WORKERS’ COMPENSATION UNIT MANAGER CHECKLIST Initial File Collaboration Explanation Coverage Timely Initial Contacts – 3 Point If cannot make contacts, contact leader Review Initial Investigation/Employer Confirmation of accident, injury and body part, wit- nesses, recorded statements, advise employer to stay in contact with employee. Contact W/Provider If able, confirm description of injury/accident given, body part, last and next appt, and work status Contact W/Employee Recorded statement, confirm accident description, confirm lost time dates, confirm all body parts injured, last appt and next appt, explain expectations/benefits, document a profile, discuss rtw expectations and prior injuries Subrogation Referral Is there recovery potential? Double Check Jurisdiction Class Code Compensability Decision Agree? Need any further investigation? Plan Of Action Elements Review all elements. Medical Records Requested? Work Status Received/Confirmed RTW Screens First Pay Due Date Back? Wage Statement Received? Benefits Calculated Correctly And Documented? Job Description Requested From Employer Job Description Sent To Provider RTW Projection Form May not need or be able to use Surgery Form May not need or be able to use Need For SIU? Nurse Case Management Needed? Medicare? HICN ORM Assumption Completed? ISO Always Comment On Reserves Form Work Completed the initial form work? Workers Empowerment Collaboration Review Explanation – Subsequent Status of the file? Check ongoing payments and calculations, work status Reserving appropriate? Following handling instructions and do reserves accu- rately reflect exposure? Pay attention to initial reserves, ensuring it reflects exposure. continued on page 9 8 9