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Workers' Compensation

Workers' Compensation reports to Human Resources

Our Responsibilities

  • Providing oversight and management of workers’ compensation claims administration ($168 million program) provided by contracted Third Party Administrator (TPA) (Sedgwick): Approve all decisions to accept/delay/deny claims; approve all monetary reserve increases of $25,000 or greater (authority level varies per examiner); approve all settlements of claims valued at $5,000 or greater (authority level varies per examiner); conduct quarterly Claims Reviews with TPA; participates in monthly program review meetings with TPA management.
  • Providing oversight of MTA Transitional Work Program (TWP): Early return to work provides a documented cost savings by returning injured workers to a modified work capacity within their physical limitations, maintaining productivity while eliminating the need to provide the temporary disability benefit (up to $986.69/week); acts in the capacity of Administrator, defined by the State of California Labor Code as a competent person pursuant to Section 15452 of Title 8 Regulations who is responsible for day-to-day management of an employer's self-insurance workers' compensation program. The responsibility includes but is not limited to, the making and reviewing of decisions relating to the furnishing of all workers' compensation benefits in accordance with law and the maintenance of the self insurer's claim records.
  • Development and implementation of SFMTA Safety and Workers’ Compensation Strategic Goals, with the stated intent of cost savings in the area of injury/illness mitigation (as recommended to and endorsed by the Executive Team): Project management of Agency Risk Review including workers’ compensation and Safety; managing and coordinating work with other stakeholders in the area of workers' compensation.
  • Preparing and directing weekly and monthly reports of projects and data analysis for submission to the Director of Human Resources as well as the Administration, Safety & Training Division: Development and oversight of budget allocation for the Workers’ Compensation Unit as well as oversight and management of other cost centers within Finance, to include Workers’ Compensation benefits and Workers’ Compensation contracts.
  • Serving in the capacity of Account Manager for Section 111 Mandatory Reporting to the Center for Medicare Services (CMS) for MMSEA and SCHIP compliance
  • Industrial Safety & Environmental Compliance - Implement the Cal-OSHA Title 8 Injury Illness and Prevention Program; inspect the safety of facilities, equipment and processes. Directs safety training classes and audits all worker injuries to reduce lost time; reviews construction designs; and manages programs designed to enhance environmental compliance.