Workers

1
Workers CompensationMay 2015
2
Management Training Class

• Workers Comp Overview for Managers
• Quarterly at SMUCLA and RRUMC
• June 16 RRUMC
• Covers processes and procedures related to
  Workers Compensation
• Reviews Disability Management and the Interactive
  Process

3
Who is eligible?

• Career, casual, Per Diem employees are covered
  from the first date of employment
• Vanpool injuries
• Non-UCLA employees are covered by their
  respective employers, e.g. Travelers, Registry,
  other temporary workers
• Volunteers

4
Initial Employee Contact

• Was this injury work related?
• If the employee believes it was work-related or
  is unsure, provide Workers Compensation forms
  and direct the employee to seek immediate medical
  treatment at either Occupational Health Facility
  or the UCLA Emergency Department
• Employee should tell the UCLA Emergency
  Department that they are a UCLAMC employee and
  that they are being treated for a work-related
  injury
• Follow all procedures for a leave of absence

5
Medical Treatment

• Where to send the employee for treatment?
• Employee should be seen by Occupational Health
  Facility or the UCLA Emergency Department for
  the first 30 days
• IF EMPLOYEE WAS SEEN AT THE EMERGENCY ROOM,
  direct employee to follow-up at UCLA
  Occupational Health.
• Medical Control
• UC directs the employees medical care for an
  initial 30 days. UCLAMCs designated providers
  are Occupational Health Facility (OHF), RRUMC
  Emergency Medicine, and SMUCLA Nethercutt
  Emergency Medicine
• Exception Employee pre-designates personal
  Medical Doctor in writing prior to the injury.
  Contact WC HR for more information.

6
New Pharmacy Network

• The University of California (UC) has partnered
  with Helios to establish a Pharmacy Benefit
  Network (PBN) for workers compensation illness
  and injury related medications as part of the
  overall pharmacy program.
• Injured workers within the PBN will only be able
  to fill prescriptions from a pharmacy within the
  network after 4/1/2015.
• Posters should be posted next to the state
  mandated WC posters.
• Pamphlets will be given to all new hires with
  other state-mandated WC pamphlet

7
Cal-OSHA

• FOR SERIOUS INJURIES,
• page UCLA Health Safety at pager 90248 within EIG
  HT hours
• or call the Campus 24-hour call-in phone number
  
• EHS Hotline [phone]
• Serious injury includes
• Amputation Concussion  
• Injury resulting in serious degree of permanent
  disfigurement such as crushing injury or severe
  burn
• In-patient hospitalization gt24 hours for other
  than medical observation
• OSHA requires notice within 8 hours of Serious
  Injury

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9
When an Employee is injured on the job . . .

• Provide the employee with
• A completed Workers Compensation Claim Form
  (DWC-1) and Notice of Potential Eligibility
• This form must be provided within 1 working day
  of notice that an injury or illness has occurred
  as mandated by California state law. (Exception
  First Aid incidents)
• 2. A completed UCLA Incident Report and Referral
  for Medical Treatment
• 3. Workers Compensation Information Sheet

10
Paperwork

• Please review and complete all lines. Sign where
  appropriate.
• Supervisor should sign all forms where indicated
• Department keeps one copy for department records.
  
• If notification was by phone, send the form to
  employee via Certified Mail
• Immediately
• FAX a copy to the WC FAX line Health System HR
  310 794 3337 or
• EMAIL to hrworkerscomp_at_mednet.ucla.edu or
• CALL 877-6UC-RPRT (877-682-7778) with the
  information on the form (see Step 5)

10
11
Paperwork

• Employee keeps one copy of completed form
• Send all other copies of the form immediately to
  Health System HR for distribution
• Notify Health System HR Workers Comp x40500 if
  employee has been taken off work.
• Follow all procedures for a leave of absence

11
12
Important Information

• Employees should be paid for the time at OHF
  and/or the EMC (to complete the work shift.)
• Charge hours to Home Cost Center
• Employees must use SL for any time at off-site
  (non-OHF or EMC) appointments, and for time taken
  for therapy, diagnostic appts
• Charge hours to Home Cost Center
• Employee may return to temporary work on a
  modified work schedule or modified duties at any
  time.
• Charge actual Modified duty hours worked as
  Modified Duty Workers Comp and to the Return
  to Work Cost Center.

