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Lieutenant Study Cards 2020 > HPM 10.7, Injury, Illnesss Case Management > Flashcards

HPM 10.7, Injury, Illnesss Case Management Flashcards

1
Q

If an employee is currently the subject of an internal investigation and files a CHP 121, what shall the CHP 121 be marked?

A

Questionable.

1-5

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2
Q

What is a DWC-7, Notice to Employees-Injuries Caused by Work?

A

A notice required by 3550 LC to be posted in a conspicuous place with the name of the current compensation carrier or adjusting agent responsible for occ. injury and illness claims.

1-7

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3
Q

What is a Cal-OSHA 300A and when is it to be posted?

A

Cal-OSHA 300A is th annual summary of work related injuries or illnesses and shall be posted from Feb 1 through April 30.

1-7

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4
Q

What is the CHP 121E?

A

Supervisor’s Incident Report-Record Only.

Annex A

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5
Q

Who determines whether an injury or illness was preventable?

A

Commanders

2-3

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6
Q

If an injury is determined to be preventable, what shall the commander or designee do?

A

Personally meet with the employee and review the reasons the injury, illness, or hazard exposure was deemed preventable.

2-3

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7
Q

A medical bill received by the command shall be expeditiously forwarded where?

A

To Fiscal Management Section.

2-4

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8
Q

What shall a commander provide to an employee in the event of an occ. injury or illness?

A

Commanders shall prepare a personalized memorandum expressing desire to assist employee with injury case management prepare attachments that outline the Departments policy regarding occ injury/illness case management and the employees rights/responsibilities.

2-4

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9
Q

What is the CHP 225?

A

CHP Officer 14 Critical Physical Activities.

2-4 and Annex P

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10
Q

What shall commanders do if an employee is not making a good faith effort toward prescribed medical rehabilitation?

A

Notify Division and provide recommendations for potential departmental actions.

2-5

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11
Q

What will commanders require related to the employees secondary employment while injured?

A

Written authorization from the employee’s medical care provider indicating the secondary employment will not affect their ability to recover.

2-5

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12
Q

If an employee’s secondary employment was suspended, but an employee provides written authorization that secondary employment will not impede recover, what shall a commander do?

A

Shall reinstate suspended secondary employment.

2-6

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13
Q

At a minimum, how frequently shall commanders (or designee) contact State Fund?

A

At least monthly.

2-6

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14
Q

How frequently shall commanders report their case management activity to Division?

A

Quarterly.

2-7

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15
Q

What is the CHP 121 D for?

A

Injury/Illness Status Report, of employees assigned to limited duty or off duty due to occupational injury or illness. The CHP 121D is to provide accessible means of identifying employees and providing status updates.

2-7

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16
Q

How often shall the CHP 121 D be submitted to Division?

A

Monthly, by the 10th of each month.

2-7

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17
Q

What shall the 121 D contain?

A

it shall contain Information on employees assigned to limited duty or are off duty for 30 calendar days or more as a result of an occupational injury or illness. Negative reports are required.

2-7

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18
Q

What shall a commander send immediately (on the first day) when an employee is off-duty as a result of an injury or illness?

A

Send a Comm-net to the appropriate AC, Division commander, DRU, and HR with the following:

  • Contact name and number
  • Employee name and ID
  • Type of injury
  • Date of Injury
  • Prior duty status/new duty status
  • Effective date
  • Estimated period of duty status
  • Dr. Name and #
  • Additional info

2-8

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19
Q

What are notification requirements for a death or serious injury?

A

Division and appropriate AC shall be phoned immediately. If AC not available then (in order until someone is contacted):

Exec. Assistant to AC
Deputy Commissioner
Commissioner

If none of the above are reached, then call ENTAC.

3-3

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20
Q

When shall Department of Industrial Relations Division of Occ. Safety and Health be notified in the event of employee death or serious injury?

A

Telephoned within 8 hours.

3-4

21
Q

Are injuries or illnesses sustained by job applicants reported as departmental acc. safety stats?

A

Shall not be included.

