Office of Risk Management

POLICIES RELATED TO WORKERS COMPENSATION

SUBJECT:	Review of cumulative trauma claims
SOURCE:	Vice President for Administration
DATE ISSUED:	September 9, 1997
RATIONALE:	To assure that injuries from cumulative trauma claims are properly identified and covered by workers compenation benefits.
POLICY:	All suspected cumulative trauma claims shall be reported the Office of Risk Management for review under the "Guidelines for reviewing cumulative trauma claims" procedures.
DEFINITIONS:
PROCEDURE REFERENCE:	Specific procedures to be followed are included in a document called "Guidelines for reviewing cumulative trauma claims"
CROSS REFERENCE:
RESPONSIBLE ORGANIZATION:	Office of Risk Management

Guidelines for reviewing cumulative trauma claims

Please note that these procedures are being reviewed as occupational health services will not be provided by the Health Center effective Jan 1 2003. Until these are updated, follow steps one and two and then you will be contacted about the next steps in the procedure.

The employee’s department is to complete the Occupational Injury/Illness Report form, attach a job description, and attach a copy of the essential and marginal function worksheet. This information is to be forwarded to the Risk Management Department.

If the employee has been treated in the past for a similar condition, the employee needs to list the names and addresses of all physicians seen for this condition and forward to Risk Management. Risk Management will obtain a medical authorization release and request medical records. These records will be forwarded to the Health Center.

After forwarding the information listed in item number one to Risk Management, the employee needs to call Helen Rogers, R.N., at the Health Center (855-4425) to make arrangements to see the Occupational Medicine Physician at the Health Center. The employee will bring a copy of the items listed in item number one above to their appointment. (Note--Ms. Rogers only arranges appointments for cumulative trauma claims.)

The Occupational Medicine Physician will obtain a medical history regarding medical conditions which may contribute to the employee's problem and whether they have been treated for this condition in the past. They will review employment activities, second jobs, hobbies and past employment.

If deemed necessary by the Occupational Medicine Physician, a site visit will be arranged through Risk Management for job site analysis and determination of whether or not new workstation layout or equipment is needed (i.e. higher/lower desk, new chair, wrist rest, or foot rest).

If work station changes are indicated, the evaluator will provide the employee's department, the Occupational Medicine Physician and Risk Management their recommendations. The employee's department is responsible for the cost of the new equipment.

The Occupational Medicine Physician will contact Risk Management with the employee's provisional diagnosis. Determination will be made regarding work-relatedness and recommendation for further medical treatment.

If the employee is not responding to conservative treatment for a work related condition, the Occupational Medicine Physician will request authorization from Risk Management for specialized tests and/or referral to a specialist for further evaluation.