Florida Department of Environmental Protection

To provide an overview of the Workers’ Compensation and Return-to-Work Program for employees and volunteers to include:How to report a work-related injury or illness;Roles and responsibilities of those involved;Timesheet completion; and Return-to-Work guidelines in accordance with state laws and rules.

Chapters 284 and 440, F.S. Section 216.251(2)(b)2, F.S. Rules 60L-34-0061 and 69H-2.007,

F.A.C.

Workers’ Compensation Program. DEP’s primary concern is for an employee’s wellbeing and full duty release and to assist injured workers in staying at work or returning to work as soon as medically possible.

Return-to-Work Program. Provides modified duty and alternate duty assignments that accommodate functional restrictions and limitations as determined by treating physician in order to bring employee back to work as quickly as medically possible.

When accidents do happen: Modified Duty (within regular position) Alternate Duty (away from normal work area)

or Back to work as soon as possible (same day) or

after release from doctor

It applies to any injury that occurs while employee is working or during work-related or required activities—for example, driving to a facility regulated by DEP, attending a training session, or going to a conference or seminar. It generally does not apply to injuries incurred while employees are commuting to or from work.

Workers’ Compensation also applies to work-related illness, including those that may develop over a long period, such as those caused by exposure to hazardous substances or repetitive motion tasks.

We want all employees who are injured or become ill on the job to get the care they need and be able to support their families while they are out of work.

We want employees to have a successful transition back to work.

We want to keep our costs down. The Return-to-Work Program saves our Department money.

Lost time claims account for 10% of Workers’ Compensation claims, but account for 80% of Workers’ Compensation costs.

The Workers’ Comp Return-to-Work Program is good for our Department and our employees.

Definitions.

Roles and responsibilities.

Policies and procedures.

Awareness and accountability.

Loss Control Committee responsibilities.

Alternate duty or modified duty tasks.

Communications, monitoring, and coordination.

Employee Notification Letter.

Exit process.

Recordkeeping.

Supervisors Employees Worker’s Comp Coordinator Program Administrator -

Agency-Wide Programs Medical Case Management

Provider Triage Nurse Nurse Case Manager Doctor

Adjuster Safety Officer Loss Control Committee Safety Advisory Board Safety Committee Safety Program Manager

Contacting OptaComp immediately (877-518-2583) to report claim, even if not an emergency, with employee present if possible.

Never denying the employee the right to file a claim and reporting all job-related injuries and illnesses even if medical treatment is not necessary.

Notifying division director by email, copying Deputy Secretary, DEP Safety Officer and Program Administrator – Agency-Wide Programs, of any work-related injury or illness within 24 hours or by the next working day. 

Contacting the DEP Workers’ Compensation Coordinator (WCC) if suspicious of an injury.

Reviewing restrictions provided by employee after medical treatment on form DWC-25 to determine if employee’s restrictions can be accommodated.

Making every possible effort to provide modified/alternate duties for injured workers in coordination with the WCC.  

Completing Employee Notification of Alternate/Modified Duties (DEP form 54-301), detailing temporary assignment if restrictions preclude employee from performing job duties and providing a copy to WCC. If alternate duty requires employee to report to different location and/or supervisor, this information will be included with specific date and time of the assignment, location, supervisor, work schedule, and period of assignment, i.e.

Communicating regularly with employee when placed on out-of-work status to promote the employee returning to work as quickly as possible. Supervisors must keep the WCC informed of any issues that may arise.

Coordinating with WCC on proper timesheet completion.

Coordinating with WCC when employee reaches Maximum Medical Improvement (MMI) or functional limitations/restrictions no longer prevent the employee from performing his or her normal job.

Notifying the employee in writing when they can return to their original duties by completing Employee Exit from Alternate/Modified Duties (DEP form 54-302).

If it is determined that employee cannot return to their original duties or there are permanent limitations, the WCC will coordinate determining the employee’s options and notification process.

The supervisor is responsible for providing the WCC with the completed Employee Exit from Alternate/Modified Duties form. 

Notifying supervisor and requesting first aid or medical treatment for non-life-threatening emergencies.

Attending all appointments with authorized treating physician.  

Returning to work after each appointment, except when physician provides a medical diagnosis that prevents employee from returning, providing supervisor with form DWC-25 after each visit.

