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Captains Test > SOP: Workers Compensation > Flashcards

SOP: Workers Compensation Flashcards

1
Q

Notice of injury or occupational disease/Incident report is what numbered form?

A

C-1

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2
Q

Employers report of industrial injury or occupational disease is what numbered form?

A

C-3

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3
Q

Employees claim for compensation/report of initial treatment is what numbered form?

A

C-4

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4
Q

A certificate of recovery and fitness is described as what form?

A

Medical release

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5
Q

What is defined by NRS as an unexpected or unforeseen event happening suddenly and violently, with or without human fault and producing at the time objective symptoms of an injury?

A

Accident

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6
Q

What is defined by NRS as a sudden and tangible happening of traumatic nature producing an immediate or prompt result which is established by medical evidence, including injuries to prosthetic devices?

A

Injury and Personal Injury

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7
Q

Who maintains a self-insured and self-administered program for industrial claims?

A

City of Las Vegas

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8
Q

Who is responsible for managing claims for all city employees?

A

The workers comp administrator

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9
Q

Personnel are responsible to know and follow SOP 100.12 ______ ______ ______ regarding modified duty/ light duty release by a treating physician.

A

Transitional Work Assignment

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10
Q

All _______ shall assist their subordinates in obtaining medical care, if needed, and complete the _______ portion of all workers comp forms.

A

Supervisors, supervisors

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11
Q

Supervisors shall submit all paperwork and forms in a timely manner, within ______ days, not ______

A

7, shifts

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12
Q

Who shall co-ordinate with Human Resources and/or workers comp administrator to ensure compliance with city policies?

A

Deputy Chief of Admin

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13
Q

Who shall manage appropriate payroll processes in compliance with city policies

A

Payroll Assistants

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14
Q

Who shall maintain an employee injury log and route forms and paperwork to Human Resources or the workers comp administrator?

A

Payroll Assistants

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15
Q

Who shall communicate as needed with the injured/ill employee regarding items related to the injury such as paperwork, schedules and time keeping?

A

Payroll Assistants

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16
Q

All work related injures/illness should be reported to their immediate supervisor within _____ calendar days, not _____.

A

7, shifts

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17
Q

When reporting a work related injury/illness, the employee shall fill out a _____ form.

A

C-1

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18
Q

Submitting a C-1 does not initiate a _____ ______ ________

A

worker comp claim

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19
Q

Submitting a C-1 is only an incident report until ______ _______ is sought.

A

medical treatment

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20
Q

The injured/occupationally diseased employee has _______ calendar days after the date of injury to seek medical care.

A

90

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21
Q

If no medical attention is sought for the injury, the competed C-1 remains on file for ________ years and then is destroyed.

A

3

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22
Q

If medical treatment Is sought, a ______ claim for compensation and supervisor investigation form must be completed and submitted.

A

C-4

23
Q

If ______ is completed and submitted, the workers comp administrator will complete the ______

A

C-4, C-3

24
Q

The design and information required on the C-1, C-3 and C-4 forms is mandated by who?

A

The state of Nevada

25
Q

If a claim is denied, instructions and appeal rights are provided to the employee by who?

A

Workers comp administrator

26
Q

Transitional work assignments are commonly referred to as what?

A

Light/Modified Duty

27
Q

Transitional work assignments shall be offered to employees with valid workers comp claims and if authorized by who?

A

The employees physician

28
Q

Taking a vacation during a workers comp claim is _____________

A

Discouraged

29
Q

If an employee goes on vacation while on occupational disease or injury, there timecard must be changed to what?

A

vacation leave

30
Q

City approved forms and information related to workers comp are available electronically where?

A

City HR Intranet

31
Q

If an injured/ill employee in in need of medical attention, they will seek treatment at an ___________ occupational clinic.

A

Approved

32
Q

For true medical emergencies, the employee may report to a ________

A

Er

33
Q

Going to an unapproved provider may ________ the employees claim.

A

Jeopardize

34
Q

The initial treating medical facility or physician must compete which form?

A

C-4

35
Q

The employee must sign the ______ section of the C-4 otherwise it is not valid.

A

Middle

36
Q

On the C-4 the treating physician completes what portion?

A

Bottom

37
Q

Typically, the treating physician sends the C-4 to the city of Las Vegas ________.

A

Directly

38
Q

Who is responsible to ensure that the C-4 is submitted and received by human resources?

A

The employee

39
Q

Human Resources receipt of the C-4 ________ the employees claim.

A

Initiates

40
Q

Who is responsible for providing his/her supervisor a copy of the completed C-4 after initial medical treatment.

A

The employee

41
Q

Due to the importance and time sensitivity of workers compensation forms, it is recommended that injured/ill employees and supervisors submit forms _________ and/or _______

A

electronically, hand deliver

42
Q

Electronically submitted workers comp forms should be sent to what email group?

A

Fire Payroll

43
Q

Who completes time cards for employees entirely off work due to occupational disease or injury?

A

Workers comp administrator

44
Q

Time off shall be coded as what?

A

Admin OJI-W

45
Q

Paid coverage of ______% is provided to IAFF employees for _______ calendar days if the claim is accepted.

A

100, 60

46
Q

After 60 days has elapsed and the employee is not able to return to work, the workers compensation fund pays approximately _______ of their monthly salary.

A

2/3

47
Q

When full pay coverage expires, the employee may use what to receive a full pay check.

A

Sick, VL

48
Q

The city will not take any _________ from the workers comp check.

A

Deductions

49
Q

What is not available if the employee is only being paid their 2/3 salary from the worker comp fund?

A

Direct Deposit

50
Q

Employees off duty for more than ______ days since their last regular worked day shall submit a fitness for duty form.

A

90

51
Q

Return to duty must be completed before the employee is assigned to the ___________

A

Training Center

52
Q

The employee is assigned to the training center to complete what?

A

Return to duty task book

53
Q
A

Captains Test (48 decks)

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