HOLLIDAYSBURG AREA SCHOOL DISTRICT
INTER-OFFICE MEMO
TO: All HASD Employees
FM: W. Dwight Straesser, Human Resource Director
SJ: Workplace Accident Procedures
This memo will summarize procedures that all employees are required to follow in the event of an accident at work.
WORKERS’ COMPENSATION PROCEDURES FOR EMPLOYEES:
1. Notify the school nurse in your building of your accident. The school nurse will get information from you in order to fill out the work-Related Incident Report form. (If a school nurse is not available in your building at the time of your injury, or if your injury has occurred on second or third shift, notify your immediate supervisor of your injury. Contact the school nurse by telephone as soon as possible, preferably the day following your injury, with information regarding your injury so that she can fill out the Work-Related Incident Report form.)
2. Seek medical treatment if necessary. If your injury requires emergency treatment, get to the nearest emergency room as soon as possible. If your injury does not require emergency treatment, see one of the panel providers during their business hours. You are required to go to one of the physicians listed on the Workers’ Compensation Physician Panel (see below). These notices should be posted in every building. All school nurses also have copies of this Panel. If you choose not to go to a physician listed on the Panel, the cost of your medical treatment will not be paid for by Workers’ Compensation or your health insurance; therefore, you would be responsible for the cost of treatment. If your accident has not resulted from a clear accident at work, it may be questionable as to whether our Workers’ Compensation insurance carrier will accept your claim. In questionable cases, you go to a PPO Blue participating physician. By following the PPO Blue procedure, you will ensure that the bill for your medical treatment will be paid at the higher “in network” level if the Workers’ Compensation carrier subsequently denies your claim. If your Workers’ Compensation claim is not questionable and clearly the result of an injury at work, you should still notify your Primary Care Physician if you have PPO Blue, within 48 hours after receiving treatment under the Workers’ Compensation Physician Panel. Please note that chiropractic visits, if denied by Workers’ Compensation, will only be covered as “in network” under PPO Blue if you choose a chiropractor covered under PPO Blue. For a complete list of chiropractors covered under PPO Blue, go to www.highmarkbcbs.com.
WORKERS’ COMPENSATION PROCEDURES FOR SUPERVISORS:
1. School nurses should complete the Work Related Incident Report—School Claims Service LLC form with the employee. Section 1 contains employee and incident information. Section 2 should be signed by the employee authorizing records to be released regarding medical treatment. Section 3 is completed if no medical treatment is necessary. Section 4 is completed only if first aide medical treatment is provided.
2. School nurses should notify the employee’s supervisor to complete the Incident Investigation Report. The supervisor completes this report as they interview the employee. Building principals are considered the supervisors for teachers, clerical and special education paraprofessionals and building secretaries; food service managers are the supervisors for all food service employees; Don Reid, District Building Supervisor, or Phil Smith, Director of Physical Plant, would be considered the supervisor of all custodial, maintenance, and grounds crew employees; Dean Rossi or Amy Smearman would be the supervisor for all coaches. The Incident Investigation Report should be filled out by the appropriate supervisor for the type of employee—teacher, paraprofessional, custodial, cafeteria, secretarial, or coach.
3. Completed workers’ compensation reports must be returned to the central office workers’ compensation coordinator within 24 hours of the injury. Injuries occurring after normal business hours on Friday through Sunday should be reported and returned to the central office by the following Monday.
4. Authorized personnel who are not employees of the HASD, such as IU8 teachers and paraprofessionals, should not go through the
5. Contact the Human Resources department at 814-695-5585, if you have any questions regarding the Workers’ Compensation procedures.
NOTICE TO EMPLOYEES
REMEMBER, IT IS IMPORTANT TO TELL YOUR EMPLOYER ABOUT YOUR INJURY
HAS PROVIDED FOR THE PAYMENT OF BENEFITS UNDER THE
PA WORKERS’ COMPENSATION ACT BY INSURING WITH
Any employee who is injured at work should report immediately to his or her manager, supervisor, or department director.
A. If you suffer a work-related injury, your employer or its insurance company must pay for reasonable surgical and medical services and supplies, orthopedic appliances and prostheses, including training in their use.
B. In order to insure that your medical treatment will be paid for by your employer or the insurance company, and that your days off count toward wage reimbursement, you must: (1) fill out an incident report form, (2) inform your supervisor of the of the injury, and (3) select from one of the physicians or other health care providers listed below:
Chiropractic
Patrick Barnes, D.C. Victor Rizzo, D.C.
695-4456 943-3536
William Schroeder, D.C. Dwight Miller, D.C.
943-3633 766-3333
ALSO SEE ADDITIONAL PHYSICIANS LISTED BELOW
C. If you need further treatment, you must continue to visit one of the designated health care providers and/or the referred licensed specialist for 90 days from the date of your first visit.
D. After this 90-day period, if you still need treatment, you may choose to go to another licensed physician or practitioner of the healing arts for treatment. You should notify the case manager of this action within five (5) days of your visit to the physician of your choice. Your bills will be paid IF your licensed physician or practitioner files reports as required (these reports must be filed within ten (10 days after your first visit and at least once a month for as long as treatment continues.)
E. If one of the designated health care providers listed above refers you to another physician or health care provider, your employer or its insurer will pay the reasonable bills for these services.
F. If you are faced with an immediate medical emergency, you may secure initial assistance from the closest hospital, physician, or other health care provider of your choice. You must seek subsequent treatment from a physician or other health care provider listed above for at least the first ninety (90) days from the date of your first treatment.
Should an employer-designated provider prescribe invasive surgery, you shall be permitted to obtain a second opinion from a provider of your choice, at the expense of your employer. If the second opinion’s recommendations differ, you may choose which course of treatment. If you choose to follow the treatment recommended by the second opinion, the treatment shall be performed by one of the employer-designated providers for ninety (90) days from the date of your first treatment
ADDITIONAL
Carroll P. Osgood, MD
James P. Burke, MD, PHD
(814) 946-9150
Keystone Rehabilitation Systems
(814) 946-0105
(814) 943-2511
Joyner Sports Medicine
601 Route 36 South
(814) 224-9992
Pro-Care Rehabilitation-Altoona
Drayer Physical Therapy Institute
3200 Pleasant
(814) 949-9500
Neil Kaneshiki, MD
2525
(814) 942-6038
Kenneth Cherry, MD
Thomas Ellis, DO
Paul Suhey, DO
Douglas Roeshot, MD
Edwin Rogusky, MD
James Martin, MD
William Tyndall, MD
Greg Bailey, DO
Todd Cousin, DO
Bradley Barter, DO
David Joyner, MD
2529
or State College, PA 16801
1-800-505-2101
Robert B. Louton, MD
Blair Co. Plastic Surgery, Inc.
GENERAL SURGERY & VASCULAR SURGERY
Stephen L. Schmidt, MD
Howard Black, MD
1312
(814) 943-4937
Samuel R. Magee, MD
(814) 946-0891
Craig W. Hartman, MD
(814) 946-2845
David E. Higgins, MD
A Leonard Zimmerman, MD
R Charles Howells, MD
(814) 944-5357
Vince Morgan, MD
(814) 943-4800
OPHTHAMOLOGY
Richard Capriotti, MD
(814) 942-9081
