Workers Compensation

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					                                  Worker’s Compensation


What do I do if I become injured or ill because of work?
Report the injury to your supervisor immediately, and obtain prompt medical care.

Who coordinates Workers' Compensation Program at Care Advantage LLC?
Care Advantage LLC
Attn: Human Resource
3440 Wilshire Blvd, Ste. 807
Los Angeles, Ca 90010
Tel: (213) 251-8880
Fax: (213) 251-8885

What is Workers' Compensation?
A no-fault, employer-paid insurance system designed to assure that employees who sustain
work-related injury or illness receive complete medical attention for the injury or illness, and a
degree of financial and other support in returning to gainful work.

Who at Care Advantage LLC has Workers' Compensation insurance coverage?
All Office Staff and Nurses

What are the main Workers' Compensation benefits?

       Medical and Hospital Care - to cure and relieve from the affects of the injury
       Temporary Disability Payments - to partially replace earnings lost during medical
        recovery
       Permanent Disability Payments - to partially replace earning power lost after medical
        recovery
       Supplemental Job Displacement benefits - to assist the worker in returning to suitable
        gainful employment
       Death Benefits - payable to dependents should the injury or illness materially lead to
        death
Who decides if I am eligible for workers' compensation benefits?
Name of Insurance Service
Address:
Telephone:

Who provides the workers' compensation benefits? -
Name of Insurance Service
Address:
Telephone:

Is there an informational pamphlet for new employees?
Yes: The Time of Hire
Is there an informational poster for the workplace?
Yes, in English and in Spanish: Posters

Is there a Care Advantage LLC office to answer my questions?
Yes, Disability Management Services:

Care Advantage LLC Human Resources
Disability Management Services
3440 Wilshire Blvd, Ste 807
Los Angeles, CA 90010
Tel: (213) 251-8880
Fax: (213)251-8885

Is there a State of California office to answer my questions?
Yes: You can call an Information & Assistance Officer at the nearest office of the State Division of
Workers' Compensation.

Who do I contact if my injury or illness is work-related?
Report your work-related injury or illness to your supervisor immediately.
See the section below for information about when to report an injury or illness and file a claim.

Who do I contact if my injury or illness in NOT work-related?
Call Care Advantage LLC office (Human Resource)

Who is Disability Management Services?
Disability Management Services (DMS) is the Care Advantage LLC office that is responsible for
coordinating Care Advantage LLC workers' compensation program.

When should I report an Injury or Illness?
All injuries and illnesses, no matter how trivial, should immediately be reported to your supervisor.
A delay in reporting an injury may result in a delay in providing benefits, or may even jeopardize
your eligibility for benefits.

You should also immediately report all injuries and illness which you believe may be work-related,
even if you are not absolutely sure they are. This will protect your right to any benefits that may
be due you.

Do I need to be off work to file a claim?
No. Many people continue to work while receiving workers' compensation benefits (medical
treatment, for instance). You can file a claim whether or not you have lost any time from work.

How do I file a claim?
Report the injury to your supervisor; claim forms will be sent to you.
Or, you can print the Employee Incident Report form, fill it out, and give them to your supervisor.
Where do I get the Employee Incident Report form?
Once you report your injury to your supervisor, DMS will send the form to you.
Or, you can print on-line form.
Or, you can call Disability Management Services, at (213) 251-8880, and we will send you the
form.

To whom do I give the completed Employee Incident Report?
If you have printed the EIR form from this web site, fill it out and give it to your supervisor.

If you received the form from Disability Management Services, fill it out and return it to Disability
Management Services at:

Care Advantage LLC Human Resources
Disability Management Services
3440 Wilshire Blvd, Ste 807
Los Angeles, CA 90010

Or, you can fax the forms to DMS at (213) 251-8880.

Who will contact me after I have filed the claim forms?
Your Claims Administrator at Insurance Services, (000) 000-0000, will call you to discuss your
injury and to explain the workers' compensation benefits and procedures in detail.

How soon will I be contacted after I report the injury?
After reporting your injury, Insurance Services should contact you within ten days at the very
latest, usually much sooner.

