The employee has returned to work. Why is the case still open?

Workers Compensation can involve a number of benefits in addition to wage loss. Often times after an employee has returned to work, the physician will continue to monitor the employee's medical progress until treatment is no longer required. Unless a condition is more severe and will result in permanent disability, typically a case will then be reviewed for closure.

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Am I required to offer TRANSITIONAL WORK / LIGHT DUTY?

No, by law you are not required to offer transitional / light duty work. However, there are a number of benefits to making transitional work available. See "EMPLOYER - The Claims Process - Transitional/Modified/Light work".

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Can I terminate an employee who is on Workers' Compensation?

The answer to this depends on the situation and circumstances. Since this issue involves an employment matter and is generally outside the scope of workers' compensation, we recommend that you consult with your labor counsel or similar resource.

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Do I have to pay the employee at the same wage rate while on transitional / light duty work?

No. If the transitional work dictates a lower wage rate, workers' compensation will cover the appropriate difference in pay. Although it is financially more beneficial to you to pay at the same wage rate, paying a lesser rate is still more advantageous than not having transitional work available at all.

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The employee provided me with a disability slip. What do I do with it?

Please forward it to us and keep a copy in your files. If we have not already received this information, we will use it to address the employee's disability status.

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What amount is the employee paid for Temporary Total Disability (TTD) benefits?

TTD is based on 2/3 (.6667%) of the employee's average weekly wages subject to a maximum amount.

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The employee said s/he paid for medications out-of-pocket and wants to be reimbursed. What should I do?

Ask the employee to send the medication receipts to his/her adjuster with a request for reimbursement. We will determine if the request is appropriate and issue a reimbursement accordingly.

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The amount of reserves on a file can impact my premiums. How are these reserve amounts determined?

Reserves are established on a case-by-case basis on the extent of the case issues and the corresponding realistic financial outcome. The amount of the reserve is monitored and adjusted continuously to ensure accuracy.

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If a third-party was responsible for the accident, is the entire claim reimbursed?

That depends. According to state law, guidelines are in place which dictate the maximum recoverable amount which the employer can receive depending on the situation. For example, if an employee retains an attorney, and we do not, that attorney will typically take a portion of the employee's recovery. Likewise, they will take a portion of the employer's recovery as well.

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How can I find out about the status of a particular claim?

Your best resource for this information is the claim adjuster who is handling that case. You may contact him/her at 537-5221. For additional contact options, see EMPLOYER - CONTACT INFORMATION.

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