WIXLIB

SUCCESS”2012 WORKERS’ COMPENSATIONBEST PRACTICES MANUALA sub‐fund ofN.J. School Boards Association Insurance Group1st Edition – May 2012

MESSAGE FROM THE ERIC NORTH CHAIRPERSONDear Members:Workers’ Compensation insurance has been the cornerstone of the ERIC North sub‐fund since itsinception. The Workers’ Compensation program represents more than 50% of the premiums paid byERIC North sub‐fund members and is the one part of our insurance portfolio that we can positivelymanage through sound reporting and training programs.Over the years, we have addressed Workers’ Compensation at numerous meetings and have discussedthe value of return‐ to‐ work programs, site safety inspections, safety committees and staff training. As aresult of these efforts, ERIC North has consistently maintained the lowest Workers’ Compensationpremium structure of all the New Jersey School Boards Association Insurance Group (NJSBAIG) sub‐funds. Reductions in staff have lowered the premiums being paid while claims have remained relativelyflat. This trend is a warning that we must reduce claims to maintain our competitive premium structure.This Manual has been developed to assist in the management of your Workers’ Compensation programby providing guidance on how to process a Workers’ Compensation claim, investigate workplaceaccidents, follow up on employee injuries and work with your managed care provider to returnemployees to work as soon as possible.I would like to thank the committee for its hard work in developing this Manual, as many hours werespent distilling a great deal of information and various procedures down to a concise and usefuldocument. We are hopeful that this Manual will assist our members in reducing claims, and ultimately,premiums.Member DistrictsEast Windsor Regional School District—Diana BonillaEdison Township Board of Education—Virginia WhiteHillsborough Township Board of Education—Teresa Von den SteinenPerth Amboy Public Schools—Wendy VelasquezTeam Academy Charter School—Leslie WadeWoodbridge Township Board of Education—Nancy E. AlbericiNJSBAIGDeborah Strasser, Linda Smith, Terry Barlow and Stephen WilliamsG.R. MurrayJay Lawton, David L. Balken, Latonya Jackson and Nancy RiccioSincerely,Patrick M. MoranPatrick M. MoranERIC NORTH Chairperson

TABLE OF CONTENTSPageINTRODUCTION . 1THE LAW. 2SUPPLEMENTAL INDEMNITY . 3RESPONSIBILITIES: WORKERS’ COMPENSATION SPECIALIST . 4EMPLOYEE INFORMATIONSAMPLE LETTERS TO DISTRICT EMPLOYEES. 5OFF‐HOURS REPORTING . 7FREQUENTLY ASKED QUESTIONS . 8THE PROCESSWORKERS’ COMPENSATION CLAIMS PROCESS CHART . 10WORKERS’ COMPENSATION INJURY TIMELINE . 11WORKERS’ COMPENSATION INVESTIGATION TIMELINE. 12REPORTING FORMS AND PROCEDURESPREPARING THE INITIAL REPORT OF INJURY . 13SUPPLEMENTAL ACCIDENT INVESTIGATION. 14DEATH OF AN EMPLOYEE DUE TO WC INJURY. 15CERTIFICATION . 16ACKNOWLEDGEMENT OF VOLUNTARY PARTICIPATION IN SCHOOL EVENTS . 17CLAIM PETITION TIMELINE. 18SAMPLE CLAIM PETITION . 19SAFETY/TRAINING INFORMATION . 21RESOURCES . 22FREQUENTLY USED ACRONYMS . 23

INTRODUCTIONNEW JERSEY'S WORKERS' COMPENSATION PROGRAMIn New Jersey, Workers’ Compensation is a no fault program that provides medical treatment, wagereplacement and permanent disability remuneration to employees with job‐related injuries or illnesses.Death benefits are available to the dependents of an employee who dies due to a work‐related injury.New Jersey has had a workers' compensation law since 1911. Prior to this, employees injured on the jobwould sue their employers for negligence under common law.There were few changes to the system until the reforms of 1979 when the program began to provideenhanced benefits to the more seriously disabled. Provisions were also made for cost‐of‐living increasesfor totally and permanently disabled workers, dependents of deceased workers and Second Injury Fundbeneficiaries.New Jersey’s workers' compensation program seeks to establish a balance between injured workers andthe employers. Employers must provide necessary medical care, temporary disability benefits and, whendocumented, an award for resulting permanent disability. In return, they are protected from tortlitigation and unlimited civil verdicts for non‐economic losses. The only remedy available to the injuredemployee is through Workers’ Compensation.Specific to school districts is Title 18A:30‐2.1, which requires school districts to pay injured workers fullsalary for up to one calendar year without having the absence charged to the annual or the accumulatesick leave. Full wages are payable from the first day of absence. The Division of Workers' Compensation(DWC) is responsible for the administration of the NJ Workers’ Compensation Law, N.J.S.A. 34:15‐1 etseq., and the disposition of disputes raised under it.References: NJ LWD Website: http://lwd.state.nj.us/labor/wc/content/intro.html An Employer’s Guide to Workers’ Compensation in New Jersey published by the NJ LWD NJ Statute Title 18A Geaney’s New Jersey Workers’ Compensation Manual 2011 Edition1