Reading and signing Employee Notification of Alternate/Modified Duties (DEP form 54-301), if given modified or alternate duty assignments.

Accepting all reasonable alternate duty offerings. If refused, employee will be required to use their personal leave or leave without pay until released to full duty by their treating physician.

Communicating regularly with supervisor and notifying supervisor of changes in ability to work.

Coordinating with employee, supervisor, Nurse Case Manager and Risk Management Adjustor to determine if the employee is able to return to regular job, modified job, alternative job or is unable to work; notifying the employee, supervisor, Safety Officer, Program Administrator – Agency-Wide Programs, Nurse Case Manager and Adjuster when employee is unable to work.

Reporting lost time and return-to-work data to Risk Management on a monthly basis; assisting with annual evaluation of the Department’s Return-to-Work Program as needed.

Assisting supervisor and employee with timesheet, payroll processing and benefit questions.

Filing Wage Statement form for the employee with Risk Management for Wage Loss Benefits when the doctor places the employee on leave for more than 40 hours, processing retirement contributions for employees that reach MMI and have returned to work for a minimum of 31 days.

Reviewing First Notice of Injury and coordinating with the Medical Case Management Provider to ensure that the Medical Treatment form from the doctor is completed accurately and the doctor provides any limitations and/or restrictions with sufficient detail.

Furnishing First Notice of Injury form to Safety Officer and Program Administrator – Agency-wide Programs, to assist in determining any trends and monitoring agency costs.

Reviewing weekly Division of Workers’ Compensation Data Reports to ensure listed employees are correctly identified as DEP employees and employees receiving indemnity payments are actually off from work.

Meeting with Loss Control Committee weekly to determine if employees are able to return to work and perform regular, modified or alternate duty assignments that accommodate restrictions determined by the doctor in order to bring employee back to work as quickly as medically possible.

Participating in quarterly Safety Advisory Committee meetings to provide updates on lost time, return-to-work and claim reporting issues.

Managing the Department’s Workers’ Compensation Program.

Reviewing and tracking initial compensability decisions made by Risk Management, reviewing medical/indemnity payments issued, reviewing files of employees listed as receiving indemnity payments, analyzing lost time claims and cost data monthly and ongoing during fiscal year to determine trends and making recommendations to management to address trends.

Providing leadership regular reports related to Workers’ Compensation and the Return-to-Work Program including loss time claims, First Report of Injury Reports and incident reports; providing information to assist them in making strategic decisions to reduce lost time claims.

Coordinating promotion of the employee Return-to-Work Program, promoting employee awareness and program accountability necessary agency-wide for managers and supervisors to reduce lost time cases.

Developing a comprehensive Return-to-Work Program evaluation process to assess outcomes and adjust program operations accordingly.

Coordinating the development and update of directives related to the Return-to-Work Program.

Preparing Workers’ Compensation and Return-to-Work Program articles or memos.

Updating New Employee Orientation and other training to familiarize supervisors and employees on Workers’ Compensation and the Return-to-Work Program.

Triage Nurse receives initial injury call from supervisor, assesses injury from information provided, arranges initial medical referral and thereafter turns claim over to assigned Nurse Case Manager.

Nurse Case Manager provides form DWC-25 to Adjustor and WCC, arranging and authorizing appointments to meet treatment plan outlined by doctor, including referrals to specialists, testing and therapies, ensuring functional limitations listed on form DWC-25 are clear/measurable.

The doctor completes form DWC-25, discusses findings with employee and provides a copy of completed form DWC-25 after each visit.

Handling Workers’ Compensation claims reported by employees.

Coordinating with the WCC to determine the compensability and lost time benefits when injured employee is unable to work.

Serving as an employer resource for questions and issue resolution.

SAFETY OFFICER IS RESPONSIBLE FOR:

Developing, implementing and administering the Department’s Safety and Loss Control Management Program.

As it relates to Workers’ Compensation specifically, the Safety Officer’s responsibilities include:

Ensuring that each on the job injury or illness is documented on an incident report and related backup documentation is uploaded to the Division of Administrative Services’ safety drive by the Safety Program Manager for the district/division/office and maintained for three calendar years.

