State Self Insurance Fund


ATTENTION STATE AGENCIES - NEW NOTICES TO POST

KWC40 (04/13) - Injuries ON OR AFTER April 25, 2013

KWC40-A (04/13) - Injuries ON OR AFTER May 15, 2011 and BEFORE April 25, 2013

These notices must be posted and maintained by EACH AGENCY
in one or more conspicuous places.

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Mission: To provide high quality medical care, prompt disability and death benefits, return to work options and customer service to state employees covered under the Kansas Workers Compensation Act.

Philosophy: We are committed to providing workers compensation services that meet The Kansas Division of Workers Compensation Rules and Regulations.  We will strive for professional competency, responsiveness, fairness, cost effectiveness, consistency, accuracy and the highest ethical standards of conduct in all our operations.  We are focused on activities and processes that are geared to getting the injured employee back to work.

What should an employee who is injured at work do?

What are the responsibilities of the agency when an employee is injured at work?

  • Obtain authorization for medical care if necessary, from SSIF.
    Note: If it is a life or a limb threatening emergency, get the employee to the closest medical provider as soon as possible.
  • Complete the Employer's Report of Accident and submit it as soon as possible to the SSIF by one of the following methods: email it to wc1101a@kdheks.gov, mail it to SSIF, Room 900-N, Landon State Office Building, Topeka, KS 66612 or fax it to 785-296-6995.
    Note: All email containing Protected Health Information (PHI) such as, the Employer’s Report of Injury, physician’s notes, medical reports, etc. must be sent securely. If you do not have a secure email delivery mechanism, you may use DHCF ’s ‘Proofpoint’ secure email delivery server to send encrypted email to DHCF .
  • Refer any medical provider to the State Self Insurance Fund at 785-296-2364 if they contact you for authorization of medical care.
  • Submission of the Employers Report of Accident does not mean that the employee has been approved for Workers Compensation. The SSIF will investigate the claim once they have received the Employers Report of Accident and determine compensability.
  • Refer the employee to this website for pertinent information about Workers Compensation.
    Note: If they don’t have ready access to the website, please print out the Frequently Asked Questions and the Information for Employees  PDF version for them. You may also refer them to the SSIF at 785-296-2364.
  • Determine if any restrictions given by the medical provider to an injured employee receiving medical care can be accommodated. If an employee is missing work due to a work-related injury and you haven’t received any information from the medical provider, contact the employee and obtain a copy of the work release or restrictions.
  • Keep the SSIF informed of any changes in the status of an injured worker. This includes changes in work restrictions, if they begin missing work or return to work.
  • When the employee is eligible to receive Workers Compensation disability benefits, they may want to supplement it with vacation or sick leave. Please contact the SSIF if you have questions about the SHARP adjustments.
  • IMPORTANT: Employees who receive Workers Compensation are NOT eligible for Shared Leave for the same medical condition. If you have questions about Workers Compensation and how it interacts with the Family Medical and Leave Act, you may contact the SSIF.
  • Contact the SSIF whenever you have questions about any aspect of handling a work-related injury. The phone number is 785-296-2364 and the fax is 785-296-6995. If you know who the adjuster is for a particular claim, you may contact them directly.

What are the Human Resource / Supervisor’s Role in the deployment of the Jordan Reses Prescription Management Program?

The program is initiated as soon as the employee reports the injury and wants to go to the doctor for treatment:

  • Complete the Employer’s Report of Injury format and submit it within 24 hours to the SSIF by one of the following methods: email it to wc1101a@kdheks.gov, mail it to SSIF, Room 900-N, Landon State Office Building, Topeka, KS 66612 or fax it to 785-296-6995.
    Note: All email containing Protected Health Information (PHI) such as, the Employer’s Report of Injury, physician’s notes, medical reports, etc. must be sent securely. If you do not have a secure email delivery mechanism, you may use DHCF ’s ‘Proofpoint’ secure email delivery server to send encrypted email to DHCF .
  • Complete the top portion of the First Fill Letter with the Injured Worker’s Name, Social Security number and Date of Injury.
  • Print off a copy of the completed First Fill Letter and give it to the employee.
  • Participating pharmacies are listed on the First Fill Letter (including CVS, Walgreens and Walmart).  You can search for a pharmacy at www.jordanreses.com
  • Instruct the employee to give the First Fill Letter, along with any prescription the doctor may prescribe to treat the injury , to the participating pharmacy.
    Note: Remember to inform the employee that the First Fill letter is only good for 24 hours after receipt and is only for their FIRST prescription(s) following the injury. The letter can only be used for prescription medications related to this injury.
  • Be aware that payment for the prescription may be denied within 5 days if the State Self Insurance Fund does not receive the Employer’s Report of Injury (Form K-WC 1101a).
  • As soon as the Employer’s Report of Injury (Form K-WC 1101a) is received by the State Self Insurance Fund, compensability will be determined.
  • If the claim is accepted, the prescription will be approved and the injured employee will receive a Jordan Reses prescription drug card in 3 to 4 days. The employee should use the Jordan Reses Prescription Drug Card for any medication related to the injury that is prescribed by the treating physician.
  • If the claim is not compensable, the employee will receive a statement in the mail indicating that it has been denied and that the employee will need to submit any bills related to the denied claim to their health plan provider.
  • The employee’s Jordan Reses Prescription Drug Card will remain valid for up to six months or as soon as the doctor releases the employee from care. If medical treatment extends beyond a six month period, the employee’s prescriptions may be transferred to a mail order program. State Self Insurance Fund staff will handle this transfer.
  • A Jordan Reses Prescription Drug Card has to be issued for each new date of injury. Employees with two injury dates requiring medications will be issued two Jordan Reses cards.
  • For assistance please contact the State Self Insurance Fund at 785-296-2364 or CompAlliance toll-free at 855-406-4411.

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