Socorro Independent School District | A
WORKERS’ COMPENSATION & EARLY RETURN TO WORK PROGRAM Risk Management Division 12440 Rojas Dr.
El Paso, TX. 79928
Department of Human Resources
District Service Center • 12440 Rojas Dr. • El Paso, Texas 79928-5200 • Phone 915-937-0000 • Fax 915-851-7345 • www.sisd.net
SISD Employee:
The Socorro Independent School District Workers’ Compensation and Early Return to Work Program Guide
was created to answer frequently asked questions and identify resources within and outside of the district. We
encourage you to read this guide and if you still have questions unanswered, please do not hesitate to contact
our Risk Management Division at 915.937.0251.
Under Division of Workers’ Compensation statute and rules, you have the right to receive medical care that is
necessary to treat your work-related injury or illness. A list of some doctors who may be willing to treat a workers’
compensation injury can be found at the following link: http://www.tdi.state.tx.us/wc/hcprovider/locatedoctor.
html (Select the Locate Doctor option from the Main Menu option, choose the type of doctor and/or the
geographic location in which you need a doctor, and view the selected individual’s information.)
Should you miss more than one day from work, you must report to the Risk Management Division prior to returning
to work for a Return to Duty Permit. Any changes in work status must be immediately reported to the Risk
Management Division.
We remind you and your doctor that the District provides an Early Return to Work program for employees who are
recovering from injury but are not yet able to return to the physical demands of full duty. While your position may
be protected under the Family Medical Leave Act (FMLA), you receive reduced compensation and may draw
against your accrued leave. The district wants you back to work as early as medically feasible.
We encourage you to respond to contacts made by the claims officers, your adjuster and when applicable,
your case manager. Delays in response can affect the prompt delivery of medical services and, in some cases,
disability benefits.
Socorro Independent School District
Socorro Independent School District does not discriminate on the basis of race, color, religion, gender, sex, national origin, age, disability, military status, genetic information, or any other basis prohibited by law in its employment practices or in providing education services, activities, and programs, including career and technical education (vocational programs). For additional information regarding Socorro Independent School District’s policy of nondiscrimination contact the Chief Human
Resources Officer at (915) 937-0201, 12440 Rojas Dr., El Paso, TX 79928.
SISD Risk Management Division
Mario Carmona . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 915.937.0232
SISD Claims Officer
Javier Alvarez. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 915.937.0251
Phone Number. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 915.593.9300
Fax Number . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 915.593.9310
Workers’ Compensation is a state-regulated insurance program that pays your medical bills and replaces a
portion of your lost wages if you are injured at work or have a work-related illness.
Employee’s Rights
1. You have the right to receive benefits. You may receive benefits regardless of who caused the injury. You may
not receive benefits if:
• Your injury occurred while you were intoxicated or you were under the influence of drugs;
• Your injury was self-inflicted;
• By an act of God;
• Your injury occurred during horseplay.
2. You have the right to receive the medical care that is reasonable and necessary to treat the work-related
injury or illness. Your medical treatment is directed by the Treating Doctor who will coordinate all medical
services. The treatment plan and select diagnostic and treatment services are reviewed by the adjuster, with
medical review by nurses and like specialty physicians. The review and approval of diagnostic and treatment
services are based upon community medical standards and treatment specific to the body part or system
injured from the accident.
3. You have the right to the initial choice of treating doctor.
4. You have the right to hire an attorney to help you get benefits or help you resolve disputes with the Third Party
Administrator.
5. You have the right to receive assistance from appropriate, qualified Division staff and, in the event of a
dispute resolution proceeding, from a Division ombudsman free of charge.
6. You have the right to confidentiality. Only people who need to know (employer representatives or employee’s
doctor) may see information concerning the incident or treatment. Anyone else who is assisting you must
have written approval.
Employee’s Responsibilities
1. Report your accident/injury immediately to your supervisor; but no later than 30 days from the date of injury
or when you first knew that the illness may be work- related. If you do not report the injury to your supervisor
within 30 days, you may lose your benefit rights.
2. Submit a claim form to the Division of Workers’ Compensation within one year of the date of injury or when
you first knew that the illness may be work-related. A claim form, DWC-41 must be sent to the Division. A copy
of the form may be obtained from the field office handling the claim, or by calling 915.351.5260.
3. You must notify the Division any time you change employment or have a change of income. You are obligated
to report any income from any other sources during the period of disability.
4. You must inform your treating doctor how the injury occurred and that the injury may be work-related. Do not
introduce other medical ailments not related to the work-related injury.
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5. You must provide your employer and the Division with an accurate and current phone number for contact.
6. You must keep your supervisor advised of any changes in your medical condition, work status or appointments
for medical care. You are encouraged to schedule follow-up medical care before or after the workday to
minimize time away from work. The time used for appointments made during the work day may be drawn
against your accrued leave.
