Core-CT claim number, the claim is a
  result of a reoccurrence
• If the Original Claim Number field is populated
  with an AWCS claim number and the Recurrence
  check box is not marked on the Incident page,
  then the claim was converted from AWCS
• If the Original Claim Number is populated with an
  AWCS claim number and the Recurrence check box is
  marked on the Incident page, then the claim is a
  result of a reoccurrence
• If a claim recurs that was not converted from
  AWCS it will be handled by the TPA

56
Walk-through and Exercise
Recurrence

• Lets log-in to Core-CT.
• Exercise 14 Record a recurrence
• Scenario After returning to work Sara Bent
  files for a recurrence of her previous claim.
  Enter the recurrence information in Core-CT.

57
Agenda
58
Overview
View Employee Injury Summary

• At any point during the workers compensation
  lifecycle you may need to look up or view details
  about an employees injury or illness. You can do
  this using the Injury Summary page in Core-CT.
• Injury information is always associated with an
  incident
• Summary information can help agencies pinpoint
  recurring injuries or illnesses
• You can only view this information for employees,
  not non-employees

59
Process Flow
View Employee Injury Summary
Workers Comp Details in Core-CT
Employee or Agency Requests Injury Information
Agency Views Employee Injury Summary
60
Walk-through and Exercise
View Employee Injury Summary

• Lets log-in to Core-CT.
• Exercise 15 View Employee Injury Summary
• Scenario Lets view the injury summary for Bill
  Williams, the employee at DRS.
• WLA Path Core-CT HR gt Monitor Health Safety gt
  View gt Viewing Employee Injury Summary
• Exercise 16 View Employee Injury Summary
• Scenario What type of treatment was used? Was
  the case reportable?
• WLA Path Core-CT HR gt Monitor Health Safety gt
  View gt Viewing Employee Injury Summary

61
Agenda
62
Overview
Workers Compensation Reports

• Agency personnel can generate reports from
  Core-CT to track workers compensation
  information.
• OSHA 300 Incident Log
• OSHA 300A Annual Summary

63
Overview
Workers Compensation Reports

• The Central Workers Compensation unit can also
  run the following reports for statewide
  reporting
• Location Incident Summary
• Employees in Incidents
• Incident Claim Detail
• Claim Summary Overview
• Incident Detail
• Incident Summary

64
Process Flow
Workers Compensation Reports
Return from Workers Compensation
Agency Enters Date Closed
Agency Enters HR Data
Agency TPA Notified of Employees Return
TPA Processes Last Check
Agency Enters TL Data
Enter Regular Pay in Time Labor
Agency Enters PY Data
Central or Agency WC Runs Reports
65
Walk-through and Exercise
Workers Compensation Reports

• Lets log-in to Core-CT.
• Exercise 17 Walk-through process to run OSHA
  300 Incident Log
• Scenario Review OSHA 300 Incident Log

66
Walk-through and Exercise

• Lets log-in to Core-CT.
• Exercise 18 Challenger Exercise

67
Agenda
68
Conclusion

• Wrapping up the Workers Compensation course
• Summary of completed course objectives
• Incident Details
• Injury Details
• Claims Management
• Updating Employee Data
• Reconciling Paycheck and Adjusting Time and Labor
• View Employee Injury Summary
• Reports
• Final Questions
• Complete the course evaluation forms

69
Sandbox Goals / Action Plan / Adjourn

• After this class, Central/Agency users can
• Use the Sandbox environment as a database for
  practice on Core-CT to reinforce what you have
  learned today
• Use all of the exercises completed in class as
  job aids in the Sandbox environment when you
  return to your agencies
• Fill out the Action Plan so you can plan when you
  will utilize the Sandbox and make the commitment
  to do so
• Check out the Core-CT website for information and
  updates!!!
• http//www.core-ct.state.ct.us