City of LA City Services Directory GSD Home What's New! Bids Directory of Public GSD Services
 
Personnel Services
Work Compensation and & Temporarily Modified Work Program (TMW)
 
Asset Management Building Maintenance Construction Forces Executive Division Facility Services Finance & Special Operations Fleet Services Fuel Services & Env. Compliance Mail Services Management Information Services Office of Public Safety Parking Services Personnel Services Publishing Services Standards Supply Services

Following are Frequently Asked Questions (FAQs) about workers’ compensation  and how to  handle common situations or questions that may arise when an employee claims an injury.  The FAQs cover various topics such as reasonable treatment for an injured employee, the necessary paper work that must be completed, temporary accommodations and other general procedures. You will find answers about workers’ compensation benefits, time keeping procedures, and handling a workers’ compensation claim.

The second section of these FAQs discuss the Department’s Temporary Modified Work Program (TMWP) formerly referred to as a Return to Work Program (RTW program).  The TMWP is designed to allow employees with temporary work restrictions to return to modified work for up to 90 days.

  1. What is workers' compensation?
  2. Who administers the workers' compensation benefits for the City?
  3. What is a work related injury?
  4. Who is eligible for workers' compensation benefits?
  5. Is mental stress a work-related injury?
  6. Is death covered by workers' compensation?
  7. What benefits are provided for an injured worker?
  8. Would injuries such as paper cuts and splinters require some type of medical treatment?
  9. What if an injury is more serious than a paper cut such as a large "cut" on the arm from a sharp object or back pain where the employee is having difficulty moving? What treatment can be provided?
  10. What should I do if an employee is unconscious or stops breathing?
  11. What should I do if an injured employee DECLINES treatment?
  12. What forms must I complete after an injury is reported?
  13. What do I need to do with the forms once they are completed?
  14. After I fax the forms, what do I do with them?
  15. Where do I get these forms?
  16. Must these forms be completed for an injury that only required first aid treatment?
  17. How should I code the employee's time sheet when an injury occurs?
  18. How will I know when to stop using the code SK? And when the claim is accepted, what code should I use?
  19. What code do I use if the employee is being accomodated for work restrictions?
  20. How should I code the time sheet when an employee has been released to duty, but does not report?
  21. Is the injured employee allowed time off from work to attend physical therapy?
  22. What should I do if the employee can only go to physical therapy during work hours?
  23. Do I have to release the employee from the job when he has a scheduled medical evaluation?
  24. Does the injured employee have any responsibilities while off duty?
  25. Why do I need advance notice of an employee's release to work?
  26. What do I do after an injured employee has given me advanced notice of his expected release to duty?
  27. What do I do when an employee reports for work without prior notice, after being off duty due to a work related injury?
  28. Can I accept an employee back to work the same day or the next day after the injury occurred?
  29. What if I suspect the injury did not actually happen or did not occur on the job?
  30. Since the claim is questionable, what type of medical treatment should be provided when the employee reports an injury?
  31. How do I code the time sheet if the claim is suspicious?
  32. Will I be informed of the outcome of any investigation of questionable claims?
  33. How long will the investigation take?

WORKERS’ COMPENSATION

1. What is workers’ compensation?
Workers’ Compensation is a no fault insurance plan administered by the City for employees who suffer from work related injuries.  

2. Who administers the workers’ compensation benefits for the City?
Workers' Comp (WC) Claims Adjusters in the Workers’ Compensation Division of the Personnel Department.

3. What is a work related injury? 
An injury or illness which arises while performing work duties or which occurs at the work site while performing work duties.

4. Who is eligible for workers’ compensation benefits?
Any City employee who gets injured while performing work duties.

5. Is mental stress a work-related injury?
Could be. However, to qualify for workers’ compensation benefits the injury must be found to be job-related.  Call the GSD Workers’ Compensation Liaison (GSD WCL) for further details. 

6. Is death covered by workers’ compensation?
Could be.  Once again, the death must have been hastened or caused by work related injuries.  The dependents of the employee may be able to file a worker’s compensation claim.  Call your GSD WCL for further details,

7. What benefits are provided for an injured worker?
There are five areas of benefits available to the injured worker as follows:
* Medical care
* Temporary disability 
* Permanent disability
* Vocational rehabilitation
* Death benefits

Call your GSD WCL for details, or browse through our WC webpages.

MEDICAL TREATMENT

8. Would injuries such as paper cuts and splinters require some type of medical treatment?
These injuries are considered minor and will most likely require a bandage from a first aid case. 