Meeting with the Loss Control Committee weekly to determine if employees are able to return to work and perform the regular/modified or alternate duty assignments that accommodate their limitations as determined by the doctor in order to bring the employee back to work as quickly as possible.

Scheduling quarterly Safety Advisory Board meetings to review injury and incident reports whether or not it results in an injury, to determine cause of accident and formulate corrective measures to prevent recurrence.

Reviewing claims data monthly and on-going during year to determine any trends and make recommendations to management to address trends.

Promoting the employee Return-to-Work Program with managers and supervisors to reduce lost time cases.

(Loss Control Committee consists of at least one representative from Bureau of Personnel Services including the WCC and at least one representative from the Safety Office and the Program Administrator – Agency-Wide Programs.)

Meeting weekly to determine if employees are able to return to work and perform regular, modified or alternative assignments that accommodate restrictions as determined by the doctor in order to bring the employee back to work as quickly as medically possible.

Evaluating employee injury and incident records, identifying trends and patterns and formulating corrective measures to prevent recurrence.

Reviewing and updating workplace safety rules based on incident review findings, inspection findings, employee reports of unsafe conditions or work practices, and addressing suggestions and concerns.

(Safety Advisory Board meets quarterly and is comprised of the Safety Officer, Safety Program Managers from each division/district/office and the Workers’ Compensation Coordinator.)

Evaluating circumstances related to reported incidents/accidents and to address safety concerns. Board makes written recommendations to Department management regarding policy changes necessary to promote a safer work environment and reduce loss time cases.

Establishing and communicating procedures for evaluating the effectiveness of control measures used to protect employees from health and safety hazards in the workplace.

Evaluating employee injury and incident records identifying trends and patterns, and formulating corrective measures to prevent recurrence.

Reviewing and updating workplace safety rules based on incident review findings, inspection findings, employee reports of unsafe conditions or work practices, and addressing suggestions and concerns.

(Safety Committee consists of a team of employees within a particular division/district/office selected by the Safety Program Manager.)

Investigating and analyzing factors related to workplace “close call” incidents, safety-related incidents, injuries, illnesses, diseases and fatalities in order to eliminate hazards or reduce their potential recurrence.

Evaluating the effectiveness of and recommending improvements to Department’s safety rules, policies and procedures for incident prevention and wellness programs in workplace.

Establishing and communicating guidelines for safety training of employees.

Promoting the Workers’ Compensation Return-to-Work Program.

Reviewing statistical analyses from Risk Management, First Notice of Injury, incident investigations, property damage and vehicle incident reports.

Assisting management in establishing and maintaining a healthy and safe working environment and providing management with information, advice, and assistance needed to formulate the division/district/office health and safety policies, directives, procedures and standards.

Assisting supervisors in providing training and technical assistance, determining needs for personal protective equipment, and assessing job-related health and safety issues as required.

Maintaining a library containing copies of codes, standards, safety manuals, and reports that regulate the Health and Safety Program and copies of records and reports regarding health and safety issues.

Promoting the Return-to-Work Program and reducing Workers’ Compensation related costs.

Ensuring each on-the-job injury/illness is documented on an incident report and related backup is uploaded to the Division of Administrative Services’ safety drive for the district/division/office and maintained for three calendar years.

When treating physician places a CS/SES/SMS employee on non-work status, employee may use disability leave beginning on the day after the injury not to exceed 40 work hours (hours type 0065).

If a CS/SES/SMS employee receives medical treatment

the day of their injury, time missed should be entered on employee’s People First timesheet as work hours (hours type 1000), leave time is not required.

OPS employees are only eligible for actual time worked on day of their injury. Time missed for appointments/treatment are not paid for by agency.

Additional Disability Leave Allowance. Upon written confirmation from doctor, CS/SES/SMS employees who are in work status will be granted up to 48 hours of additional disability leave (hours type 0065) to be used intermittently to cover appointments to health care providers, physical therapy and similar activities provided that these activities are directly related to employee’s WC injury. If injured worker has not exhausted initial 40 hours of disability leave, then all or any remaining hours may also be used for follow-up medical appointments or treatment required by doctor.