7. Employee’s released to return to work (Full or Restricted duty) must report to the Risk Management Division
prior to returning to work.
First Report of Injury
1. Employee will immediately inform supervisor about the injury and report to the nearest nurse.
2. Nurse will check on the employee’s welfare and determine the severity of the injury. An accident report will
be provided to the employee for completion.
3. SISD Risk Management Division is notified via the completed accident report.
4. You will be receiving a call from an SISD Claims Officer to obtain further information regarding your injury and
provide assistance to you during the workers’ compensation process.
5. If the report is submitted to Claims Administrative Services, the district’s contracted Third Party Administrator
(TPA), the assigned adjuster will be asking you questions regarding your injury. They will also be speaking to
your supervisor, witnesses and treating physician.
6. Based on the outcome of the investigation, the adjuster will determine the compensability (legitimacy of the
claim based on the Division of Workers’ Compensation “DWC” rules and regulations).
Medical Providers
1. In the State of Texas, it is the right of the injured employee to choose his or her treating doctor. Texas
offers the injured employee free-choice to any medical provider (Medical Doctor, Orthopedic, etc.).
2. The district has identified a Primary Care Provider for you to see for your initial consultation.
3. Do not pay for any medical services that you receive for your occupational injury. This will only complicate
matters and may result in a disallowance for those services. Do not use your group health benefits as payment
for any medical services associated with your work-related injury.
Forms and Notices
1. You will receive in the mail the DWC-1, First Report of Injury. If there is an error in the DWC-1, please notify your
Claims Officer for corrections at 915.937.0251. You will receive the DWC-1 (amended) noting any corrections.
2. If the claim is denied, you will receive a written notice (PLN, Plain Language Notice) from Claims Administrative
Services advising that the claim was denied and what actions you can take to appeal the decision.
3. The next notice that you will receive is the DWC-3, Wage Statement, prepared by the Risk Management
Division. The Wage Statement calculates the wages you received prior to the date of injury. From these
calculations, your Temporary Income Benefits “TIBS” will be issued. See “Compensation”.
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4. The TIBS checks will be issued after you missed eight or more days from the job. Included with the check is
the DWC-26, Notification of First Payment, which advises the employee of the schedule of payments and
responsibilities of the employee.
5. Should you wish to change treating physicians, you must complete the DWC-53, which can be obtained from
the Division of Workers’ Compensation, your adjusteror your doctor. A change of treating doctor must first be
approved by the DWC before seeing the new doctor.
6. Should there be a change in status, i.e. return to work, off work again, quit, etc., you must notify your supervisor
and the Risk Management Division. A DWC-6, Supplemental Report of Injury, will be prepared reflecting the
change.
Compensation
1. Payment of appropriate medical services will be made for medical treatment and services due to your injury.
This does not include conditions that are not directly related to the injury/ accident.
2. In compliance with the DWC, if you miss more than seven days of work (includes Saturdays and Sundays), you
are eligible for Temporary Income Benefits “TIBS”.
3. If you make $10.00 per hour or greater, you will receive 70% of your average pre- injury income, up to $913.00
per week. If you make less than $10.00 per hour, you will receive 75% of your pre-injury income for six months
followed by 70%.
4. The calculation of average wages is based upon an average of 13 weeks for TIBS and 52 weeks for IIBS of your
pre-injury EARNINGS.
5. TIBS will be your only source of income while out due to a work-related injury. Your regular wages are stopped
during this time.
6. Should your recovery from the injury be extended, you will continue to receive TIBS for up to 105 weeks.
7. During the recovery, or at the end of 104 weeks from the date benefits begin to accrue, your treating doctor
will determine that you have reached Maximum Medical Improvement (MMI) and the TIBS will be suspended.
8. Along with the MMI status, the treating doctor will assess an Impairment Rating Percent for your injury. You
will receive three weeks of earnings for every one percent of impairment. For example, a five percent (5%)
impairment would result in 15 weeks of compensation up to the maximum allowable rate (currently $639.00
per week). The Impairment Rating can be challenged by all parties with an independent physician selected
by the DWC. The decision of the Designated Doctor is final.
TIBS And Earnings Coordinations
1. Under no circumstances should you receive TIBS payments and SISD earnings (from accumulated personal
leave/sickness) greater that 100% of your pre-injury earnings.
2. If available, you can choose to supplement TIBS with accumulated sick/personal leave. Upon your return,
payroll will deduct from your accrued leave a percent of each leave day based upon the TIBS payment.
For example, if you commonly earn $500.00 per week (pre-injury income), received $350.00 in TIBS (70% of
$500.00), and will receive $150.00 from your district paycheck (30% of $ 500.00), then 30% of an accrued leave
day will be deducted from your accrued leave days.