9. What if an injury is more serious than a paper cut such as a large “cut” on the arm from a sharp object or back pain where the employee is having difficulty moving?  What treatment can be provided?
Be prepared!  Effective supervisors should already know where the nearest medical facility is located.  Take the employee there immediately.   If you don’t know where the nearest medical facility is, call your GSD WCL for a referral or GSD Security Services Dispatch office at (213) 978-4670 (24/7)

10. What should I do if an employee is unconscious or stops breathing?
If the employee is in immediate danger, call 911 and use any necessary first aid training to stabilize the person until help arrives.  Use common sense, paperwork can wait until your employee is safe.

11. What should I do if an injured employee DECLINES treatment? 
If this happens, document it.  Note: an employee can DECLINE treatment; but you should NEVER deny treatment when an injured employee requests medical attention.  

DOCUMENTATION OF INJURY

12. What forms must I complete after an injury is reported?
There are three forms that must be completed immediately after an injury has been reported to you:
*  Initial Report on Injury (IRI). This form must be completed and faxed to GSD WCL at (213) 922-8513 on the day the employee reports the injury. Make sure the IRI form used shows a revision date of August 2005. All other versions should be discarded.
*  Employee's Claim for Workers' Compensation Benefits Form (Form DWC-1). This form must be provided to the injured employee within 24 hours after the employee reports the injury.
*  Employer's Report of Occupational Injury or Illness (Form 5020). Document what happened to the employee by conducting a mandatory investigation, writing down the facts, names of witnesses and collecting statements from those witnesses and attach the information to the Form 5020. Work with staff in our safety operations services (SOS) section on the accident investigation.

13. What do I need to do with the forms once they are completed?
Fax both forms to the Personnel Department, Workers’ Compensation Division at 213-922-8513 AND your GSD WCL at 213-922-8513.  The Workers’ Compensation Division will either fax or call you with a claim number a few days later. If you don't hear from them, call for the claim number. If the employee refuses medical treatment and does not wish to file a WC calim, not this on the bottom of the 5020 and the date the DWCI form was given to the employee. 

14. After I fax the forms, what do I do with them?
Once you have completed the forms (claim number, signatures, etc.), keep a copy for your division files and send the originals to the GSD WCL in GSD Personnel (Rm. 307 CHS, Stop 508), and a copy by fax to Workers Comp Div. at (213) 847-9038.

15. Where do I get these forms?
Ask your supervisor or call the GSD Personnel Office at 922-8585, or download from our Workers Comp webpage.  

16. Must these forms be completed for an injury that only required first aid treatment?
Better safe than sorry!  Even if the injury only needed a bandage, its good practice to keep some kind of documentation of it.  So fill out the form 5020, file it away and hope there are no unexpected surprises in the future.

TIMEKEEPING PROCEDURES

17. How should I code the employee’s time sheet when an injury occurs?
The code SK (sick leave benefits) should be used until you receive  a ‘duty certificate’ indicating that the claim was accepted. 

* If the claim is in dispute or under investigation,
   you may approve the use of sick leave
   benefits upon receipt of acceptable
   documentation (doctor’s notes) from
   the employee for the stated period
   of absence. If there is no available sick
   time, you can approve the use of vacation
   benefits (VC) or approve a leave of absence (LW). 

* If the employee does not provide acceptable justification or timely doctor’s notes for absences, the time
   can be marked absence without authorization (AW). Work closely with your Personnel Division Liaison when considering AW time for an employee who has an approved, open workers' compensation claim.  

18. How will I know when to stop using the code SK?  And when the claim is accepted, what code should I use?
The GSD WCL will notify you through a duty certificate for the employee.  Once you receive the certificate, you can use the code “IS”. 

19. What code do I use if the employee is being accommodated for work restrictions?
Use the LD code. 
 

20. How should I code the time sheet when an employee has been released to duty, but does not report?
Mark the employee absent without authorization (AW). Again, work closely with your Personnel Division Liaison on these cases.  
 