Effect of Holidays. If holidays provided for in s. 110.117, F.S., occur while employee is in full pay status during the first seven days following job-connected disability, holiday counts towards initial 40 hours. When holiday occurs during subsequent disability, employee will receive holiday pay in lieu of using leave credits.

Sick, Annual or Compensatory Hours. If employee is unable to return to work after the initial 40 hour disability period, supervisor will advise WCC of their status. Risk Management will pay directly to the employee 66 2/3 percent of employee's average weekly wage. The Department will pay the other 33 1/3 percent not paid by Risk Management by charging employee with eligible leave credits, if available, to keep employee in full pay status. Until the employee returns to work, monthly pay warrants will be based on the prorated leave usage. After exhaustion of all leave credits, an employee will be on approved leave without pay.

OPS Employees. If an OPS employee is injured and an authorized treating physician places them in non-work status, Risk Management will pay approximately 66 2/3 percent of the employee’s salary beginning with the eighth calendar day. After 21 days of non-work status, Risk Management will retroactively pay employee for the first seven days missed.

Payment by the Employee. During the time an employee is only receiving WC benefits and the employee does not have sufficient paid leave time to cover their payroll deductions, the employee is responsible for payment. The WCC will coordinate this with the employee.

Timesheet Completion. The WCC will assist supervisors in accurate timesheet completion in People First and payroll processing. Employees placed on out-of-work status for more than 40 hours will be noticed of their leave eligibility as provided in the Family and Medical Leave Act (FMLA).

Leave Without Pay. If employee has no accrued leave, has exhausted all leave or wishes to be placed on leave without pay, employee will be entitled to receive WC benefits at the rate of 66 2/3 percent of pre-injury average weekly wage, not to exceed the maximum weekly compensation rate and will be placed in leave without pay status for the period of time actually missed from work that is not covered by WC.

Employees receiving benefit payments are considered to be in "pay status" even though the People First timesheet reflects leave without pay. Employee will continue to earn leave credits as long as the employee is carried in a payroll leave without pay status due to an on-the-job injury or illness.

Employees may request mileage reimbursement for trips made to an approved medical care provider on Risk Management Mileage Reimbursement which can be found as part of the OptaComp Orientation Booklet. Trips to the drug store and medical equipment suppliers (i.e., wheelchairs, walkers, crutches, etc.) are not reimbursable.

Completed Mileage Reimbursement forms are to be submitted directly to the Adjustor at the Division of Risk Management for payment.

Supervisors will receive training on WC and the Return-to-Work Program upon hire, as part of basic supervisory training, and each time the directive is amended.

Employees will receive training on WC and the Return- to-Work Program as part of New Employee Orientation and other pertinent information by email and on the Bureau of Personnel Services web site.

Return-to-Work Program articles will be featured in Department-wide emails and the Division of Administrative Services’ electronic bulletin board.

The Return-to-Work Program will be evaluated annually using metrics provided by the Division of Risk Management.

Failure to timely notify OptaComp when an injury or illness occurs could result in the Department being responsible for the payment of interest and penalties.

In the event the Department is penalized, the applicable director or designee will be responsible for arranging for payment of such penalties and interest from the organizational unit’s appropriated funds.

Confidential WC information is securely maintained in a locked cabinet or locked room.

A file will be created and maintained by the Bureau of Personnel Services for employees who are in an out-of-work status and a Return-to-Work Section will be created within the existing file. Once the employee has reached MMI and is released to return to work or it is determined that they will not be able to return to work, these records will be placed in the employee’s official Personnel file.

Workers’ Compensation Procedures and Provider Handbook are located on the following Personnel Website: http://www.dep.state.fl.us/admin/Personnel/

DEP Directive 450, Workers’ Compensation & Return-to-Work Program

Paige Fenner, DEP Workers’ Compensation Coordinator (WCC), 850/245-2511

Jeff Loflin, Safety Officer, DEP Safety Office, 850/245-2312

Betty Clark, Program Administrator – Agency-Wide Programs, DEP Division of Administrative Services

Report all work-related

injuries/illnesses promptly.

Help workers file claims.

Maintain contact with workers

on leave.

Help make the transition back

to work.

Reduce claims and keep down

costs by promoting safety and

preventing accidents.

Return-to-Work (RTW)

programs are essential to

reducing claim costs.