Your Skill And Experience Is A Valuable Resource To Your

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					Your Skills and Experience Are a
  Valuable Resource to Your
 Department and to the City of
  Houston. We Wish You an
 Expedited Recovery and Safe
       Return to Work

                              1
  We understand that Texas Workers’
 Compensation policies and procedures
    mixed with the City of Houston’s
  policies and internal benefits can be
 quite confusing. We trust that this slide
show will clarify questions or direct you
       to the appropriate person for
                information.
                                       2
HR Risk Management unit, “S.W.E.AP.” - a City
of Houston internal unit, has teamed up with
outside subcontractors. This team is available to
assist you with your claim and recovery. You may
be contacted by one or more of the team members
at various times during your recuperation.
                                             3
The S.W.E.AP. Team consists of the following team members:
  • Salary Continuation – Claim Coordinators provide oversight
     of indemnity benefits which supplement the workers’
     compensation benefits. They ensure that you are brought up
     to the required percentage of pay in accordance with the
     salary continuation policy.
  • Workers’ Compensation – Human Resources will provide
     oversight of your workers’ compensation claim handled by
     the Third Party Administrator.
  • Early Return-To-Work – Administrative Coordinators will
     facilitate transitional duty when you have been deemed
     medically able to safely perform essential work activities.
  • Accident Prevention – Safety officers will contact you or
     your supervisor in an effort to investigate your claim and
     determine the root cause of your accident. They will also take
     steps to make your work area a safer place.                 4
The Subcontractors include the following:

• Cambridge Integrated Service Group, Inc. – Your TPA
  investigates and administers your workers’ compensation
  claim.




• The TPA utilizes other subcontractors to review medical
  bills for compliance and payment as well as other cost
  containment functions.




                                                            5
                   Highlights of Your Rights and
                         Responsibilities:

• You must continue to cooperate with any ongoing
  investigation.
• The minor emergency clinic or hospital attended at the
  direction of your supervisor is not considered your choice
  of treating doctor. You have your choice of treating doctor
  as long as they are on the City of Houston & TDI
  Approved Medical Provider list. This list can be found at
  www.houstontx.gov/hr/wcpages/wc.htm or obtain
  information from your supervisor. Contact your assigned
  adjuster as soon as you are aware of your treating doctors
  information. The adjuster will need this information to
  authorize medical treatment.                                6
Highlights of Rights and Responsibilities:
(Continued…)

• You must contact your adjuster after every
  doctor’s or treating doctor’s referral visit
  (this does not include PT visits). If unable to
  reach your adjuster ensure that your
  message includes: current work status,
  treatment plan given by the doctor and the
  next office visit date.


                                                7
Highlights of Rights and Responsibilities:
(Continued…)

• Any change in your work status must
  immediately be communicated to your
  department representative, administrative
  coordinator and adjuster to ensure that the
  proper benefits are initiated or stopped.
  This will prevent overpayments causing
  hardship    at    time     of   mandatory
  reimbursement to the City.

                                             8
Highlights of Rights and Responsibilities:
(Continued…)

• You may have specific departmental policies
  and procedures to follow while on injury
  leave. You will need to contact your
  designated department representative for
  details.




                                             9
Highlights of Rights and Responsibilities:
              (Continued…)
            • Your department will be keeping
               contact with you on a daily basis.
               You are required to be available
               with the exception of medical
               care, City of Houston business
               appointments, and meetings with
               the TDI-WC or TPA.
            • You may be required to attend
               safety classes while on injury
               leave.

                                              10
  The following should occur once you report your injury:


• Complete the accident
  report with your supervisor
• Receive a call from the Third
  Party Administrator
• Obtain your adjuster’s
  contact information
• Provide your recorded
  statement




                                                        11
  The following will occur once you report your injury:
  (Continued…)

• Initial and sign the On The
  Job Injury Reference
  Sheet which highlights
  some of your benefits and
  responsibilities.




                                                          12
  The following will occur once you report your injury:
  (Continued…)

• Receive a copy of The
  Summary Workability
  Guidelines E.O. 1-33
  (For Injured Employees)
  booklet which gives you
  key contact information,
  details of the Salary
  Continuation Program and
  your responsibilities as an
  injured worker of the City
  of Houston.


                                                          13
As a valued City of Houston employee, it
is your responsibility to be available to the
S.W.E.AP. team members and your
department representative. This may
include phone calls and/or visits to your
residing location to discuss details of your
claim to help you with a safe and early
return to work.



                                          14
     The City of Houston respects and values its
                    employees.
Our goal is to provide quality customer service to our
injured employees. We want to hear your feedback on
 the overall experience since your injury. Your input
         will help us to improve our services.
 Please give this information to your Administrative
                      Coordinator.
   Their contact information can be found in your
  Summary Workability Guidelines E.O. 1-33 (For
            Injured Employees) Booklet.

                                                   15

				
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posted:7/25/2012
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