Understanding Workers’ Compensation
Jennifer Lister
Workers’ Compensation Supervisor
FARA
Please allow this to serve as a brief understanding of the workers’ compensation system, and what your employees may expect once in the system. When an accident and injury occurs, it is the employee’s responsibility to report it immediately to his or her employer. The employer’s responsibility is to complete the Notice of Injury, refer for initial medical treatment, and report the injury to FARA immediately. An employer may report the injury to FARA either by E-mailing claimopening@FARA.com or faxing to 877- 652-3272.
Once an employee treats with his/her Primary Care Physician he/she will be given a DWC-25, wherein it will clearly state if the injury is work related, and if additional treatment is being recommended such as diagnostic testing, physical therapy, or possible referral to a specialist due to the severity of the injury. Please note after the employer’s initial referral for medical treatment, all other authorization must go through FARA. Workers Compensation will not cover for any treatment/testing without prior authorization from FARA.
The DWC-25 will also clearly document the claimant’s work capabilities. It will note either that he/she is on a no work status, a full duty work status, or a light duty work status. If the claimant is on a light duty work status it will provide the specific restrictions that must be accommodated when the claimant returns to work. It is at that time the employer must determine if they have light duty work available within the employee’s restrictions.
We suggest all employers have a transitional duty program. A transitional duty program is a program designed to return to work employees who are unable to perform their normal job duties because of a work related injury or illness. A transitional duty program can involve temporarily modifying an employee’s existing job so they are physically capable of performing it, or temporarily putting an employee into a different job that is within the restrictions placed by the treating physician.
A transitional duty program is beneficial to the employer as it maintains production and workflow, maintains an experienced work force, it enables the employer to ensure restrictions are being followed, returns the employee to their regular jobs more quickly, and improved morale and self esteem. A transitional duty program is beneficial to the employee as it sends a message that the employee is valued, it enhances the employee’s sense of self-worth, it eliminated the psychological effect of idleness/disability, and it speeds return to regular duty, and provides for rapid resumption of salary and other interest.
Once the employee completes medical treatment the doctor will release him/her to Maximum Medical Improvement. At that time the doctor will address if the claimant as a permanent impairment rating, and if he/she has any permanent restrictions. It will be up to the employer at that time to determine if they are able to return the employee to work within his/her permanent restrictions.
Once the claimant reaches Maximum Medical Improvement and all the Indemnity and Medical benefits have been paid, the file is ready for closure. In workers’ compensation there is a Statute of Limitations wherein if the employee goes 2 years from the date of accident, and once year from the last date of medical treatment, the statute of limitation will run, and they are no longer entitled to workers’ compensation benefits. We ask though that employer refers the employee to FARA to make this determination if additional medical treatment is requested.
In conclusion it is the employer’s responsibility to report claims timely, direct employee to an authorized provider, have a transitional duty program in place, and follow claimant to Maximum Medical Improvement and hopefully return and employee to work with no restrictions.