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The role of the HR representative in Georgia Workers’ Compensation Claims

What does Georgia's Workers’ Compensation Act expect of me as the HR representative for my employer?

The law expects you to educate all employees with emphasis on supervisors.

Why the emphasis on educating supervisors?

Because the supervisor is the quarterback of the Worker’s

Compensation Team.

The HR rep is the receiver on the WC team

What do I need to do to educate the employees of the company? Get the employee’s signature on a document acknowledging he has been informed and understands his rights under Georgia’s Workers Compensation Act, has seen the panel and the Bill of Rights.

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What rights do I include in the document?

That the employee has :*seen the panel of physicians*knows what to do if injury occurs and to whom to report it*understands how the panel works*has seen the Bill of rights*knows HR will assist him in getting medical treatment

What must I tell supervisors?

*Report all injuries to HR*Keep records of all reported injuries*Interview witnesses and keep records of statements given*Escort the employee to HR/nurse*Take all reported work injuries seriously

How do I instruct supervisors?

Don’t tell the employee to shake it off

Don’t tell employee to go to HRDon’t Tell employee to get back to

workDon’t Tell employee “you ain’t hurt”

Don’t Tell employee to put Biofreezeon his injury

Don’t tell the employee he is firedDon’t Tell employee to go home and

rest and come to work next dayDon’t Tell employee to continue to

work until shift overDon’t Tell employee to call his wife to

come take him to a doctorDon’t Tell a co worker to take

employee to HR or nurse’s station

Hold regular meetings with supervisors

When do I educate employees about workers’ compensation?

TWO TIMES : (1) at the time of hire and (2) at the time of injury!

How do I create a panel of physicans?

List 6 OR MORE doctors on the panel.One must be an orthopedic surgeon and one must be a minority

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Where do I post this panel of physicians?

In many places that are seen by the employee such as break room, time clock, whereeveremployee’s gather.

How do I pick the doctors to put on the panel?

*Interview docs before putting them on the panel that they know WC law.*Make sure the doctors know what your company does*Make sure you have the name of the person at the doctor’s office to contact for immediate response

Once the panel of physicians is posted in several places, does the law require me to do anything further with it?

YES ! You must constantly monitor the panel for accuracy because doctors move, die and retire !KEEP OLD PANELS !!!

Once I offer an employee a job, is there anything I need to do before he goes to work?Get the worker to complete a POST OFFER MEDICAL QUESTIONAIRE.

What does the law require me to do when an employee reports a work injury to me or to his supervisor?

Make sure ALL supervisors know that everyone who reports an injury must contact HR ! This is where the ball is usually dropped!

I have received notice from an employee that he has injured himself at work. Now what?

*Get a statement from him of how injury occurred.*Let him choose a doctor from the panel.Get a signed 207 form.*Let him circle and initial his choice*Get a Dr’s appointment for him.*Offer transportation if he has none.

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SEND EMPLOYEE FOR AN IMMEDIATE DRUG SCREEN !!

Does an employee verbally have to report a work injury?

NO !!

This is NOTICE of a work injury !

The employee has gone to the doctor, now what does the law require me to do?Call the doctor’s office , fax her a signed 207 form and have her fax you her medical report !Ask the doctor if the employee can return to regular duty work. If not, why not?Offer the employee light duty workAsk the doctor when is she to see the employee again and keep track of this!Ask the doctor what the employee stated was his method of injury.

Employer needs to know the Treatment plan of every injured worker. Send this to adjuster !

Test results ?Physical therapy needed ?Medications prescribed ?Conservative treatment?Surgery proposed ?

What does the law want me to do next?

*CONTACT THE INSURANCE ADJUSTER.*SEND ADJUSTER SIGNED 207 AND ALL MEDICAL REPORTS *STAY IN CONSTANT COMMUNICATION WITH THE ADJUSTER. YOU TWO ARE A TEAM !!!

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Why are you leaving the management of your workers’ comp claims completely in the hands of your adjuster?

I RECEIVED THE MEDICAL REPORT FROM THE

DOCTOR. DOES THE LAW HAVE SPECIFIC REQUIREMENTS OF HOW I HANDLE MEDICAL

REPORTS? YES !!!! HIPAA REQUIREMENTS.

All medical records of employees

in the possession of the employer MUST be kept in a LOCKED filing

cabinet and not co-mingled with

personnel or workers’ compensation files.

Access to the filing cabinet containing employee medical

records MUST be restricted.

Any time medical records are

under review by the employer,

access to the reviewing personnel MUST be restricted.

Tip: work injuries are not short term disability claims

What do I do when employees have non work injuries?

If the employee is out of work receiving worker’s comp, do I need to be doing anything? YES!!

Employee loves to hunt and posted this on facebook, twitter and instagram

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Supervisors must be the street committee !!!

You should report all Non work related accidents to treating Dr.

The law requires HR rep, not the adjuster, to keep track of the injured worker ! Report this to Dr.

Does the law expect me to tell the doctor about the employee’s activities away from work? YES !!

SPORTS

GYM JUNKIES

Does HIPAA prevent me from talking to the treating physician? NO !!

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What do I do if the panel doctor wants to refer the employee to another doctor?

Make sure the panel doctors know you must approve ALL referrals before she makes a referral !

What does the law say about a panel doctor making a referral?

If the case goes to court, what will the judge

expect from me?

Proof of posted panel

Proof that employee selected his own choice and a second choice

Accident report signed by employeeProof employee was assisted in getting medical

appointmentMedical records that document prompt and

appropriate treatment was provided for employeeMedical records show history, diagnosis, treatment

and return to work dateMedical records that show CAUSATION or LACK

THEREOFCredible testimony from knowledgeable supervisor

and witnessesOffer of light duty work if appropriate

Detailed , convincing medical opinionsProof that employee was engaged in activities which

show ability to work

*Errors made by HR rep that impact the cost of a workers compensation

Failure to interview doctors before putting them on panel

Failure to keep panel up to dateFailure to keep old panels for older dates of accident

Failure to allow injured worker to select physician from panel

Failure to allow injured worker to make a second choice from the panel

Failure to assist injured worker in making appointment

Failure in providing transportation if neededFailure to get the injured worker back to panel

physician if he strays from itFailure to provide doctor with information about job

duties and specifics of the injury Failure to correct inaccurate information in medical

recordsFailure to provide doctor with light duty job

descriptionFailure to educate supervisorsFAILURE OF HR rep TO MANAGE THE MEDICAL CARE OF THE

INJURED WORKER

Does the law expect me to know the defenses to a workers comp claim? YES! Report all to the adjuster !

Willful misconductHorseplayIdiopathic injuriesIntoxication by drugs/alcoholNon work related injuries

Aggravation of a preexisting condition

The employer is only liable for workers compensation benefits for an aggravation of a preexisting injury as long as the aggravation by work exists. Once the aggravation is over, the employer is no longer obligated to pay worker’s compensation benefits.

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Behind every favorable decision for the employer is a knowledgeable , competent work comp HR representative

Knowledgeable, competent workers’ comp HR representative

Website

www.sbwc.georgia.gov