Archdiocese of Kansas City S ummer Camp 2019 Kansas WC Overview - - PowerPoint PPT Presentation
Archdiocese of Kansas City S ummer Camp 2019 Kansas WC Overview Benefits are paid at the employers expense Coverage begins on first day on the j ob Benefits include medical expenses and income benefits An employee
S ummer Camp 2019
Kansas WC Overview
Benefits are paid at the employer’s expense
Coverage begins on first day on the j ob
Benefits include medical expenses and income benefits
An employee cannot be fired, demoted, or discriminated against for filing a claim in good faith.
Employees can obtain free assistance by contacting the WC Ombudsman’s
The law provides for penalties for employee fraud
What determines if a claim is accepted?
An inj ury is deemed to arise out of the employment if:
There is a “ causal connection” between the work conditions and the resulting
accident, and… .
The accident is the prevailing factor causing the inj ury or condition.
“ Arising out of and in the course of employment” doesn’ t include:
Natural aging process by normal daily activities Inj uries from a “ neutral risk” Inj uries due to a risk personal to the worker Inj uries due to idiopathic causes
Details of obligations
Y
an inj ury
Y
(S panish)
Must be reported within 28 days of notice by the employer (if the inj ury incapacitates the employee for more than the remainder of the day, shift, or turn
A claim may be denied if employee fails to notify employer within 20 days of the accident inj ury, or within 20 days from date of medical treatment, or within 10 days of the last day worked (if employee no longer works for employer)
Church Mutual files the FROI with the state
Weekly benefits includes a one week waiting period. If disability exceeds 3 weeks, the employee is paid for the waiting period.
Permanent partial benefits are “ scheduled” when possible
Guidelines for Medical Treatment
Employers are entitled to choose the treating physician. If an employee self- selects a physician who is not authorized or agreed upon by the employer/ carrier, the employer is responsible for only the first $500 in medical bills from such self selected physicians.
An employee shall submit to any reasonable physical examination order by the employer.
A fee schedule is in place, it is revised annually, to ensure health care cost containment, yet insured the availability of necessary treatment and care.
Report a an Injury
Y
Other Methods include:
Let's get started
Phone
Fax
churchmut ual.com
Nurse Hotline – Preferred 24/ 7
Why? For one, it’s free!
Other Methods of Reporting
Employee reports to mgmt late, and has already secured outside medical care
Employee is not available to discuss with nurse at the time of call
No matter how reported, key is to have employees report all work inj uries/ conditions to you immediately, and then to involve the Nurse Hotline
What Happens Next?
S
employer contact, based on the initial loss information. Or, can over-ride this with a singular employer contact, for all losses, regardless of location.
Notice Only - EE/ ER receives letter indicating who is assigned, and that no formal claim is being pursued.
Med Only – EE/ ER receives letter, ER and Med Provider called (in some cases, EE called, too)
Lost Time – EE/ ER receives both letters, and calls, Med Provider also called
New Claim -Initial Discussions
satisfaction/ performance.
Days Off?
Church Mut ual will at t empt t his cont act wit hin 24 hours of not ificat ion of loss, if not a Not ice Only case.
Nurse Hotline Results
Catholic Mutual Group Claim Advocacy
Catholic Mutual Group and Church Mutual became S trategic Alliance Partners to provide Workers Compensation and Auto Insurance in 2016.
The Catholic Mutual Claim Advocacy Program was developed to assist Church Mutual in providing
Claim Advocates assist Members with claim issues, adj uster contact information, coordinate Claim Reviews and facilitate communication with Church Mutual adj usters.
Holli S ampson is the Claim Advocate for the Archdiocese of Kansas City. S he can be reached at 402- 514-2439 or hsampson@ catholicmutual.org.
Jen Wentworth is the Claims Relationship Manager. S he can be reached at 402-514-2393 or j wentworth@ catholicmutual.org
Ken Freudenburg is the Loss Control Representative. He can be reached at 402-514-2384 or kfreudenburg@ catholicmutual.org.
