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COURSE TITLE
Workers’ Comp 101: A Day in the Life of a Claim
2009 Summer Institute
July 27, 2009, Oakland, CA
COURSE DESCRIPTION
This class is a very practical one day overview of the California Workers Compensation system, with a focus on the 85% of the claims that go through without major problems. Through case examples and a simple diagram, class participants will leave with the ability to communicate with adjustors, providers, employers, and injured workers. The class will walk the audience through the beginning, middle and end of a typical claim, focusing on practical ways to work together for better outcomes. A syllabus with websites and copy of all relevant forms will be provided, and resources for further assistance/training will be provided. This class is for HR directors and employers, nurses, NPs and nurse case managers, industrial hygienists and safety personnel, physicians and front line claims adjustors, QMEs who are relatively new to the system and want a practical approach. This one day class is taught by Linda Morse, a Board Certified Occupational Medicine physician with over 25 years full time clinical experience, and Alan Jenkins, a former Senior Claims Administrator for over a decade, now responsible for training about workers compensation issues for Kaiser Northern California.
Agenda
| 8:20-8:30 |
Opening Remarks - Goals, Syllabus, Structure of the Day |
Linda Morse |
| 8:30-945 |
Administrative Overview of the System
Brief history of Workers’ Compensation systems in
US/International; Basic structure of system - how
company is insured (self, self insured TPA, SCIF,
private insurers, premiums, benefits); How paid for
typical case - brief discussion of the reforms;
Brief discussion of other systems (Federal, Longshore, etc.)
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Alan Jenkin |
| 9:45-10:00 |
Break |
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| 10:00-10:45 |
Diagram of a Case: Beginning, Middle and the End
Claim overview diagram; LOHP study
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Linda Morse
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| 10:45-11:15 |
Patient Case: Injured Worker – How Could It
Have Been Better?
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Robin Baker |
| 11:15-12:15 |
The Beginning
How a claim is set up, what the employee, employer,
carrier and treating physician all need to do. Talking
points for communication between involved partied.
Forms for reference, case examples
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Alan Jenkins |
| 12:15-1:15 |
Lunch (on your own) |
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| 1:15-2:15 |
The Middle – Period of Active Treatment
Medical care; MPNs; finding good physicians; Good and
bad medical care; Patient and employer and provider
responsibilities; Utilization review; Communication tips;
Work status issues; Cases
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Linda Morse |
| 2:15-2:30 |
Break |
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| 2:30-3:30 |
The End of a Claim
Discharged from care, Permanent & Stationary;
Benefits at this point; Compromise and release;
Future medical care; Retraining/permanent modified
duty - Roles/responsibilities of injured worker, employer
carrier and treating physician; Communication tips; Forms
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Alan Jenkins
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| 3:30-4:00 |
Employer Case - Fraud |
Bill DeCarion |
| 4:00-4:45 |
Current Controversies in Workers’ Comp |
Linda Morse
Alan Jenkins
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COURSE DIRECTOR
Linda H Morse MD, FACOEM is Board Certified in Occupational and Environmental Medicine. She is an Assistant Clinical Professor of Medicine at the University of California Medical Center in San Francisco, and has practiced clinical Occupational Medicine for over 25 years She helped create and run two large Occupational Medicine programs in Silicon Valley and more recently at Kaiser San Francisco where she still works. She has written many articles and book chapters and is co-author of the "Occupational Injuries Text published by Mosby. She teaches frequently on a variety of subjects including workers compensation, musculoskeletal injuries, medical surveillance and respiratory protection.
Other Faculty:
Robin Baker, MPH, Director, Labor Occupational Health Program, UC Berkeley
William DeCarion
Alan C. Jenkins, WCCP, Senior Consultant, Regional Occupational Health, Kaiser Permanente
OBJECTIVES
At the end of this course participants will
- Understand the basic legal/administrative structure of the current California Workers Compensation System
- Develop approaches to use in discussing the system with injured employees/patients/ clients
- Understand from an injured employee’s perspective why the system can be so alienating, and how to be proactive with the employer/ claims adjustor
- Be able to utilize a simple diagram to describe the system from the beginning through the end of the claim to demystify it and empower employees and employers.
AUDIENCE
Managers; employers; union and labor reps; Qualified Medical Evaluators; also nursing, medical, and safety/industrial hygiene professionals who want an understandable, practical overview of the California Workers’ Comp system
CREDIT
Physicians COEH is accredited by the Institute for Medical Quality/California Medical Association (IMQ/CMA) to provide continuing medical education for physicians. COEH takes responsibility for the content, quality & scientific integrity of this CME activity. COEH designates this educational activity for a maximum of 6 AMA PRA Category 1 CreditsTM. This credit may also be applied to the CME Certification in Continuing Medical Education.
Qualified Medical Evaluators 6 hours of QME continuing education credit applied for. Provider # 420
Industrial Hygienists
1.0 Safety CM Point. ABIH approval # 09-2670
Safety Professionals Meets criteria for 0.5 BCSP COC point
Nurses COEH Continuing Education is a California Board of Registered Nursing approved provider BRN # 12983 / 7.2 contact hours
Course Schedule
Date |
Time |
Location |
Price |
July 27, 2009
Monday
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8:30AM - 4:30PM
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State Office Bldg
1515 Clay Street, 2nd Floor
Oakland CA 94612
Directions
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$195 ($225 after 7/9/09)
*Price includes course materials, continental breakfast, and coffee
breaks
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