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BENEFITS - PRACTICE 9

Workers' Compensation

WHAT

TVA provides claim and case management, and return to work services for employees who incur job-related injuries. These services include:

  • Initial treatment by TVA or contract medical providers where available or assistance as necessary to obtain other treatment by the physician of the employee's choice.
  • Helping employees submit workers' compensation claims correctly and obtain benefits through the Office of Workers' Compensation Programs (OWCP) according to the provisions of the Federal Employees Compensation Act (FECA).
  • Monitoring the medical recovery of employees following job-related injuries.
  • Facilitating prompt return to work through cooperative working relationships with the injured employee and the employee's physician.
  • An aggressive case management program to ensure timely, appropriate benefits and prevent unnecessary lost time and misuse of benefits.

The primary benefits provided through FECA include:

  • Continuation of regular pay for up to 45 calendar days of disability for work.
  • Payment for medical care.
  • Wage loss compensation.
  • Payment for rehabilitative services.
  • Monetary compensation for loss of a body member or function.

WHO

  • All employees and former employees who file claims or who have had claims accepted for job-related injuries or illnesses.

WHY

TVA provides these services to:

  • Help employees file claims correctly and obtain benefits promptly.
  • Facilitate recovery from work injuries.
  • Prevent unnecessary time away from work.
  • Prevent inappropriate benefits and unnecessary costs.
  • Meet the requirements of FECA and other applicable laws and regulations.

HOW

THE WORK INJURY MANAGEMENT PROCESS

  • All major TVA plants and organizations should have an employee designated and trained to assist injured employees in processing workers' compensation claims. This responsibility is often assigned as a clerical duty. Senior management for major plants and work sites are encouraged to also designate individuals to receive training and be responsible for effective work injury management which is often assigned to a manager with health, safety, administrative or human resource responsibilities.
  • Employees should be encouraged to report work injuries to their supervisors immediately.
  • The supervisor/management designee ensures the employee obtains prompt medical care when needed and accompanies the employee to obtain treatment (to the TVA or contract medical provider when available or to an emergency room or private physician.)
  • The supervisor/management designee notifies the physician that light duty will be made available if necessary to prevent work stoppage or hasten return to work.
  • The supervisor/management designee ensures that the employee is assisted in completion of proper injury or illness reports, CA-1 (traumatic injury) or CA-2 (occupational illness). The supervisor/management designee completes the supervisor's portion of the form and submits it to TVA's Workers' Compensation Department (at BR 3D-C ) within 8 workdays of receipt from the employee.
  • The supervisor/designated manager ensures that all work injury or illness claims are investigated to obtain an objective, factual record for use in improving safety and managing workers' compensation claims and costs. The report of investigation is submitted after the CA-1 or CA-2 is submitted and a case number is available. Suspected fraud should be referred to the Office of the Inspector General.
  • The supervisor/designated manager contacts TVA's Workers' Compensation Department at telephone (423) 751-2894 immediately if an employee stops work or does not return to work following a work injury (regardless of leave status) to initiate the case management process.
  • Injured employees are returned to work as soon as their return is medically approved. If an employee is not capable of resuming his/her regular job duties, temporary light duty is assigned during the recovery process to promote recovery and prevent unnecessary time away from work.
  • The supervisor or designated manager and the return to work coordinator from TVA's Workers' Compensation Department will work together to coordinate and identify light duty work and prepare a description of the work. The return to work coordinator will provide case management services including monitoring medical recovery and obtaining and expediting medical approvals for the employee's return to work.
  • For employees working with medical constraints, supervisors/designated managers should contact the Workers' Compensation Department promptly at anytime there is difficulty identifying or continuing light duty work or when employees do not return to regular duty in the time period expected.

ROLES

Employees Who Incur Job-Related Injuries or Illnesses

  • Report job-related injuries - what happened, how it happened, and where and when it happened.
  • Obtain medical treatment if necessary.
  • Obtain medical documentation for any subsequent disability for work.
  • Return to work as soon as they are able to do so.

Supervisors

  • Assist injured employees in getting needed medical care and completing and submitting proper workers' compensation claim forms (CA-1 or CA-2) within 8 workdays of receipt.
  • Determine relevant facts about each new claim and submit a documented report of findings.
  • Contact the Workers' Compensation Department return to work coordinator immediately to initiate early intervention case management for any employee who loses time from work or does not report for work following the work injury.
  • Provide temporary light duty to allow injured workers to continue working without work stoppage or to expedite his/her return to work.

Workers' Compensation Department

  • Plans and ensures implementation of TVA's workers' compensation program; provides corporate and interagency coordination and agency-wide initiatives and improvements.
  • Provides nurse case management services as necessary for an effective return-to-work program.
  • Maintains data and provides statistical reports and information.
  • Provides regulatory and procedural information, assistance and training for line organizations to effectively manage work injury claims.
  • Responds to and resolves specialized claim and program inquiries and issues.
  • Serves as TVA's liaison with the Office of Workers' Compensation Programs (OWCP).

RESOURCES

  • Individual performing compensation clerk duties at plants, worksites, line organizations
  • Health Station Nurses
  • Health and Safety Managers; Safety Managers/Technicians; Human Resource Representatives
  • Microsoft Exchange; Public folders; TVA; TVA Workers' Compensation
  • Workers' Compensation Department - 423/751-2247 - Address - BR 3D-C

BENEFITS
PRACTICE 9

Workers' Compensation

Last Revised 3/07

 

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