Articles 10-11 Flashcards
what forms must be completed to request leave without pay?
dc form 1199, special report addressed to the FC
upon appoval of leave without pay what must an applicant do?
submit to a physical at the PFC
what physicals are required for uniform operation all hazard personnel?
annual, promotional, return to duty, fitness for duty
who gives approval for afternoon sick call (1300-1430)?
MSO or clinic liason in absence of MSO
who gives permission to reschedule PFC appointments?
MSO
if a member being carried on POD fails to report for a scheduled appointment at the PFC, what happens?
they will be carried on sick leave until they report for the new appointment
all employees are ______ from outside employment while on sick leave
prohibited
how many hours prior to a physical must you fast?
6-8 hours
how many days from the original appointment may you schedule a makeup?
30 days max
who must be contacted to reschedule a clinic appointment?
MSO
how is department mail marked that contains health information?
protected information
how long after injury or illness does a company officer have to complete a 44.4 safety?
24 hrs
where is the form 44.4 safety distributed?
original to safety office, copy to MSO
what forms must be completed when a unifom operational EMT is transported to the hospital?
DCDCP forms 1,2,3
when a uniformed operational all hazards employee is requesting POD, what forms must be completed?
form 44 medical, form 44.4 safety
sick leave shall be reported in _____ equivalents.
hourly
how many hours of sick leave are earned per pay period for uniformed all hazards employees? other members?
4.5hrs, 4 hrs
what forms need to be completed for an advance in sick leave?
dc form 1199, form 11.4, special report
what form number is to used to request annual leave in lieu of sick leave?
form 11.5
where are bills for transport forwarded?
MSO
what forms are filled out when a member is exposed to a communicable disease?
form 44.1 in duplicate, form 1c-1
when a member reports for medical care at the PFC due to exposure what forms are completed?
form 44, form 44.4 safety within 24hrs
if you are a victim of exposure where do you go and how quick?
within 1 hour to PFC or Providence if after hours
uniformed operational employees complete what form for an exposure?
dcdcp form 1
who do you notify when admitted to the hospital?
communications, MSO, head of employees division through COC
before returning to full duty after 1 yr on LD what must happen?
TA for refresher training
who approves LD assignments?
AFC-S
how many days can you stay on LD for a non POD injury?
30 calendar days
who sends an email to MSO containing the names of personnel who called in sick for each tour of duty?
each BFC
how long prior to the tour of duty are you allowed to go sick?
not less than 1 hr
who is exluded from the minor illness program?
probationary members
how many hours prior to your tour of duty may you MIP?
no more than 12 hrs , no less than 1 hour
what form is completed to MIP?
44.6 MIP
how long does MIP restriction last?
2 full designated periods
where are entries made when you lose your ability to MIP?
company journal, battalion journal, back of 33.1
when a change of duty status is made at the PFC who do you notify?
on duty company commander, if not available
1)on duty BFC 2)any on duty BFC 3)division commander
on form 44 if employee is incapacitated how is form signed?
company officer shall note “incapacitated” in signature block
who do you present clinic data record form to when returning to full duty?
on duty platoon commander
where are the copies of form 44 medical sent?
original to MSO , copy retained by employee
if requesting POD, how long does a CO have to submit a 44.4 safety?
10 days
if you do not report to the PFC or urgent care facility after an injury or illness will you recieve POD?
no
where are line of duty burn injuries transported?
medstar
what is the “best” reporting time on weekends to an urgent care facility?
0730
when notifying the on duty company officer of being placed on sick leave what must you tell them?
where they can be reached on sick leave, record in journal
how long does the MSO have to make a POD ruling?
no more than 30 days
how long do you have to appeal a POD ruling? and who do you appeal to?
30 days, AFC-s
when appealing a POD decision what must you include with special report?
original 44.4 safety
if on sick leave during POD appeals process what leave will you be placed on?
administrative leave
how many days after the AFC-s recieves a POD appeal will a decision be made?
max of 60 days from reciept of appeal
what is a form 158? when is it completed?
on or before 15 Jan. report of administrative leave. shows member ruled POD for preceding year
what form is completed to leave metropolitian area while on sick leave?
form 34
if a ruling is not made within 30 days what happens?
presumed POD
when will a member of operations/ administrative be processed for retirement?
64/192 cumulative workdays in less than full duty status for over 24 months. does not apply to pregnant females
at 32/96 cumulative workdays in less than full duty status who notifys employee?
MSO
_____ days before the employee is scheduled for referal to retirement board MSO shall notify the FC with recommended extention of POD.
60
if injured in performance of duty requiering critical care in the ICU, how long till you are processed for retirement?
170 cummulative work days in less than full duty over 2 years
where will members on POD will have prescriptions filled
CVS, Providence pharmacy
where are uniformed EMT or paramedics transported?
PFC or nearest apprioprate medical facility. try to use Providence or WHC
Who does the BFC or ems supervisor call when an EMT is hur ton the job?
DC disability compensation hotline, obtain the claim number. foward to office of complaince with in 24 hrs
what form must be filled out a pfc by uniformed EMT?
dcdcp form 1
when a EMT is returning for duty what must employee bring to duty station?
clinic data record, SF 71
to continue on continuation of pay status what must be submitted to the office of compliance every 30 days?
treating physicians diagnosis and prognosis
if hired after jan 1 1980 how many days does an EMT get for continuation of pay?
21 calendar days, before 45 days
for an EMT to get more than 21 days of continuation of pay, who approves?
compliance officer
what form is completed to extend past 21 days on COP?
form CA-7
where do uniformed EMTs report to, to go on LD?
office of compliance by 0815
if a uniformed EMT is sick for more than ___ days a DR’s note is requiered
3