13
Disability Management

• Mark Briskie
• UCLA Health System Human Resources
• [phone]
• Legal ResponsibilitiesWorkers
  CompensationFamily Medical Leave

14
Contacts for Return to Work Program

• Contact UCLA Health HR Workers Compensation/
  Return to Work coordinators to confirm employee
  meets eligibility criteria
• UCLA Health Human Resources WC 310 794 0500
• Mark Briskie mbriskie_at_mednet.ucla.edu 310 794
  0525
• Cynthia Vazquez cvazquez_at_mednet.ucla.edu 310 794
  0522
• Ingrid Garcia igarcia_at_mednet.ucla.edu 310 794
  3036
• Return to Work Coordinators
• Mark Briskie mbriskie_at_mednet.ucla.edu 310 794
  0525
• Suzanne Bleibtreu sbleibtreu_at_mednet.ucla.edu

15
Injury Prevention resources

• UCLA Health Safety
• SAFETY INSPECTIONS/TRAINING ERGONOMIC EVAL
  ACCIDENT INVESTIGATIONS
• Jennifer Mempin jmempin_at_mednet.ucla.edu 310-267
  -9886 phone [phone] fax PAGER
  99828
• SAFE PATIENT-HANDLING COORDINATOR
• Larona Taylor lataylor_at_mednet.ucla.edu
• 310-267-9897 phone [phone] fax
  PAGER 91136

16
Injury Prevention resources

• Ergonomic Evaluation Request Form
• Bruin Ergo - UCLA UCLA Health Online Ergonomics
  Program (Cardinus)
• User ID Employee ID Number (link on HR
  website)
• To request onsite eval UCLA Health Support
  Services Center 
• Bruin Break
• Jeri Simpson 310 794 0500 jasimpson_at_mednet.ucl
  a.edu

17
Directory

• SEDGWICK CMS
• P.O. Box 14533
• Lexington KY 40512-4533
• Mail code 691448
• Phone [phone]
• Fax [phone]
•  
• CAMPUS PAYROLL
• UCLA Wilshire Center, Suite 620
• MC 141648
• Phone [phone]
• Fax [phone]
•  
• UCLA HEALTHCARE PAYROLL
• UCLA Wilshire Center, Suite 1700
• MC 167646
• Phone [phone]
• Fax [phone]
•  

OCCUPATIONAL HEALTH FACILITY (OHF) 67-120 Center
for Health Sciences Monday through Friday 700
a.m. to 430 p.m. Mail Code 172524 Phone 310 825
6771 Fax [phone] www.ohs.uclahealth.org
  EMERGENCY DEPARTMENT 757 Westwood Plaza (ER
entrance Gayley Ave, N of Le Conte) Phone 310 267
8406 Open 24 hours a day   SMH Nethercutt
Emergency Room 1255 15th Street, Santa
Monica Phone [phone]
18
Policy

• Health System Policy HS 7318
• Employee Work-Related Illness and/or Injury
• http//www.mednet.ucla.edu/Policies/pdf/enterprise
  /HS7318.pdf
• Health System Policy HS 7324
• Employee Transitional Return to Work(TRTW) Policy
• http//www.mednet.ucla.edu/Policies/pdf/enterprise
  /HS7324.pdf

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Other Required forms

• Required Workplace postings
• DWC 7 Notice to Employees Injuries Caused By
  Work
• Workers Compensation Pharmacy Benefit Network
• HR Website http//hr.uclahealth.org
• New Employee Pamphlets
• Notice to Employees Injuries Caused by Work
• Helios/Pharmacy Benefit Network
• Distributed at time of Hire by HR Rep
• Pre-designation of Physician form
• HR Website http//hr.uclahealth.org