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Bureau of Internal Business Services

BIBS is the provider of central services for the City of Portland

2016 Workers' Compensation Service Catalog

City Risk LogoWorkers' Compensation

          Risk Management, Portland, OR


Contents:

Service

Description of Service 

Administer the City of Portland’s Workers’ Compensation Program

 

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  • Compliance with ORS 656 and OAR 436 and 438 as required to retain the City’s self-insured and self-administered status.

  • Monitor statute, administrative rule and case law changes and communicate and adjust practices and activities as needed.

  • Communicate and cooperate with Government Relations regarding relevant legislation

Claim Management

 

 

 

 

 

 

 

 

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  • State certified team of Claim and Disability Adjusters process, evaluate and manage claims per ORS 656 and OAR 436 and 438 through claim closure.   

  • Provide Injured Worker Packet to encourage and facilitate prompt reporting.

  • Determine compensability: accept and manage or deny and adjudicate.

  • Calculate and pay medical and wage loss benefits per statute.

  • Determine eligibility and pay for awards and vocational services.

  • Monitor Vocational Services for eligible employees.

  • Participate in defense of litigated claims.

  • Comply with Federal Medicare Regulations for reporting.

  • Process payments through Portland EBS/AP requirements

  • Recordkeeping administration per Oregon Retention Schedule

Employer-At-Injury Program (aka Modified/Light/Transitional duty and Early Return to Work)

 

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  • Consult with bureaus on their program development and practice and procedure documentation.

  • Assist Bureaus with Early Return to Work options, equipment, tools, and resource selection for each Injured Worker

  • Collect required documentation and seek reimbursement on behalf of bureaus for their Injured Workers’ Return-to-Work and Modified Duty wages and equipment.

  • Maintain records to comply with OAR 436-105

Claim Reviews With Bureaus and Cross-Functional Subject Matter Experts

 

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  • Conduct regular Quarterly claim reviews with most active bureaus.

  • Coordinate participation of a cross functional team for each bureau to include: BHR, Bureau Safety Reps, Legal staff, and Loss Prevention Team members.  Liability team included when there are related employment or subrogation claims. 

  • Update Action Plans regarding claim management, return to work, employment issues and litigation case management to close the claim and resolve the injured employee’s employment status.

Case Conferences with Cross-Functional Subject Matter Experts 

 

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  • Coordinate special case conferences on complex claims to assure compliance with Workers’ Compensation, Protected Leave, ADAAA, Reemployment/Reinstatement and bargaining requirements. 

State of Oregon Audit and Reporting compliance

 

 

 

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  • Host multiple, on-site State of Oregon compliance audits, respond to Audit findings and maintain a 90% accuracy of benefits.
  • Prepare and submit Annual Loss Report per OAR 436-050-9175 and Bulletin 209. 
  • Timely notification of excess insurance carrier information per OAR 436-050-0170. 
  • Timely notification of the City’s CAFR and Actuarial results per OAR 436-050-0175 and 0300. 
  • Coordinate reporting and pay quarterly Payroll Assessment per ORS440-045-0020; 0025 

Job Physical Demand Analysis

 

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  • Team with Loss Prevention and/or outside vendor to develop accurate and current job analyses for return-to-work and safety improvements. 
  • Develop an accurate description of the physical job requirements as required by OAR 436-030-0020 for claim management
  • Create a library of job analysis by classification and job title available for BHR and Bureau safety Reps 

 Workers Compensation 101, EAIP and Job Analysis Annual training to Bureaus

 

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  • Training for bureaus offered annually 
  • Focused training specific to line employees, as well as supervisors and managers
  • EAIP training to maximize City reimbursements