3-4

22
Q

If an employee sustains a recurrence of an injury, what shall be completed and by whom?

A

A CHP 51, by the employee detailing the circumstances of the recurrence and description of the injury/illness within 24 hours.

3-5

23
Q

What is the OSHA 300 log?

A

6410 LC, and Title 8, Section 14301 CCR, require employers to compile a log of specific occupational injuries and illnesses. The OSHA 300 fulfills requirement.

4-3

24
Q

Within how many days shall an injury be recorded on the OSHA 300 log?

A

Within 6 work days following knowledge of the injury.

4-4

25
Q

What is not included on the OSHA 300 log?

A

Record only injuries or first aid only without medical expenses.

4-4

26
Q

By when and to whom are the previous years OSHA 300 logs signed and sent?

A

By January 15 each year sent to Division.

4-6

27
Q

What is maintained in the OSHA 300 file for injury on the log?

A

A CHP 121 (SHALL)

4-7

28
Q

How long shall commands retain the OSHA 300 logs?

A

Five years following the end of the calendar year that these records cover.

4-7

29
Q

By whom and within what time frame shall a CHP 121 be completed?q

A

Employees supervisor, 24 hours.

5-1

30
Q

Within what time frame shall a commander (or designee) review and sign the

A

Within three days of the notification of injury.

5-1

31
Q

Within what time frame shall the 121 is filed with the appropriate SCIF office?

A

Within 5 days.

5-1

32
Q

Under what circumstances can a 121 be delayed to SCIF?

A

Shall not be delayed!

5-1

33
Q

By whom and within what time frame shall the CHP 121, Sup. Review of Occ. Inj. be done?

A

By Supervisor, within 24 hours.

5-2

34
Q

When shall a commander review the CHP 121A

A

Three days.

5-3

35
Q

What is the CHP 121B and who completes it?

A

Employee report of injury, by employee within 24 hours.

5-4

36
Q

What is the CHP 121C, who completes it, and when?

A

Medical Information Release Authorization, employee signs, within 24 hours.

5-4

37
Q

What is the CHP 442 and when is it completed?

A

Individual Accident, Injury and Safety Recognition Record, updated within 3 days of injury.

5-5

38
Q

What is provided to employee and within what time frame?

A

CHP 600, Right to Privacy
CHP 601, Coping with Your Injury
SCIF 3301, Work Comp Claim

Within 24 hours.

5-6

39
Q

What is a commanders responsibility related to disabled employees?

A

Shall ensure that disabled employees return to work in a limited duty capacity as soon as medically appropriate.

8-3

40
Q

Commanders shall assign an employee to limited duty when:…?

A
  • Employee is temporarily and medically unable to perform reg. duty
  • Dept. needs require such assignment
  • Employee is waiting for CalPERS to medically retire

8-3

41
Q

How long of a limited duty assignment may a commander authorize?

A

1 year.

8-6

42
Q

If a medical care provider will not specify a termination date, may a limited duty assignment be authorized?

A

May not be.

8-6

43
Q

What shall occur if an employee refuses to perform medically approved and department ordered limited duty?

A

The employee shall be removed from pay status, and action to terminate employment shall be initiated.

8-7

44
Q

Who is responsible for maintaining ongoing communication with temporarily disabled employees and for arranging a return to full duty as soon as medically appropriate?

A

Commanders and supervisors.

8-8

45
Q

What are retraining requirements for an employee who has been absent for:

Less than 1 year?
12 months to 2 years?
more than 2 years?

A

Less than 1 year - Area

12 mo. - 2 years - Refresher training at Academy

more than 2 years - Reinstatement training at Academy

8-9

46
Q

What shall a commander furnish an employee who is medically determined to be precluded from returning to their regular job duties?

A

An options letter.

14-3

47
Q

Policy states an employees review of the options letter not exceed __ days.

A

14

14-3

48
Q

Who shall a commander notify if an employee refuses to respond to an options letter?

A

Division and DRU.

14-4

Lieutenant Study Cards 2020 (49 decks)

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