WC Basics
What is a waiting period, and where are they listed?
The amount of time a worker must "wait" before being eligible for TTD benefits. They are listed on the Waiting Periods & Panels tab of the WC spreadsheet.
What is Anthem EAP and who can access it?
Anthem EAP is an Employee Assistance Program that can be accessed by any Aya employee (regardless of benefits). Services include helpful online tools, resources, and access to professionals such as licensed therapists and legal advisors.
What is a retroactive period?
If a worker remains off work after reaching the retroactive period, they will receive "retroactive" benefits for the original waiting period.
How do you check an employee's sick time balance?
Sick time balances are listed on paystubs, found within Dayforce.
What does it mean if a claim is "Medical Only"?
Worker received medical treatment but there was no lost time beyond the waiting period, claim does not require investigation, and the medical costs are under the MO threshold.
How do you check if an employee is eligible for sick time?
Employees become eligible for sick time usage at 90 days from their date of hire. If in doubt, the TXM can confirm eligibility.
What is TTD and how is it calculated?
Total Temporary Disability is compensation while the worker is medically unable to work. It is calculated using their wages and earnings according to state guidelines.
What is a per diem traveler, and how are their schedules, earnings, and benefits different from a traveler?
Per Diem employees do not have a contracted number of hours to work each week. Number of days & hours worked each week may vary depending on facility need and employee's schedule. Per Diem employees are not eligible for stipends or health benefits.
1. Lost time exceeds the state waiting period.
2. Medical costs exceed the MO threshold.
3. Investigation is needed.
4. Claim becomes litigated.
Name 3 red flags you might notice from a worker's profile and/or work history.
- Professional conduct concerns or CXL
- Previous WC claim(s) for bodily injury
- Pre-existing injury to same body part
- Unhappy at facility, planning to self-CXL, etc.