Work Comp by the Numbers
CMIC Program Total
188 Claims $1,377,565 Total Incurred
Top Causes of Loss
Fall, S
lip/ Trip 76 claims $ 728,708
S
train 41 claims $ 302,921
Total Top 2 Causes
117 claims $1,031,629
Top Claims by Occupation
Teachers
62 claims $764,227
Maintenance
30 claims $102,559
Total Top 2 Occupations
92 claims $866,786
By the Numbers continued
Claims at or over $50,000
1329365
Teacher Fall, S lip/ Trip, skull $ 68,461
1338307
Teacher S train, ankle $202,892
1377587
Admin. Fall, S lip/ Trip, wrist $ 49,497
1308504
Clergy S triking against, head $126,577
1296803
Teacher Fall, S lip/ Trip, thigh $292,825
Total Top 5 Losses
$623,977
Work Comp by the Y ear
2016 Totals
72 Claims Total Incurred $710,853
Top Cause of Loss
Fall S
lip/ Trip 30 claims $412,142
S
train 16 claims $ 39,454
Total Top 2 Causes
46 claims $451,596
Top Claims by Occupation
Teachers
27 claims $355,000
Food S
ervice 8 claims $ 86,241
Maintenance
8 claims $ 51,444
Total Top 3 Occupations
3 claims $415,068
By the Y ear continued
2017
72 Claims Total Incurred $498,387
Top Cause of Loss
Fall, S
lip/ Trip 30 claims $173,899
S
train 13 claims $290,970
Top 2 Causes
43 claims $464,869
Top Claims by Occupation
Teachers
27 claims $370,166
Maintenance
11 claims $ 34,687 Total Top 2 Occupations 38 claims $404,853
By the Y ear continued
2018
44 Claims Total Incurred $168,324
Top Cause of Loss
Fall, S
lip/ Trip 16 claims $142,667
S
train 12 claims $ 8,006
Top 2 Causes
28 claims $150,673
Top Claims by Occupation
Maintenance
11 claims $16,428
Teachers
8 claims $39,061
Top 2 Occupations
19 claims $55,489
Online Learning Management System
Available Training Resources:
Transpor
Be Smart – Drive Safe II New!
Church Transportation – Is it Necessary and Ministry Based?
11-15 Passenger Van Policy
“CAR ARES” S” Best Practices Libr brar ary
Yout
h Mini nist stry
Youth Ministry – Everything Matters and Everyone Has a Role
Safe Safe Env Environment
Safe Haven – It’s Up to You is a 60-minute USCCB compliant training video
A Safe Haven Starts at Home is a 20-minute internet education video for parents and teachers
A Safe Side of the Line is a 20-minute video dedicated to boundary issues when working or volunteering with children.
Vulnerable Adults eLearning Training
Parish sh Festi tiva vals
Safe and Successful Parish Festivals
Busi usiness of
the Chur Church ch
Best Practices for Financial Management and Cash Handling
Best Practices in HR Management
Best Practices for Facilities Usage Management
Sc Schoo
Safety
Defeating a Violent Intruder
Getting Ready to Defeat a Violent Intruder
Bloodborne Pathogen Training
Playground Safety eLearning video New!
School Top Safety Hazards eLearning video New!
Anti-Bullying Training New!
Cyb yber er Liab ability ty eLearn arning ng Series es
Malware and Phishing video
Safet Safety
Fire Safety
Preventing Slips, Trips & Falls
Preventative Maintenance
New User
Go to: https://kansascityks.cmgconnect.org Register for a new account. Select your participation category so the system can assign the correct training. Get started!
How to Access CMG Connect:
Returning User
Go to: https://kansascityks.cmgconnect.org Sign-In to your existing account (upper right hand corner). Forgot your password? Recover on the site or send an email to
cmgconnect@catholicmutual.org
Landing Page
Creating Your Account
Training Dashboard