AR 215-1 - Soldier Support Institute - U.S. Army

(2) Item 12: The address of the servicing Department of Labor district office in table 19–4.
(3) Item 13: Obtain from RIMP the RIMP claims service contractor.
c. Send the completed Part A with the employee to the physician or medical facility whenever possible. In
emergencies or where circumstances do not permit the employee to choose a physician, note on the LS–202 that LS–1
was not completed.
d. The doctor or medical treatment facility will send Part B to the Department of Labor district office and the claims
service contractor.
Note. The medical authorization in LS–1 will be valid only for initial treatment. Additional or continuing treatment will be
authorized only by the claims service contractor.
e. Complete LS–202 as prescribed by paragraph 19–85. The NAFI/entity is subject to Department of Labor fines if
this report is not filed within 10 days.
f. Complete LS–210 (Employer’s Supplementary Report of Accident or Occupational Illness) if LS–202 described
above does not show a return to work date. A sample LS–210 is shown at the MWR Web site, www.armymwr.org/
f i n a n c e / d e f a u l t . a s p ? I D = 6 u n d e r o f f i c e s . A s e p a r a t e L S – 210 w i l l b e c o m p l e t e d a n d s e n t t o t h e c l a i m s s e r v i c e
contractor—
(1) For every pay period the employee remains disabled from performing assigned duties.
(2) When the employee returns to work.
g. Assist the claims service contractor with coordination through the CPAC–NAF.
h. Send all related documents, such as bills, reports, and correspondence of any kind received from any injured
e m p l o y e e , a g e n t , d o c t o r , o r m e d i c a l f a c i l i t y , t o t h e c l a i m s s e r v i c e c o n t r a c t o r w i t h c o o r d i n a t i o n t h r o u g h t h e
CPAC–NAF.
19–87. Use of military medical facilities
a. Use of military medical facilities by NAF employees normally is limited to initial or emergency treatment only
and is free of charge. NAF employees are eligible for occupational health services in accordance with AR 40–5. In
nonemergency cases and for all other treatment, employees must select a civilian doctor or medical facility, as
explained in paragraph 19–83.
b. In CONUS remote areas and OCONUS areas where no adequate civilian medical facilities exist, followup
treatment or hospitalization is authorized at rates set by The Surgeon General of the Army. The employee must
personally pay for military medical treatment. Itemized receipts, however, are sent to the claims service contractor for
reimbursement.
c. The first reports explained in paragraphs 19–84 and 19–85 are filed regardless of the source of medical treatment.
19–88. Modified Duty/Return to Work Program
a. A modified duty/return to work program is one of the best ways to keep the costs of workers’ compensation
claims down. Every effort should be made to return the injured employee to work as soon as the employee is medically
released.
b. When bringing an employee back into the workforce on modified duty, the following procedures are followed:
(1) The claims service contractor will notify the CPAC–NAF when an injured employee is released to modified or
full duty by the treating physician. A copy of the medical limitations or restrictions imposed by the medical physician
is sent to the CPAC–NAF.
(2) The CPAC–NAF, in coordination with the employee’s supervisor, will determine whether the employee, with
reasonable accommodation, is able return to his/her regular position. If the employee, with reasonable accommodation,
cannot perform the essential functions of the position, the CPAC–NAF will review all available openings at the
installation to determine if another position exists, which meets or can be modified to meet the physical restrictions of
the employee. If a position is not identified for the returning employee, the claims service contractor is notified in
writing.
(3) The identified position must be actual work with a proper job description, where the employee can accomplish a
task beneficial to the overall workings of the installation. A made-up position will not be acceptable.
(4) When the position is identified and the job description written indicating the modified duties of the position, the
job description is provided to the claims service contractor for approval by the treating physician.
(5) After the physician approves the modified duties in the job description, a job offer letter is sent to the employee
by certified mail/return receipt requested. If the employee declines the position, the claims service contractor is notified
immediately. If the employee accepts the position, the employee is expected to report to the CPAC–NAF on the date
and time indicated. If the employee does not appear for work after accepting the position, the claims service contractor
is notified immediately.
c. When the employee reports to work, the supervisor will explain exactly what duties are expected of the employee.
Every effort is made for a smooth transition back to work.
162 AR 215–1 • 31 July 2007