PHYSICAL THERAPY TREATMENTS

21. Is the injured employee allowed time off from work to attend physical therapy?
Yes, if the physical therapy has been approved by the Personnel Department's Workers' Compensation Division. Physical therapy should be treated the same as a doctor's appointment for evaluation or treatment of an on-the-job injury or illness. Call the WC Division for clarification, the time is recorded as "LP"

22. What should I do if the employee's doctor offers physical therapy after work hours, but the employee wants to go on City time?
The employee may attend on their own time. If therapy cannot be rescheduled after work hours, the employee may attend on City time. Call GSD WCL to clarify. The time is recorded as "LP". An employee who has an accepted workers' compensation claim should be allowed to attend workers' compensation medical appointments on City time when such appointments are scheduled during the employee's regular work shift. However, you may ask the employee to schedule appointments as close as possible to the beginning or the end of the work shift, or during off-duty hours, to the extent that such appointments are available. This also applies to workers' compensation claims where the employee has been returned to full duty and issued an award that includes future medical care. If in doubt, contact GSD's WCL or the Workers' Compensation Division.  

23. Do I have to release the employee from the job when he has a scheduled medical evaluation?
Only if the City Attorney’s Office or Personnel Department scheduled the medical evaluation.  The employee uses his/her own time if the evaluation is scheduled by the employee or his attorney.  Ask the employee for verification. If you have concerns about the appointment, call GSD WCL or the Workers Comp Division for assistance.
 

RETURNING EMPLOYEES TO WORK
WITH OR WITHOUT RESTRICTIONS

24. Does the injured employee have any responsibilities while off duty?
The employee should: 
* Comply with doctor’s orders (treatment, medication,
   restrictions);
* Stay in touch with you; 
* Provide doctor’s notes and updates to the WC Claims
   Adjuster at the Personnel Department and to his/her supervisor regarding his/her work status;
* Notify you in advance and as soon as possible of
   the date of his/her expected return to duty,
   with or without restrictions.  Make
   sure you contact the GSD WCL for
   approval to return the employee
   to work with or without restrictions.
* Document instructions you give to the employee.

25.  Why do I need advance notice of an employee’s release to work?
Advance notice of an employee’s return to work is an advantage to everyone.  This gives you, the GSD WCL and the WC Claims Adjusters time to prepare for any accommodations of restrictions.

26.  What do I do after an injured employee has given me advanced notice of his expected release to duty?

* Instruct the employee not to report for duty until you
   contact his/her with reporting instructions.
* Notify the GSD WCL of the employee’s anticipated
   return.  The GSD WCL has to approve the
   anticipated return and any
   accommodations for the employee if
   there are work restrictions.
* If you get a copy of the doctor’s note, fax a copy
   to the GSD WCL at 922-8513;
* Instruct the employee to provide a copy of
   the note to the Personnel Department's WC Division.
* The GSD WCL will coordinate the employee’s
   release to duty with or without restrictions
   with the Personnel Department. 
   Placement in the TMWP would be considered
   if the employee has temporary work
   restrictions that require accommodations.
* Once the employee has been cleared by the GSD WCL,
   you can contact the employee with
   reporting instructions.
* For exceptions to the above instructructions, contact the GSD WCL.

27. What do I do when an employee reports for work without prior notice, after being off duty due to a work related injury?
* Whether the injured employee is reporting for duty one day or
   one year after an absence from the job, obtain
   a doctor’s note from the employee regarding his/her work status and fax it
   to the GSD WCL at 847-5736. 
* Send the employee home to await further instructions from you. 
* Instruct the employee to provide a copy of the note
   to the Personnel Department's Workers' Compensation Division.
* Once the employee has been cleared by the GSD WCL, you
   can contact the employee with
   reporting instructions.

28. Can I accept an employee back to work the same day or the next day after the injury occurred?  
Yes.  The injury may not be severe enough for the employee to be off duty.  Be sure to obtain a doctor’s note that either clears the employee to return to full duty or outlines any restrictions that may require accommodation.  Notify the GSD WCL of the employee’s situation so that a record can be made of the accommodation.  The GSD WCL can also provide guidance and directions if you need assistance.
 

SUSPICIOUS CLAIMS

29. What if I suspect the injury did not actually happen or did not occur on the job? 

* Call the GSD WCL to discuss your suspicions and obtain
   assistance as to the necessary steps to take. 
* Conduct a thorough investigation and collect as
   much documentation as possible to support your
   belief. Indicate in a seperate correspondence, your
   suspicions and attach your documentation
   or comments to the form 5020. The employee does not need to
   know that you question the claim. 

30. Since the claim is questionable, what type of medical treatment should be provided when the employee reports an injury?
Make sure the employee is provided adequate treatment. 

31. How do I code the time sheet if the claim is suspicious?
Handle timekeeping the same as other cases.  WC Claims Adjusters and the GSD WCL will notify you if different.

32. Will I be informed of the outcome of any investigation of questionable claims?
Yes. The GSD WCL will receive either a  copy of the denial letter that is sent to the employee or a copy of the duty certificate authorizing payment of ID. You may request a copy of The GSD WCL.  

