1 Your Skills and Experience Are a Valuable Resource to Your Department and to the City of Houston. We Wish You an Expedited Recovery and Safe Return to Work

2 We understand that Texas Workers’ Compensation policies and procedures mixed with the City of Houston’s policies and internal benefits can be quite confusing. We trust that this slide show will clarify questions or direct you to the appropriate person for information.

3 HR Risk Management unit, “S.W.E.AP.” - a City of Houston internal unit, has teamed up with outside subcontractors. This team is available to assist you with your claim and recovery. You may be contacted by one or more of the team members at various times during your recuperation.

4 The S.W.E.AP. Team consists of the following team members: S alary Continuation – Claim Coordinators provide oversight of indemnity benefits which supplement the workers’ compensation benefits. They ensure that you are brought up to the required percentage of pay in accordance with the salary continuation policy. W orkers’ Compensation – Human Resources will provide oversight of your workers’ compensation claim handled by the Third Party Administrator. E arly Return-To-Work – Administrative Coordinators will facilitate transitional duty when you have been deemed medically able to safely perform essential work activities. A ccident P revention – Safety officers will contact you or your supervisor in an effort to investigate your claim and determine the root cause of your accident. They will also take steps to make your work area a safer place.

5 The Subcontractors include the following: Cambridge Integrated Service Group, Inc. – Your TPA investigates and administers your workers’ compensation claim. The TPA utilizes other subcontractors to review medical bills for compliance and payment as well as other cost containment functions.

6 Highlights of Your Rights and Responsibilities: You must continue to cooperate with any ongoing investigation. The minor emergency clinic or hospital attended at the direction of your supervisor is not considered your choice of treating doctor. You have your choice of treating doctor as long as they are on the City of Houston & TDI Approved Medical Provider list. This list can be found at or obtain information from your supervisor. Contact your assigned adjuster as soon as you are aware of your treating doctors information. The adjuster will need this information to authorize medical treatment.

7 Highlights of Rights and Responsibilities: (Continued…) You must contact your adjuster after every doctor’s or treating doctor’s referral visit (this does not include PT visits). If unable to reach your adjuster ensure that your message includes: current work status, treatment plan given by the doctor and the next office visit date.

8 Highlights of Rights and Responsibilities: (Continued…) Any change in your work status must immediately be communicated to your department representative, administrative coordinator and adjuster to ensure that the proper benefits are initiated or stopped. This will prevent overpayments causing hardship at time of mandatory reimbursement to the City.

9 You may have specific departmental policies and procedures to follow while on injury leave. You will need to contact your designated department representative for details. Highlights of Rights and Responsibilities: (Continued…)

10 Highlights of Rights and Responsibilities: (Continued…) Your department will be keeping contact with you on a daily basis. You are required to be available with the exception of medical care, City of Houston business appointments, and meetings with the TDI-WC or TPA. You may be required to attend safety classes while on injury leave.

11 The following should occur once you report your injury: Complete the accident report with your supervisor Receive a call from the Third Party Administrator Obtain your adjuster’s contact information Provide your recorded statement

12 The following will occur once you report your injury: (Continued…) Initial and sign the On The Job Injury Reference Sheet which highlights some of your benefits and responsibilities.

13 The following will occur once you report your injury: (Continued…) Receive a copy of The Summary Workability Guidelines E.O (For Injured Employees) booklet which gives you key contact information, details of the Salary Continuation Program and your responsibilities as an injured worker of the City of Houston.

14 As a valued City of Houston employee, it is your responsibility to be available to the S.W.E.AP. team members and your department representative. This may include phone calls and/or visits to your residing location to discuss details of your claim to help you with a safe and early return to work.

15 The City of Houston respects and values its employees. Our goal is to provide quality customer service to our injured employees. We want to hear your feedback on the overall experience since your injury. Your input will help us to improve our services. Please give this information to your Administrative Coordinator. Their contact information can be found in your Summary Workability Guidelines E.O (For Injured Employees) Booklet.