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3. While you are receiving TIBS payments, no deductions will be taken out of this check (i.e. health insurance,
403B, 457 plans).
4. If you receive TIBS checks in error (you have returned to work but are still receiving TIBS checks) it is your
responsibility to notify the Risk Management Division at 915.937.0251. Any overpayment of SISD earning will be
collected from future payroll checks.
Legal Representation
1. You can obtain legal representation to assist you with your claim. You will be required to sign an authorization for
direct payment to your attorney. Attorneys commonly receive 15%-25% of your weekly indemnity payments.
2. The district and DWC recommend that prior to hiring an attorney, you contact the DWC’s Office of Injured
Employee Counsel (no charge) to answer your questions and offer counsel at 915.351.5260.
FMLA and Workers’ Compensation
1. You are eligible for Family Medical Leave (FMLA) if you have worked for the district for at least 12 months and
have worked a minimum of 1,250 hours during the past 12 months.
2. If eligible, you will automatically be placed on FMLA if you are on workers’ compensation and receiving
TIBS. By Federal Law, the district is required to place you on FMLA effective the date of injury to provide
you the desired benefits and protections of FMLA. If you are not eligible for FMLA you will be placed on
Temporary Disability.
3. FMLA provides eligible employees up to 60 scheduled days of unpaid, job- protected leave a year.
4. FMLA, Workers’ Compensation and accrued Personal Leave/Sick Leave will run concurrently. Irrespective of
your leave status, FMLA will continue up to 60 scheduled duty days.
5. You will be placed on Temporary Disability should you not return to the district by the conclusion of your FMLA,
you have exhausted your accrued personal leave and you are still on Workers’ Compensation and absent
from work. Once the Temporary Disability is exhausted, you will no longer be on “active” status with the district.
Your position at the school or pay location will be open enabling your supervisor to seek a replacement.
6. When placed on Temporary Disability, the Benefits Department will be notifying you by mail to contact them
to discuss continuation of your medical benefits. Once the Temporary Disability is exhausted, you will receive
information from the Health Insurance Administrator on COBRA, which provides for limited continuation
of current enrolled medical coverage (medical, visions, and dental) for you and your currently covered
dependents for a limited time period of time. You will be responsible for the cost of COBRA. COBRA is the total
premium which includes both your portion of the premium and the portion the district normally contributes on
your behalf. For further information, contact the Benefits Department at 915.937.0227.
Nurse Assistance
If you are losing time from work due to an injury, our Third Party Administrator may assign a case manager to your
claim. If so, the case manager will be in contact with you to obtain additional information regarding your claim
and details of the treatment that you are receiving.
We encourage you to discuss with your case manager the treatment prescribed by your treating physician. Too often treatments are prescribed by the treating doctor without the employee fully understanding the treatment plan, duration of treatment, and potential outcome. Do not hesitate to contact the case manager
with any questions that you may have regarding your medical care and recovery.
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At times there may be some questions regarding your medical care that you want to ask and hear a “second
opinion”. The nurse is available to you to clarify these issues and hopefully make you a more informed,
knowledgeable patient.
Early Return to Work Program
The Socorro ISD Risk Management Division believes that the best approach to controlling incidents and costs is
to keep injuries and illnesses from occurring. We are committed to utilizing our resources to provide a safe work
environment for everyone.
We have developed a plan and process designed to help injured employees receive prompt medical attention
and recovery assistance. This plan is called the “Early Return to Work” injury management plan. It includes a team
effort involving the injured worker, the treating health provider, the district’s Workers’ Compensation insurance
carrier and our internal company management.
When incidents do occur, it is in everyone’s best interest that injuries are properly managed. We will make every
effort to provide modified work intended to facilitate a return to regular work duties as soon as medically feasible.
These positions may be offered at any location or any department/shift as we can accommodate.
Failure to report for work at any of the designated times or places may affect the employee’s time loss
compensation and/or re-employment rights. This policy statement is not intended as a guarantee of continuity
of benefits or rights.
Policy/Procedures for Early Return to Work Program Policy
Socorro ISD supports a policy that fosters early return to work for recovering employees. Our plan is designed to
provide injured workers with modified duty work during a pre- defined period of medical recovery, when unable
to perform pre-injury duties without risk. The extent of time will be based on the healthcare provider’s treatment
plan and prognosis for full recovery. Eligibility to be in the program is contingent on an approved disabling
workers’ compensation claim. The SISD Claims Officer will coordinate the employee’s participation in the plan
with their supervisor, the treating provider, the employee, and the insurance carrier’s claim representative.
Procedures
1. Modified duty is defined as any work within the employee’s physical and cognitive capacity, and is to be
designed to be temporary (there is a progressive end to this position), and adapted to accommodate what
the worker can do. All modified positions must be approved by the Claims Officer and/or the director in
charge of the Risk Management Division. Availability is subject to the business needs of the school district
at that time and with the recovery and treatment plan in mind. The maximum length of time for transitional
(modified) duty is twelve (12) continuous weeks.
