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NASA Procedures and Guidelines |
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| | TOC | Preface | Chapter1 | Chapter2 | Chapter3 | Chapter4 | Chapter5 | Chapter6 | Chapter7 | AppendixA | AppendixB | AppendixC | AppendixD | AppendixE | AppendixF | AppendixG | ALL | | |||||
6.1.1 Introduction
a. The prevention and management of occupationally related injuries and illness is a key function in ensuring the health and safety of the NASA workforce. Timely reporting and early medical intervention following an injury or illness helps to facilitate the recovery process and reduce the potential for disability. Case management for cases involving lost time injuries/illnesses facilitates a safe and timely return to work utilizing modified duty and/or work accommodations. These efforts are critical to reducing days away from work and reducing the costs associated with injuries and illnesses.
b. Case management is a collaborative process that assesses, plans, implements, coordinates, monitors, and evaluates options and services required to meet individual health needs, using communication and available resources to promote quality and cost-effective outcomes.
6.1.2 Responsibilities
a. The Center Medical Director is responsible for the medical aspects of civil service workers' compensation cases. This includes initiating and providing medical evidence to NASA compensation personnel for claims that do not appear to be work-related and should be refuted. The respective Center Human Resources Office (HRO) and Compensation Claims Office (CCO) will assist as required.
b. The NASA OHP establishes the responsibilities and procedures for the workers' compensation program. The OHP is responsible for the evaluation of workers' compensation data trends and monitoring costs Agencywide.
6.1.3 Process Description
a. Center OHP personnel ensure that treatment options are available for any employee with an occupationally related injury or illness during and after normal business hours.
(1) The employee is responsible for reporting the injury or illness and seeking treatment.
(2) The health care provider obtains history, assesses injury or illness, and provides treatment.
(3) Ongoing care and followup are provided until issue is resolved or Maximum Medical Improvement (MMI) has been reached.
(4) A determination of the ability to return to work and the need for job modifications or accommodations is made.
b. Case managers are essential when a case involves lost time, needs medical limitations, or the case has been managed by a health care provider outside of the OHP clinic at the Center. Duties of case managers include the following:
(1) Supporting employee throughout the treatment and return-to-work process.
(2) Monitoring appropriateness and effectiveness of care being provided.
(3) Assessing employee compliance with treatment recommendations.
(4) Facilitating early and safe return to work within medical limitations.
c. Assistance from the Offices of Human Resources and Compensation Claims will be requested as needed.
d. Human Resources Office personnel work with the Center Medical Director as an employee is cleared for return to work, modifying duties in a job description as needed to expedite a productive return and transition to full duty.
e. CCO's are responsible for working with employees to assist in filing claims and working with the Center Medical Director as needed for potential cases of controversy. The latter may require advice from the Office of Chief Counsel.
f. The NASA OHP is kept apprised of all WCP actions.
6.1.4 Reference
a. NPD 1840.1A, NASA Workers' Compensation Program, dated February 23, 2001.
b. NPR 1840.1 Management of Workers'Compensation Injuries and llnesses, August 23, 2001.
6.1.5 Flow Diagram
The flow diagram for this process is shown in Figure 6.1 at the end of this section.
6.2.1 Introduction
The Office of Workers' Compensation Programs (OWCP) determines the information and timeliness requirements for processing civil service workers' compensation claims and reports. Prompt processing of WC claims through a case management system assures the most expeditious authorization of medical care for the injured and facilitates the return of the injured employee to productive employment. Management of a case is a process used to track medical treatment and return to work of the injured by the Center WC Officer or in combination with Center medical, human resources and safety personnel, as appropriate.
6.2.2 Responsibilities
a. Employees are responsible for notifying the Agency of injuries.
b. The WC Officer for each Center issues or authorizes issuance of OWCP forms and tracks status of claims and claim forms.
c. The supervisors of the injured employees complete their portion of the OWCP forms within 2 working days and return the form to WC Officer.
d. The OHP monitors Agency OWCP data trends and costs.
6.2.3 Process Description
a. Continuation of Pay (COP)
The WC Officer reports COP on a quarterly basis. Reports are completed and submitted no later than January 15, April 15, July 15, and October 15, for the quarter ending the preceding month. The report includes the number of COP cases listed by claimant name; hours, and cost of COP; number of full, partial, and calendar days of COP used for that quarter; and for payments made in that quarter, and for COP incurred in a previous quarter. The WC Officer controverts payment of COP if medical evidence of injury is not provided.
b. Reserved
(1) Reserved.
(2) Reserved.
(3) Reserved.
(4) Reserved.
c. Reporting
The WC Officer maintains a record of the date of injury, dates of issue of CA-1, CA-2, or CA-16 forms, whether the claim was first aid only, the date (if applicable) when the first- aid injury became a nonfirst-aid reportable injury, and when the initial claim forms CA-1, CA-2, and CA-7 were sent to OWCP. Reporting follows the sequence below:
(1) Employee notifies Agency of injury.
(2) Appropriate OWCP forms issued by Center.
(3) Employee completes form, obtains appropriate medical documentation.
(4) Employee's supervisor completes appropriate forms.
(5) WC Officer verifies completeness of form, supports or controverts payment of COP, and challenges nonwork-related claims.
(6) WC Officer verifies a case management process to facilitate appropriate medical treatment and prompt return to work.
(7) WC Officer reports COP and pertinent injury data to the OHP for Occupational Health and to their Center management.
6.2.4 Flow Diagram
The flow diagram for this process is shown in Figure 6.2 at the end of this section.
| TOC | Preface | Chapter1 | Chapter2 | Chapter3 | Chapter4 | Chapter5 | Chapter6 | Chapter7 | AppendixA | AppendixB | AppendixC | AppendixD | AppendixE | AppendixF | AppendixG | ALL | |
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