Order Book Article 11 Maintenance of Employee Wellness pg23-32 - Sheet1

Question 1

From the Order Book:

On or before the 15th of January of each year, Company Officers shall

Answer 1

execute the F&EMS Form 158: Report of Administrative Leave - for members who was on POD

Question 2

From the Order Book:

In preparing the Form 158, Company Officers shall ensure that the POD granted for the period of absence is correct and that any unused portion of the form is crossed out. What two forms will the Company officer fill out?

Answer 2

Form 44.5 Tracking, and the F&EMS Form 33.1

Question 3

From the Order Book:

It is the responsibility of the Company Officer to ensure that the number of hours listed on these documents is identical (for each instance of POD) at the

Answer 3

Company level and at the MSO

Question 4

From the Order Book:

Who’s responsible for double checking the form 158?

Answer 4

Company commanders shall double check for accuracy and “Note” same.

Question 5

From the Order Book:

The Form 158 shall be forwarded to whom?

Answer 5

The Battalion Commander

Question 6

From the Order Book:

Members on Sick Leave desiring to leave the Metropolitan area shall prepare a

Answer 6

F&EMS Form 34, stating the reasons for such request

Question 7

From the Order Book:

The employee shall hand carry all copies of the Form 34 to the

Answer 7

PFC physician

Question 8

From the Order Book:

Who will

certify that the employee’s medical condition is such that they may or may not leave the Metropolitan area

Answer 8

A PFC Physician

Question 9

From the Order Book:

Who willapprove or disapprove the request for a memeber the leave the Metropolitan area?

Answer 9

The Medical Services Officer

Question 10

From the Order Book:

No employee shall leave the Metropolitan area until they have final approval of their request Any disapproval will be explained on the back of the?

Answer 10

Form 34.

Question 11

From the Order Book:

The department has how many days to rule if the injury/illness is POD or Non-POD?

Answer 11

Within 30 calendar days

Question 12

From the Order Book:

If the Department fails to make a ruling within 30 days, the claim shall be presumed to be

Answer 12

A POD injury/illness

Question 13

From the Order Book:

When will the process for retirement begin

Answer 13

Any
employee who spends 64/192 (Operations Division/Administrative Divisions) cumulative workdays in a less than full-duty status over any 24-month period as

Question 14

From the Order Book:

The 64/192 cumulative workdays does not apply to

Answer 14

pregnant females in a limited duty status.

Question 15

From the Order Book:

Who

shall notify each employee when the employee has spent 32/96 cumulative workdays in a less than full duty status.

Answer 15

The Medical Services Officer

Question 16

From the Order Book:

How many days will the

Medical Officer shall notify the Fire Chief with the recommendation for extension of POD administrative Sick Leave

Answer 16

60 days

Question 17

From the Order Book:

When a member receives a prescription from a Police and Fire Clinic
(PFC) outside specialist, the member shall

Answer 17

bring the prescription to
the PFC and have it re-issued by the PFC.

Question 18

From the Order Book:

The ____ will initiate a form CA-7 (claim for
compensation) by contacting the injured or ill EMS employee to set u pan
appointment to discuss whether the injury or illness will extend beyond (21)
calendar days.

Answer 18

Compliance officer

Question 19

From the Order Book:

If the PFC is closed, order the employee to report for Sick Call between

Answer 19

0700 and 0830 the next day the PFC is open

Question 20

From the Order Book:

Who

reportsthe On-The-Job Injury and obtain a claim number for the employee.

Answer 20

The Battalion Fire Chief or EMS Supervisor must contact the District of Columbia Disability Compensation hotline, 1-888-832-2524,

Question 21

From the Order Book:

The claim number must be forwarded within?

Answer 21

(24) hours to the Office of Compliance

Question 22

From the Order Book:

The employee must submit a copy of the treating physician’s diagnosis and prognosis__________ to the Office of Compliance in order to continue in a continuation of pay status.

Answer 22

every 30 days

Question 23

From the Order Book:

Notification that an Operational employee intends to call in for Sick Leave must be made at least____________ prior to the official start time of the work scheduled shift to the on-duty Company Officer of their assigned Duty Station

Answer 23

1 hour

Question 24

From the Order Book:

Employees returning from a job-related injury or illness to a Limited Duty status must:

Answer 24

Report to the Office of Compliance at 0815 hours.

Question 25

From the Order Book:

Toset up an appointment to discuss whether the injury or illness will extend beyond twenty (21) calendar daysthe Compliance Officer will initiate a

Answer 25

Form CA-7 (Claim for Compensation)

Question 26

From the Order Book:

In accordance with the DPM, Sick Leave may also be used when an immediate family member is afflicted with a

Answer 26

contagious disease