Worker s compensation workshop
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Worker’s Compensation Workshop. Procedure for Processing a Worker’s Compensation Claim The Office of Human Resources. The Mission of the State Government Worker’s Compensation Program is to ensure ethical and equitable treatment of injured employees in a cost efficient manner.

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Worker’s Compensation Workshop

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Worker s compensation workshop

Worker’s CompensationWorkshop

Procedure for Processing a Worker’s Compensation Claim

The Office of Human Resources


Worker s compensation workshop

The Mission of the State Government Worker’s Compensation Program is to ensure ethical and equitable treatment of injured employees in a cost efficient manner.

Encourage Safe Work Practices


What constitutes a worker s comp claim

What Constitutes a Worker’s Comp. Claim?

An On-the-job injury due an incident occurring on or off campus.

Encourage Safe Work Practices


Who is covered

Who is Covered?

  • Permanent Employees

  • Temporary Employees

  • Part-Time Employees

  • Working Students

Who is Not Covered?

  • Independent Contractors

  • Non-Working Students

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Supervisor s responsibilities

Supervisor’s Responsibilities

  • Ensure that the injured employee receives immediate and appropriate medical attention

  • Direct the employee to the authorized primary care physician

  • Complete the required NCIC Form 19 and forward to the Worker’s Compensation Administrator within 24 hours of the injury

  • Assist in the accident investigation to determine the cause of the accident

  • Correct unsafe conditions immediately

  • Communicate with injured employees to ensure their needs are met. If the employee is out of work make contact weekly.

  • Report the total number of days missed due to injury to the WC Administrator

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Authorized primary care physician

Authorized Primary Care Physician

Prime Care of Highland Oaks

600 Highland Oaks Drive

Winston Salem, NC 27103

(336) 774-0044


Worker s compensation workshop

If it is a life threatening emergency, or after hours go to the nearest medical facility

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Filing a claim

Filing a Claim

  • Contact HR for a Form 19 and Medical Authorization Form

  • Complete a NC Industrial Commission Form 19 (Employee must sign and date form on the back)

  • Send the Form 19 to Benefits Rep. in Human Resources

  • Give the injured employee the Medical Authorization Physician’s Report write “No Drug Test” in the upper right corner

  • Send the employee to the care provider listed on the Quick Reference Guide

  • Employee should return the Medical Authorization form to his/her supervisor or office manager to forward to HR

  • If he/she is given a prescription please send them to one of the pharmacies listed on the reverse side of the Quick Reference Guide for Employees.

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Worker s compensation workshop

Forms

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Medical authorization form

Medical Authorization Form

http://www.keyrisk.com/pdfs/claimsPharmacy-PhysiciansReport.pdf

If the employee has to be rushed to an emergency facility, this form can be waived for a hospital report form.

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Prescription pharmacy form

Prescription Pharmacy Form

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Worker s compensation workshop

In case of an extreme emergency and the injured employee is taken to the emergency room; The same forms are needed. A police report must be filed with the form 19 and the Medical Authorization Form or a hospital report form.

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What do i do if an employee refuses treatment

What Do I Do If an Employee Refuses Treatment?

  • Notify Mary Ellen Haynes

    in Human Resources

    Note: An employee can still file a claim within the 2-year period allowed by law, even if a release statement of Refusal of WC Benefit was provided.

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Wc leave policy

WC Leave Policy

Day of Injury

No leave is charged on the day of the injury if the treating physician instructs the employee not to return to work and provides a statement

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Wc leave policy1

WC Leave Policy

Leave Options

Elect to take sick or vacation leave during the required waiting period and then go on WC leave and begin drawing WC weekly benefits.

Elect to go on WC leave with no pay for the required waiting period and then begin drawing WC weekly benefits.

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Worker s compensation administrator

Worker’s Compensation Administrator

Mary Ellen Haynes,

Benefits Representative

770-1451

[email protected]

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