Workers Compensation/Return to Work
Date of Current Revision: January 2008
Responsible Officer: Director, Human Resources
- PURPOSE
The purpose of this policy is to outline the university’s plan for compliance with applicable Workers Compensation law, providing resources for employees who are injured on the job, and the reporting procedure for accidental injuries or occupational diseases arising out of and in the course of university employment.
- AUTHORITY
The university is charged with managing the treatment and processing of employees whose work-related injuries are covered under the Virginia Workers’ Compensation Act and the Governor’s Executive Order 52 (99). The Americans with Disabilities Act of 1991 and the Family and Medical Leave Act of 1993 also may be related to the execution of this policy.
- DEFINITIONS
Return to Work Coordinator:
The Workers Compensation Coordinator works with injured or ill employees and their supervisors to assist the employee in returning to work. .
University Panel of Physicians:
A list of three local physicians that have agreed to treat JMU employee for work related injuries or illness will be provided to injured employees. Injured employees must choose one of these physicians to provide medical care in order to be compensated for job-related injuries or illnesses. No other physician will be compensated for services rendered except when referred by the panel physician unless prior approval from the Workers Compensation Coordinator is obtained. If the university Panel Physician cannot schedule an appointment with the injured or ill employee in a timely manner, the employee must choose another physician from the panel. The panel physician will file claims directly with the State Workers Compensation Program’s Designee. Billing information is available from the Workers Compensation Coordinator. In the event the employee goes to the Emergency Room and is unable to choose a panel physician for treatment of a critical situation, the employee should choose a physician from the James Madison University Panel of Physicians for follow-up care unless the ER Physician has made a referral to a specialist.
VSDP:
The Virginia Sickness and Disability Program. It provides many Virginia employees with income protection if they become unable to perform normal job duties because of an illness or injury. The program pays an income during periods of short and long-term disabilities. In addition to disability income, VSDP provides sick leave and family and personal leave that may be taken for short-term absences throughout the year.
Workers' Compensation:
A state-administered insurance system designed to provide compensation to employees who are injured or contract an occupational disease due to their employment. The university holds Workers Compensation Insurance.
Workers Compensation Coordinator:
A member of the Human Resources team who specializes in customer service related to safety, injury and Workers Compensation claims.
- APPLICABILITY
This policy applies to all employees.
- POLICY
James Madison University endeavors to provide all employees with a working environment that is free from recognized health or safety hazards. In the event of an accidental injury or occupational illness, the university will work to balance the needs of the employee and the organization by providing restricted duty assignments when possible for a ninety (90) calendar day period. The university will analyze accidents and illnesses with the intention of gaining knowledge to assist in avoiding future accidents or occupational illnesses.
5.1 Determination of Compensability
The State Workers Compensation Program, or their designee, determines if an accident or illness is compensable under the Virginia Workers Compensation Act after the case is properly investigated.
5.2 Time Lost from Work
Only the chosen panel physician or specialist can order days away from work due to the work related injury or illness.
For accidents/illness that have been certified as compensable the first seven periods of time (often, workdays) away from work will be charged to the employee’s leave. If the employee is away from work for twenty-one calendar days. the first seven days of leave will be reimbursed as describe by the Virginia Workers Compensation Act.
On the eighth calendar day, the State Workers Compensation Program’s designated insurance carrier will begin to pay 66 2/3% of the average weekly salary and the university will supplement by paying the remaining portion of the average weekly salary. If the employee is enrolled in VSDP, VSDP will pay the remaining portion according to the published guidelines. Employees who are not participating in VSDP will receive the remaining portion of the average weekly salary paid by James Madison University for a period of 60 days. Wage employees are not eligible for the additional supplement.
In the event the employee is unable to return to work after 60 consecutive workdays, the employee will cease to earn leave. Employees may be eligible for Family & Medical Leave as detailed in Policy 1308 – FMLA.
5.3 Restricted Duty
The panel physician will communicate in writing any altered duty restrictions for the injured or ill employee with the Workers Compensation Coordinator.
The Workers Compensation Coordinator will work with the panel physician, the employee, and the supervisor to develop a plan for the employee’s return to work. During transitional duty, the Workers Compensation Coordinator will meet with the injured/ill employee to discuss concerns and to evaluate progress. This duty can be altered, upgraded, or changed in a manner consistent with medical restrictions and in accordance with an individual's improved condition. The plan will include a defined period of disability, the physical restrictions recommended by the physician, specific duties that the employee will be expected to perform, and a defined begin and end date to the plan.
