10.7 Injury and Illness Case Management Manual Flashcards
What are the program objectives of the injury and illness case management program?
- Benefits – workers’ compensation benefits
- Reporting – injury and illness reporting
- Communication – communicate with employees off duty for occupational injury/illness
- Return to Work – return employees to work as soon as possible.
What is the definition of an occupational injury?
Any injury resulting from an incident or exposure involving a single event in the work environment.
What is the definition of an occupational illness?
Any abnormal condition, other than one resulting from an occupational injury, caused by exposure to environmental factors associated with employment.
What are the different categories of injuries / illnesses?
- Record only
- First Aid
- Non-disabling
- Disabling
What is a non-disabling injury or illness?
Requires more than first-aid, but the employee is able to return to work (full or limited duty) for the next scheduled work shift.
What is a disabling injury of illness?
Results in the employee being unable to return to work for the next scheduled work shift.
What is a hazardous exposure?
Exposure to any chemical, biological, or physical agent which does not result in injury or illness.
What is the difference between a recurrence and aggravation of injury or illness?
- Recurrence does not have a new defined incident to cause injury. It is a spontaneous reappearance of a prior condition.
- Aggravation has an identifiable new incident of injury and shall be processed as a new injury.
Should an injury or illness should be deemed questionable as work-related if it was not witnessed?
No. Should not be deemed questionable as work related.
When should an injury or illness be deemed questionable as work-related?
Pending State Compensation Insurance Fund (SCIF) decision of acceptance or denial.
What is a record-only injury or illness?
One that is non-disabling and does not require first aid or medical treatment.
What is a first-aid injury or illness?
Minor, non-disabling injury or illness that involves one-time medical treatment.
What is the State Compensation Insurance Fund (SCIF)?
Adjusting agency for occupational injuries and illnesses by state employees.
Can an employee who is off work due to injury or illness have his / her request for secondary employment suspended?
Yes, if the medical care provider indicates in writing that the secondary employment may impede the ability to recover.
Employees should or shall notify a supervisor if their secondary employment is affecting the ability to recover.
Shall.
When would a supervisor attend a Workers’ Compensation Appeals Board trial or hearing?
The supervisor shall attend the trial or hearing if he / she has knowledge of the case.
How involved are supervisors in injury and illness case management?
Shall be personally and actively involved.
Are supervisors responsible for reporting and routing procedures for injury, illness, and exposure?
Yes.
Who assists employees in receiving prompt and proper medical care?
Supervisors.
Supervisors should or shall accompany employees to their initial medical appointment to discuss work capability with the medical care provider.
Shall, if practical.
Supervisors should be present when employees are being examined by medical care providers.
Shall not attempt to be present in any event.
When should a supervisor attend a medical appointment for an employee from another command?
When the medical appointment is in the supervisor’s Area and it would be impractical for a supervisor from the employee’s command to attend.
What shall supervisors do if an employee is not making a good-faith effort toward medical rehabilitation?
Shall notify the commander.
When shall an employee notify a supervisor of a job-related injury?
As soon as possible and prior to seeking medical treatment unless immediate emergency care is needed.
Does the medical care provider need to be notified that the injury is believed to be occupational?
Yes. Employee shall advise the medical care provider.
What is an employee’s responsibility when off-duty due to occupational injury?
Inform his / her commander of where and how they may be contacted.
What does an employee need to obtain in order to reinstate a suspended secondary employment request?
Written authorization from the medical care provider.
Do the reporting and routing procedures for injury, illness, and exposure do no change depending on the severity of the claim.
Yes. Procedures do change depending on the severity.
Who reviews injury / illness / exposure claims forwarded by commands?
The Division Health and Safety Coordinator.
Is documentation concerning an employee’s injury / illness / exposure is confidential.
Yes
Does occupational injury of job applicants have to be reported?
Yes
Who initiates the reporting of an occupational injury of a job applicant?
The supervisor managing the application process.
What form is used to document the occupational injury of a job applicant?
CHP 121.
On the 121 for an occupational injury of a job applicant, what is indicated as “salary,” what is indicated as “occupation?”
None” for salary, and “job applicant” for occupation.
Are departmental volunteers eligible for workers’ compensation benefits?
No. They are not considered to be employees (unless the Department designates them as such).
Within how long after reporting a recurrence of an injury or illness does the employee have to submit a memo detailing the circumstances?
24 hours.
What shall happen if an employee is incapable of submitting a memo within 24 hours after reporting a recurrence of an injury or illness?
The employee’s supervisor shall write the memo within 24 hours and indicate the circumstances of the recurrence and the reason why the employee couldn’t write the memo.
What specific reporting is required of employers by Cal-OSHA and the California Code of Regulations concerning occupational injuries?
A Log of specific occupational injuries and illnesses must be kept. Called the OSHA 300.
When shall injuries / illnesses be recorded on the Log?
Within 6 workdays of knowledge of injury / illness.
Does the Log have to be updated for a status change in injury / illness?
Yes.
Do record-only and first aid injuries have to be recorded on the Log
No.
Who completes the CHP 121 for an employee’s injury? Within how much time?
The employee’s supervisor. Within 24 hours of notification of the injury / illness / exposure.
A CHP 121 should or shall be typed?
Shall.
When must the employee review and sign his / her 121?
Within 24 hours of reporting the injury / illness.
What happens if the employee is incapable of signing the 121 within 24 hours?
The supervisor shall document the circumstances that prevented the signing in the comments section of the 121. The employee then signs as soon as possible.
What shall happen if the employee refuses to sign his / her 121?
The supervisor types or prints “refused to sign” in the employee’s signature block and document the refusal in the comments section of the 121.
When does the 121 have to be filed with SCIF? Are there exceptions?
Within 5 days of notification of injury / illness. A 121 does not have to be filed with SCIF for record-only or first aid injuries.
Will SCIF accept a partial (incomplete) 121? How about a fax copy of a 121?
File a partial 121 to SCIF in order to meet the 5 day deadline. Include a statement that additional information is coming as soon as possible. Fax copies are OK pending completion of the completed original.
If an employee is temporarily assigned to another command and gets injured, which command completes the 121? Which command is responsible for subsequent case management?
The temporarily-assigned command, unless the assignment is for civil disturbance. Case management is the responsibility of the employee’s permanent command.
Who is responsible for completing an employee’s 121 in the injury occurs while the employee is traveling to or from a temporary assignment in another command?
The employee’s permanent command.
Who is responsible for completing an employee’s 121 if an injury occurs while the employee is temporarily assigned to and / or under the direct supervision of an entity other than the Department?
Appropriate Assistant Commissioner completes the 121. A copy of the 121 is forwarded to the employee’s permanent command which is responsible for case management.
Who is responsible for completing the 121 for a cadet who gets an occupational injury?
Academy. The 121 is sent to the cadet’s permanent command upon graduation. That command is then responsible for case management
What is the CHP 121A?
Supervisory review of occupational injury / illness / exposure.