Newsletter

Responding to Catastrophic Injuries in the Workplace: A Guide

In the unpredictable world of workplace incidents, the California JPIA recognizes the critical importance of preparation and swift response when faced with catastrophic injuries. Workers’ Compensation Program Manager Jeff Rush is the Authority’s expert on navigating these challenging situations. At the 2023 California JPIA Risk Management Educational Forum, the City of Azusa’s City Manager, Sergio Gonzalez, Police Captain Robert Landeros, Director of Administrative Services, Talika M. Johnson, and Rush outlined their recommended catastrophe response strategy.

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“The key to an effective response is doing what you can to plan in advance,” said Rush. “Knowing who you’re going to call and who your resources are is the first step to ensure that your employees are cared for when the unexpected happens.” Read on to learn about Rush’s checklist to guide employers through the process of catastrophic injury response.

Plan:

You should know who to contact if an employee sustains a potentially catastrophic injury. After confirming that the employee has been referred for the appropriate medical treatment, you should contact Jeff Rush and your designated claims examiner at Athens Administrators. Jeff will implement the Authority’s Catastrophic Claim Response Plan on your employee’s behalf.

Immediate Actions:

The primary benefit of the Catastrophic Claim Response Plan is the immediate assignment to a nurse case manager. The nurse will lead the communication between the employee and their family, coordinate the employee’s medical treatment, and communicate pertinent information to the employer, Athens, and Authority staff.

Jeff Rush will work to coordinate a meeting with the employee and/or their family as soon as practicable. This meeting aims to educate the employee and their family about the next steps regarding their medical care, indemnity benefits, and the additional support available during their recovery.

The assigned Athens examiner will also notify the Authority’s reinsurer, Safety National, following our policy reporting requirements.

Ongoing Actions:

Depending on the severity of the employee’s injury and the complexity of their medical treatment, follow-up meetings may include their nurse, Athens examiner, Authority staff, and the employer.

Another important consideration is the potential involvement of an attorney. If the employee retains an attorney, this will preclude their Athens examiner from contacting them, and their attorney may request the nurse cease communication with the employee. This does not prevent the nurse from continuing to monitor the employee’s medical treatment even if communication with the employee is not possible. The nurse will often continue to monitor the employee’s recovery until their condition stabilizes and they reach maximum medical improvement (MMI). In some cases, this can take a year or longer.

The employer should also consider FEHA requirements and initiate an interactive process with the employee. The employer should monitor updates from Athens and the nurse case manager so the most current work restrictions can address the employee’s ability to perform their usual and customary work or modified duty.

Catastrophic claims require additional attention, and the Authority has the resources to assist members and help their employees get the best result possible.

Rush also led a presentation titled “Is Your Pool Ready for a Workers’ Comp Catastrophe?” at the Association of Governmental Risk Pools (AGRiP) Governance Conference in early March. Rush is available to all California JPIA members via email if you want to learn more about this topic.

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