THE LAWTITLE 18A ‐ EDUCATIONSection 18A:3018A:30‐2.1 ‐ Sick leave payment for service connected disability; satisfactory service18A:30‐2.1. a. Whenever any employee, entitled to sick leave under this chapter, is absent from his postof duty as a result of a personal injury caused by an accident arising out of and in the course of hisemployment, his employer shall pay to such employee the full salary or wages for the period of suchabsence for up to one calendar year without having such absence charged to the annual sick leave orthe accumulated sick leave provided in N.J.S.18A:30‐2 and 18A:30‐3. Salary or wage payments providedin this section shall be made for absence during the waiting period and during the period the employeereceived or was eligible to receive a temporary disability benefit under Chapter 15 of Title 34, Labor andWorkmen's Compensation, of the Revised Statutes. Any amount of salary or wages paid or payable tothe employee pursuant to this section shall be reduced by the amount of any workmen's compensationaward made for temporary disability.2

SUPPLEMENTAL INDEMNITYIf your school district carries Workers’ Compensation Supplemental Indemnity Insurance throughNJSBAIG, the following information is provided to assist you in processing your claims. Supplementalcoverage provides the district with partial reimbursement of the injured employee’s salary that is notpaid under the primary Workers’ Compensation policy.The policy is triggered by an employee’s lost time of (7) seven consecutive days due to a work‐relatedinjury. On a weekly basis, NJSBAIG emails Lost Time Reports to each member district and broker withthis coverage. It requires completion of a claim form. In addition to the claim form, the following mustbe provided:1.2.3.4.Copy of First Report from the Workers’ Compensation insurance carrier;Confirmation of the employee’s annual salary;Confirmation if he/she is a 10‐ or 12‐month employee; andCopy of all lost time checks that were issued by the Workers’ Compensation insurance carrier.Send the completed claim form and related information to:BMI BenefitP.O. Box 51176 Main StreetMatawan, NJ 07747Attention: Dawn SolanPhone: 800‐445‐3126 (x300)Fax: 732‐583‐9610Email: dawnv@bobmccloskey.comOnce received, the claim will be forwarded to BMI Benefits for processing. Claim forms can be obtainedby contacting NJSBAIG, BMI Benefits, or your broker.3

RESPONSIBILITIES: WORKERS’ COMPENSATION SPECIALISTBASIC FUNCTION:Under the general direction and supervision of the business administrator/risk manager, the Workers’Compensation Specialist is responsible for overseeing all claims district‐wide. This includes coordinatingclaims, creating accurate case history documentation, contacting injured workers, consulting with claimsadjusters and others to administer litigated claims, answering telephones, providing information andassisting employees.DUTIES AND RESPONSIBILITIES:1. Prepare and maintain a log for all accidents and document them when they are reported.2. Prepare and maintain a Workers’ Compensation file on injured employees. Monitor, coordinate andfollow up until claims are closed.3. Gather and forward all documentation, reports, statements, correspondence, bills, and informationpertaining to the injured worker. Provide information to appropriate personnel using establishedprocedures within 24 hours.4. Communicate openly with administrators, school nurses, claims adjusters and attorneys. Provideadditional information upon request.5. Provide information and assistance to employees and district staff regarding medical care,attendance and any concern that develops.6. Coordinate temporary, restricted or modified‐duty positions for workers with injuries who can worksafely while recovering. Obtain medical data to make decisions regarding transitional return‐to‐workassignments. Find suitable temporary positions for employees within medical limitations.7. Develop and present Workers’ Compensation training presentations for district staff.8. Coordinate and maintain employee injury reports, including administration of OSHA’s form 301, lossruns and actual time lost from work to meet OSHA/PEOSH recordkeeping requirements.9. Post Workers’ Compensation reporting procedures in all buildings, to keep employees informed ofall reporting requirements.10. Perform related duties as assigned.4

SAMPLE LETTER TO DISTRICT EMPLOYEES—ANNUAL EMPLOYEE NOTICE(Should be placed on district letterhead)MEMORANDUMTO:All Employees of Board of EducationFROM: ‐ Business AdministratorREF:Course of Action for Reporting Workers’ CompensationDate:September 2012Providing a safe working environment is important. Equally important is insuring that your work‐relatedinjured is properly address and managed. With this thought in mind, I would like to take thisopportunity to highlight the course of action for reporting a work‐related injury: In the case of an “emergency”, please go to the nearest Emergency Room for treatment. Pleasecontact your school nurse and your supervisor within 24 hours or as soon as practical. If you are injured but do not want to seek medical attention, please notify the school nurse and/orsupervisor. QualCare will not be called; however, the school nurse and/or supervisor will file areport as “record only.” Please note: QualCare is the managed care provider chosen by the district’sWorkers’ Compensation carrier, New Jersey School Boards Association Insurance Group. If you are injured and your injury requires non‐emergency medical treatment, a call is to be placedto QualCare. Together, you and a school nurse and/or supervisor will place the call to QualCare. AQualCare representative will obtain all the necessary information and coordinate treatment. Pleasenote: Treatment centers and/or doctors are identified by QualCare. A QualCare nurse intakes injury information and directs you to an appropriate participatingprovider. All appointments and follow‐up care will be scheduled by QualCare. The nurse and/or supervisor will provide you with the appropriate Workers’ Compensation materialwhen the work‐related injury occurs. Upon arrival at the doctor’s office, you should present theappropriate Workers’ Compensation material to the identified treatment center. Once you return to work, all follow‐up appointments will be scheduled after work hours.Please be advised that failure to promptly report on‐the‐job injuries will jeopardize your Workers’Compensation coverage. If you have any questions, feel free to contact , the Workers’Compensation Coordinator, at .Thank you for your cooperation.5