2. Before the employee starts the modified duty job, the supervisor will meet with the employee and review the
restrictions and capabilities specified by the treating provider. The supervisor must emphasize the need for
the employee to perform the job with the specific limits and parameters prescribed and outlined for them.
3. The employee’s modified duty status will end when the employee is:
• Released to pre-injury job status
• The WC claim is closed
• The employee has accepted an alternative position
• The 12 week maximum period is reached
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4. The supervisor is responsible for monitoring the employee’s participation and progression in the transitional
duty job, and keeping track of inconsistent behavior or work practices that do not fulfill the intent of the
treatment plan or modified task. This detail must be communicated to the Claims Officer. Any problems
reported are to be discussed immediately with the employee and with the insurance carrier. Any adjustments
or modifications to the worker’s task will be completed by the supervisor with direction and support from the
Claims Officer. Any changes to the transitional duty task must be approved by the treating provider(s)
Role and Responsibilities of Campus Administrators and Department Supervisors
Following are some key responsibilities and a description of the role each department supervisor will take to
fulfill our commitment to our disability management plan. Each person in our organization has a critical role,
and each must be carried out effectively to reach our ultimate goal, to return injured employees back to
their pre-injury status as soon as medically feasible. These are our expectations of campus administrators and
department supervisors:
Roles of the principals or supervisor include:
1. Provide a vital link to the success of our disability management program by acting as a coach and liaison
with YOUR recovering employee and the other primary parties (healthcare professional, Claims Officer & the
insurance carrier).
2. Act as a technical guide in the selection and delivery of workplace task improvements or adjustments for the
transitional work assigned the recovering employee.
Responsibilities of the principals or supervisor include:
1. Identify potential jobs or tasks for opportunities for transitional duty work. These jobs will be submitted to our
claims officer for approval. If not approved, the supervisor will be notified of the decision and the reason for
the rejection so revisions and new accommodations can be made. The supervisor will be involved in any new
revisions and collaborate with the sisd claims officer and the employee.
2. Meet with the employee to review the restrictions and capabilities specified by the treating provider. Train and
coach the injured employee about their new tasks emphasizing safety and health precautions. Emphasize
the need for the employee to perform within the job limits and parameters prescribed.
3. Implement adjustments or modifications to the worker’s task with input from our claims officer, based also on any
regression or progression in the recovery process. Communicate closely with our claims officer since the medical
recovery and treatment plan can be seriously compromised, and the length of disability potentially extended.
Role and Responsibilities of Injured Employees
1. Promptly report any physical changes with medical implications to their immediate supervisor and our Claims
Officer.
2. Follow all pertinent health and safety procedures identified during initial orientation and weekly retraining.
3. Arrange re-examination with the treating provider during the fourth week (or sooner) of the first review point.
Return the signed medical progress report (DWC 73) from the treating provider to our Claims Officer.
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Glossary
Bona Fide Offer: A formal, written offer of light duty employment made by employer to an employee after a
work-related injury.
Disability: Exists if the injured worker is not able to work as a result of the injury, or has returned to work but is making
less than pre-injury wages because of the injury.
Full Duty Release: A decision made by a doctor that an injured worker is able to return to work with no medical
restrictions.
Job: The duties and responsibilities assigned to an employee. (Also called a “position”)
Job Description: A list of the most important parts of a job, including the general description, skill, effort, responsibility
and working conditions of the work performed.
Job Modification: A change to an employee’s regular job, to meet medical restrictions.
Light Duty Assignment: Work that allows the injured worker (who has not fully recovered) to remain safely on the
job, but in modified or alternate duty. It allows the injured worker to ease back into the workplace after an injury.
(Also called “transitional duty”)
• Modified Duty: The injured worker’s regular job but changed to meet medical restrictions imposed by the
doctor. (May include schedule changes, reduced hours, reduced duties, or sharing parts of the work with
others.)
• Alternate Duty: A temporary work assignment, different from the injured worker’s regular job, which meets
medical restrictions.
Lost time: After the date of a work-related injury, any time missed (when an employee is unable to report to work
as scheduled) due to the injury.
Medical restrictions: The physical activities limited by a doctor related to a work-related injury. (Also called “work
restrictions”)
Regular job: An employee’s normal job prior to their work-related injury.
Return-to-Work Program: An employer’s plan, which encourages employees to return to work as soon as possible
following a work-related injury. As part of this program, the employer attempts to find light duty work for the
employee, which meets the doctor’s restrictions.
Work Status Report: The form that a doctor fills out explaining an injured worker’s medical restrictions or ability to
work. (Also known as the DWC Form 73.)