RESPONSIBILITY OF EMPLOYER - 2581.2

(Revised: 12/2013)

The employer is responsible for carrying out state and departmental injury prevention policies. In case of injury this responsibility includes initiating action to obtain prompt medical treatment for injured employees. Employer includes every person having direction, management, control, or custody of any employment, place of employment, or any employee.

The employer shall:

Assure that first aid is administered for minor injuries or arrange medical treatment by an employer selected physician or the employee’s pre-designated physician when necessary. For extreme emergency get the injured to any available doctor, hospital, or public medical service.

Arrange for treatment with the employer selected physician or medical facility within the Medical Provider Network (MPN) or with the employee’s pre-designated personal physician or medical group.

Arrange for transportation to doctor's office or to hospital. Use state vehicle, ambulance, taxi, or whatever is appropriate at the time.

(Note: The employer or designated representative can accompany the employee to get medical treatment.)

Provide the ill/injured employee with the Workers’ Compensation Claim Form & Notice of Potential Eligibility form (DWC 1 /e3301) if medical treatment other than first aid was required or the illness or injury results in lost time. The SCIF e3301 must be provided to the injured employee within one working day of the department’s notification an illness or injury has occurred.

Make a report of action taken and the facts about the accident by completing both sides of Employer's Report of Occupational Injury or Illness form, SCIF e3067(STATE).

Submit SCIF e3067 (STATE) to State Fund.

The employer shall:

Maintain contact with injured employee.

Arrange for completion of Absence and Additional Time Worked Report STD. 634 or equivalent form, for payroll purposes.

Discuss return to work with employee, physician, State Compensation Insurance Fund Claims Adjuster, and departmental Return-to-Work Coordinator.

Forward all medical documentation to the departmental Return-to-Work Coordinator.


The employer shall:

Go to the scene of the accident and collect data to reconstruct the circumstance of the accident, if appropriate.

Question witnesses and others who have knowledge of the injury. Review the Supervisors Section of SCIF e3067 (STATE), to:

Assure adequate information has been recorded for injury prevention. Make initial determination if injury is work-related or not.

Identify responsibilities for training-instructions and supervisory follow-up.

Reconcile questions and problems raised by either the supervisor or the employee.

Initiate injury prevention changes that will minimize the potential of recurrence of a similar accident.  Process the form in accordance with agency safety plan.

Review SCIF e3067 (STATE) for completeness of data.

Submit SCIF e3067 (STATE) and SCIF e3301 as soon as possible, but no later than five (5) days after notification of employees work injury or death.  If there is a question or doubt about the injury or illness being job-related, the supervisor shall attach a memorandum to SCIF e3067 (STATE) outlining the facts as they are known and request further investigation by State Compensation Insurance Fund.


Revisions

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