Workers' Compensation Process
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A work injury occurs.
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Employee reports injury to manager, then goes to Occupational Medicine for evaluation and treatment.
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Occupational Medicine treats employee and determines if offsite evaluation may be necessary.
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Employee is given First Report of Injury or Illness to fill out and return to WC Case Manager in Legal or given to personnel in Medical to forward to Legal.
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Entry of FROI is made into Third Party Administrator (TPA) web-based system by WC Case Manager.
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Employee is given temporary work or released to full duty.
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Adjuster may request additional information from employee during claim.
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Medical provider contacted for information if necessary.
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Adjuster sends required benefit notices and approves medical treatment as appropriate.
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Adjuster calls employee and employer to set up claim and verify eligibility for benefits.
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If employee is unable to work, claim status will change and benefits will be paid. WC Case Manager coordinates benefits payments and BEA time loss.
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Work status is monitored and coordinated for modified duty through full release.
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Employee is released to full duty.
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Upon release from care, employee is sent a closing letter.
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Claim file is closed. Occupational Medicine may close file prior to TPA closing of file.
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WC Process