Transitional duty shall be made available to those employees who are expected to return to their pre-injury position and may not normally exceed 90 days. At the conclusion of 90 days, the supervisor, in consultation with Human Resources, may terminate the transitional duty assignment. If it is determined that the employee has permanent restrictions that result in his/her inability to perform the essential functions of his/her primary position, the provisions of the Americans with Disabilities Act (ADA) and other applicable laws will be applied to determine suitability for employment. The employee will continue to receive all Workers Compensation benefits for which they are eligible. Other university/state benefits would be treated as any other employee leaving employment.
- PROCEDURES
6.1 Accidents or illnesses may be reported to the Workers Compensation Coordinator by using one of the following methods:
- The paper “Employers First Report of Injury” form
- Electronic Claim Filing located: http://www.jmu.edu/humanresources/benefits/wcclaimform.shtml
- If the department has an Internal Accident Report form, a copy of that may be used.
6.2 If the injury/illness is serious in nature:
- Call 911 for transportation to Rockingham Memorial Hospital.
- Call campus police at 6911 for immediate emergency medical treatment or traffic control,etc.
- If the accident or illness is life threatening, the supervisor should accompany the employee to the Emergency Room.
- Call the Workers Compensation Coordinator, who will contact the family of the employee, if they have not already been contacted.
- File the Employers Accident Report and Panel Physician form with the Workers Compensation Coordinator within 24 hours.
6.3 If medical attention is needed, but the injury/illness is not life threatening:
- The supervisor fills out the accident report.
- The employee chooses a physician from the university Panel of Physicians
- The employee makes an appointment and goes to the panel physician for treatment.
- Work Restrictions should be returned to the supervisor and a copy forwarded to the Workers Compensation Coordinator.
6.4 First Aid/For Record Only:
- The supervisor fills out the accident report.
- Choose a physician from the panel in case the need for medical treatment arises at a later time.
- File the accident report and the Panel of Physician Selection Form with the Workers Compensation Coordinator.
6.5 Accidents While Traveling
An employee traveling on university-approved business is covered under Worker’s Compensation for injuries/illnesses incurred in the course of transacting business for the university.
Employees should report to a medical facility for appropriate treatment and inform the facility that it is a work-related claim. The facility may contact the Workers Compensation Coordinator for billing information.
The employee must inform their supervisor as soon as possible so the supervisor can file the appropriate paperwork.
A panel physician will administer follow-up treatment.
- RESPONSIBILITIES
Employee Responsibility:
- Perform the job in the safest manner possible, observing all safety and health rules.
- Report all accidental injuries/occupational illness to their supervisors regardless of the severity.
- Choose a physician from the James Madison University Panel of Physicians for treatment.
- Follow the recommendations made by the Panel Physician.
Supervisor Responsibility:
- Understand and follow the university's safe workplace policies.
- Encourage employees to understand and follow the university's safe workplace policies.
- Assist the employee in getting medical treatment in the event of an accidental injury or illness.
- Contact the Workers Compensation Coordinator (x82358) as soon as possible, but within 24 hours if medical attention is required.
- Report all accidental injuries/occupational illnesses to the Workers Compensation Coordinator within three days if there is no medical attention required.
- Work with the Workers Compensation Coordinator to provide productive altered duty when possible for an employee who has been released by the Panel Physician.
Workers Compensation Coordinator Responsibility:
- The Workers Compensation Coordinator is also the Return to Work Coordinator
- Report all accidental injuries and occupational illnesses to the State Workers Compensation Program.
- Facilitate “Return to Work” for an employee by communicating with the Department Supervisor, the Employee, and the Panel Physician to provide productive altered duty to an employee who has been released by the Panel Physician for restricted duty.
- Coordinate with the Panel Physician and State Workers Compensation Program's Designee regarding payment of bills for the employee.
- Facilitate investigations of accidents or occupational illnesses by coordinating the appropriate parties, compiling accident data, communicating results of the data analysis to departments.
- SANCTIONS
Injured employees who do not comply with this policy risk not being covered by Workers Compensation Insurance. They would therefore be subject to uncompensated medical bills and lost work time.
Supervisors of injured employees who do not comply with this policy will be subject to disciplinary measures.
Sanctions will be commensurate with the severity and/or frequency of the offense and may include termination of employment. - EXCLUSIONS
The Virginia Workers Compensation Program, or their designee, may determine that an accident or illness is not compensable under the Virginia Workers Compensation Act. Such injuries or illnesses would not then be covered under this policy.
- INTERPRETATION
The authority to interpret this policy rests with the President, and is generally delegated to the Workers Compensation Coordinator.
Previous version: April 2004
Approved by the President: April 2002
Index of terms
Workers Compensation
Injury
Illness
Lost time
Return to work
Workers Compensation Coordinator
VSDP
Accident