33. How long will the investigation take?
The Personnel Department has up to 90 days to investigate and make a determination whether to accept or deny the claim.  Due to the time limit, the sooner a questionable claim is reported, the better.  
 

TEMPORARY MODIFIED WORK PROGRAM
INTRODUCTION – TMWP PROGRAM

The Department’s Temporary Modified Work Program (TMWP), formerly called Return to Work Program (RTW Program), was initiated in January 1997 in an effort to reduce workers’ compensation costs, increase productivity, improve morale and assist in transitioning the injured employee back to work. The program’s premise is to accommodate temporary work restrictions with modified assignments until the employee is released to full duty. The City also has a City-wide TMWP, which was revised in January 2005.

1. How long can employees remain in the program?
The participation period is no more than 90 calendar days.  This includes sick time, vacation, jury duty, and any other requested time off of work that is not IOD. As of January 2005, departments may extend the 90 calender days on a case-by-case basis up to 150 days.

2. What happens if the employee cannot return to full duty after 90 days?
The employee is taken off work and returns to IOD status, if applicable. Based on revisions made to the City wide TMWP effective January 2005, employees can be extended beyond the 90-day period on a case-by-case basis, with the approval of GSD's Personnel Services Division. See the department's WCL regarding extensions beyond the 90 callender day period.   

3. Who can participate in this program?
Any employee who has experienced a work related injury and whose WC doctor has released him to duty with temporary work restrictions. Employees with permanent restrictions or non-work related restrictions are not considered for this program. Processing of non-work related restrictions should be discussed with your Personnel Division Liaison at (213) 485-5816.

4. Who determines when, where, and how the injured employee is accommodated?  Why?
The GSD WCL or the employee's Personnel Division Personnel Liaison has the expertise to determine how the employee can be accommodated and may be placed outside of the current duties.
 

5. What position does the employee occupy while participating in the TMWP?
The injured employee will occupy his own position and will be paid at the same salary he was receiving prior to the injury regardless of actual duties.

6. Where is the work location of the accommodated position?
First choice is to have the employee work in his current division.  But, if an accommodation cannot be found there, we will find an accommodation in other Divisions or areas of GSD. If none can be found, he/she will be considered by the Personnel Department for temporary City-wide placement under the city's TMW Program. 

7. Can I backfill the position if the employee is being accommodated in another Division or area?
No you can’t.  Remember the employee is occupying his/her own position.

8. Can working hours be changed to accommodate work restrictions?
Yes.  Changing an employee’s working hours is another way to accommodate work restrictions. However, when changing an employee’s work schedule, adequate notice should be given in accordance with appropriate MOU provisions. 

9. How is the employee paid while participating in TMWP program?
The employee occupies his pre-injury position and is paid his regular salary.  The time sheet is coded LD.  

10. Can the TMWP employee work overtime?
No, since the employee is still recuperating from an illness/injury.

11. Must the injured employee participate in the TMWP?
Yes.  If the Department has determined that the work restrictions can be accommodated, the employee must report for duty and cannot refuse the assignment.  If the employee refuses to cooperate and fails to report for duty, notify your supervisor and the GSD WCL immediately. The Personnel Department may terminate benefits based on a refusal or failure to report for duty. 

12. How is an employee with work restrictions placed in a TMWP assignment?
The GSD WCL will notify the employing division (Division management and supervisor) to discuss placement. 

13. What if the employee complains that the modified duties are causing pain?
Notify the GSD WCL.  We may have to have the employee visit his/her treating doctor for further care and review.  There is a possibility that the treating doctor may revise the restrictions and thus require us to look for a new TMWP assignment. 

14. What if the employee complains the assignment is out of his job classification?
Modified duties do not have to be within the employee's current job classification  

15. Could a probationary employee participate in the TMWP?
Usually, no.  The probationary period is used to evaluate the employee’s ability to perform the duties in the class appointed. Contact your Personnel Division Liaison for guidance in this area.

Index Personnel Home City Employment Opportunities Affirmative Action/Equal Employment Opportunity Accommodation & Placement Hiring & Position Authorities Employee Recognition FAQ Employee Training & Development FAQ GSD Training Center Standards of Conduct Discipline FAQ Grievance Handling Overtime Workers' Compensation & Temporary Modified Work Sick Leave Monitoring Drug/Alcohol Testing Sexual Harassment Documentation & Supervisory Notes Contact Us