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Policy 1312
Workers' Compensation/Return to Work

Date of Current Revision: April 2017
Primary Responsible Officer: Director of Human Resources

1. 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 illnesses arising out of and in the course of university employment.

2. AUTHORITY

The Board of Visitors has been authorized by the Commonwealth of Virginia to govern James Madison University. See Code of Virginia § 23.1-1600; § 23.1-1301. The Board has delegated the authority to manage the university to the president.

STATE OR FEDERAL STATUTE AND/OR REGULATION

The university is charged with managing the treatment and the processing of employees work-related injuries or illnesses that are covered under the Virginia Workers' Compensation Act § 65.2-100. The Americans with Disabilities Act Amendments Act (ADAAA), and the Family and Medical Leave Act (FMLA) also may be related to the execution of this policy.

3. DEFINITIONS

Benefits Specialist 
The Benefits Specialist works with employees who suffered a work-related injury or illness and their supervisors to assist the employee in returning to work.

University Panel of Physicians 
A list of local participating physicians who have agreed to treat JMU employees for work-related illnesses or injuries.  This list will be provided to injured/ill employees. Injured employees must choose one of these physicians to provide medical care in order to be compensated for eligible work-related injuries or illnesses. No other physician will be compensated for services rendered, unless referred by the panel physician or prior approval from the Benefits Specialist is obtained. If the university panel physician cannot schedule a timely appointment with the injured or ill employee, 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 Benefits Specialist. In the event the employee is treated at the Emergency Room and was unable to choose a panel physician for treatment in a critical situation, the employee is required to choose a physician from the 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 (VSDP) provides covered 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/or long-term disability. In addition to disability income, VSDP provides sick leave and family/personal leave that may be taken for short-term absences throughout the year. 

Workers¿ Compensation 
A state-administered insurance program designed to provide compensation to employees who are injured on the job or contract an occupational disease resulting from their employment. University employees are covered by Workers¿ Compensation Insurance.

4. APPLICABILITY

This policy applies to all university employees.

5. POLICY

James Madison University is committed to providing a work 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. 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 treating panel physician or specialist can order days away from work due to the work-related injury or illness.

For accidents/illnesses that have been certified as compensable, the first 7 absences away from work will be charged to the employee's leave. If the employee is away from work for 21 calendar days, the first 7 days of leave will be reimbursed as described by the Virginia Workers¿ Compensation Act.

On the 8th calendar day, the State Workers¿ Compensation Program's designated insurance carrier will begin to pay 66-2/3% 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 participants in the Traditional Sick Leave Program and are absent from work on Workers' Compensation leave for more than 7 calendar days will receive supplements in the form of the difference between payments required by the Workers¿ Compensation Act and their regular salaries, for a period of up to 92 calendar days from the beginning of their absences from work on Workers' Compensation leave. Agencies have the discretion to extend payment of the supplements described above beyond employees' 92nd calendar day of absence on Workers' Compensation leave, provided that such extensions do not exceed 480 work hours.

Only full-time employees are eligible for the additional supplement.

In the event the employee is unable to return to work after 90 consecutive calendar days, the employee will cease to earn leave.

Employees may be eligible for Family and 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 Benefits Specialist.

The Benefits Specialist will work with the supervisor to develop a plan for the employee's return-to-work. During transitional duty, the Benefits Specialist 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. The supervisor, in consultation with the Benefits Specialist, 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 Amendments Act (ADAAA) 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.

6. PROCEDURES

6.1 Accidents or illnesses must be reported to the Benefits Specialist by the supervisor and/or the employee, using the following method:

Accident/Incident Report

6.2 If the injury/illness is serious in nature:

  • Call 911 for transportation to Sentara RMH Medical.
  • Call campus police (6911) for immediate emergency medical treatment or traffic control.
  • If the accident or illness is life threatening, the supervisor or designee should accompany the employee to the Emergency Room.
  • The Benefits Specialist works in conjunction with the supervisor to contact the family of the employee, if they have not already been contacted.
  • The supervisor completes the Accident/Incident Report within 24 hours.

 6.3 If medical attention is needed, but the injury/illness is not life threatening:

  • The supervisor or the employee completes the Accident/Incident Report within 24 hours.  
  • The Benefits Specialist schedules an appointment for the injured worker and the employee goes to the panel physician for treatment.
  • The panel physician communicates, in writing, any work restrictions to the Benefits Specialist, who provides a copy of the restrictions to the supervisor and employee.

6.4 First Aid/For Record Only:

  • The supervisor or the employee completes the Accident/Incident Report within 24 hours, even when no medical attention is required.   

6.5 Accidents while traveling
An employee traveling on university-approved business is covered under Workers¿ 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 Benefits Specialist for billing information.

The employee must inform his/her supervisor as soon as possible so the supervisor can file the appropriate paperwork.

A panel physician will administer follow-up treatment.

7. 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.
  • When the employee is unable to do so, complete the Accident/Incident Report within 24 hours, even if no medical attention is required.
  • Work with the Benefits Specialist to provide productive altered/transitional duty when possible for an employee who has been released by the Panel Physician.

Benefits Specialist Responsibility:

  • 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 and the employee to provide productive altered/transitional 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.

8. 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.

Sanctions will be commensurate with the severity and/or frequency of the offense and may include termination of employment.

9. 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. 

10. INTERPRETATION

The authority to interpret this policy rests with the President, and is generally delegated to the Director of Human Resources.

Previous version: July 2011
Approved by the President: April 2002