Where do I go for medical treatment?


Who authorizes medical treatment?
All medical treatment that is beyond First Aid or Emergency care must be authorized by:

Name of Insurance Service
Address:
Telephone

No one else may authorize such medical care.

Can my supervisor authorize medical treatment?
Your supervisor can make an initial referral for:

       First Aid treatment,
       Emergency care,
       Or, to the University's designated medical provider.
But, your supervisor cannot authorize any follow-up care. Only Insurance Services can authorize
medical care beyond the initial referral.
In the case of a need for Emergency care, your supervisor should refer or escort you to the
nearest emergency care facility, or call an ambulance, as circumstances require.
Who do I contact about my medical care?
Call Insurance Service at (000) 000-0000


Who do I contact for a copy of my medical report?
Call Insurance Service at (000) 000-0000


Who do I contact about my medical bills?
Call Insurance Service at (000) 000-0000


Who do I contact to find out who is handling my claim?
Call Insurance Service at (000) 000-0000

Who do I contact to find out my Claim Number?
Call Insurance Service at (000) 000-0000

Who do I contact to see if my claim is still open?
Name of Insurance Service
Address:
Telephone:

What happens if my claim is accepted?
Insurance Company will begin to provide benefits immediately. Most claims are accepted.

What should I do if my claim is delayed?
It can take up to ninety (90) days from the date you reported the injury to your supervisor for
Insurance Company to make a decision on your claim. During this time, workers' compensation
disability benefits will not be paid.

How long can my claim be delayed?
It can take up to ninety (90) days from the date you reported the injury to your Supervisor for
Insurance Company to make a decision on your claim. During this time, workers' compensation
disability benefits will not be paid.

What should I do if my claim is denied?
Contact Care Advantage LLC Human Resource at (213) 251-8880.

Who do I contact about my Temporary Disability payments?
Name of Insurance Service
Address:
Telephone:
How much are the Temporary Disability payments?
While you are off work recovering from your injury or illness, you will receive Temporary Disability
(TD) payments from Insurance Services.

Temporary Disability partially replaces lost wages. It is always less than 100% of your regular
earnings. The amount of the TD benefit depends on your average weekly earnings at the time
you were injured and upon maximums set by law.

You can elect to use your Sick Leave, or both your Sick Leave and your Vacation Leave to
supplement the TD payments bring you up to a total income of 100% of your regular earnings.

When will I receive the first temporary disability (TD) payment?
You should receive your first Temporary Disability payment within 14 days.

How often are Temporary Disability payments made?
Temporary Disability is paid every two weeks.

When do Temporary Disability payments end?
TD payments end when:

You return to work, or
Your medical condition stabilizes

What is Transitional Work?
Transitional Work is a temporary, medically approved modification of your work duties during the
transitional period of your medical recovery.

While you are medically recovering from your injury or illness, you may not be able to perform
your usual and customary work duties. Temporarily modifying your work duties may allow you to
continue to work, maintaining your income.

Transitional Work plans are individually designed and carefully structured.

What if my injury permanently prevents me from returning to my job?
If your injury permanently prevents you from returning to your usual and customary occupation,
you may be eligible for Supplemental Job Displacement Benefits. Insurance Services will advise
you of your potential eligibility.

The staff of Disability Management Services is available to assist you in exploring modified or
alternative work.

Where can I get information about Supplemental Job Displacement Benefits?
If you have filed a claim, ask your Insurance Claims Administrator at (000) 000-0000.

You can also call Disability Management Services at (213) 251-8880.

Who do I contact about workplace safety?
Contact Care Advantage LLC Human Resource at (213) 251-8880.
Who do I contact if I need an ergonomic workstation assessment?
BEFORE INJURY (PREVENTION)
Care Advantage LLC Human Resource at (213) 251-8880.

You can also use the OSHA eTool for Computer Workstation ergonomics on the OHSA web site.

AFTER INJURY
Report the injury to your supervisor, and contact Insurance Services at (000) 000-0000.

If you have any questions, or would like to discuss your individual situation, you can call Disability
Management Services of Care Advantage LLC at (213) 251-8880.

				
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