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WORKERS COMPENSATION. Objectives Explain –Purpose –Employee responsibility –Supervisor responsibility –Procedure.

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Presentation on theme: "WORKERS COMPENSATION. Objectives Explain –Purpose –Employee responsibility –Supervisor responsibility –Procedure."— Presentation transcript:


2 Objectives Explain –Purpose –Employee responsibility –Supervisor responsibility –Procedure

3 What Is Workers’ Comp? Accident insurance program outlined in Florida Statutes (F.S. 440) State of Florida is self insured Division of Risk Management administers WC program OptaComp– Medical Case Management (2009)

4 Purpose Provide medical treatment/benefits to employees for work related injuries to facilitate return to gainful employment Provide, if appropriate –Medical treatment/prescriptions –Supplement wages –Requirement of Light duty –Reasonable travel costs for medical treatment –Possible rehabilitation services (not required) USF provides 40 hrs. of disability leave (leave eligible employees)

5 Who is Covered? Employees –From 1 st day of work –Part time, temporary, student workers Volunteers providing services to University –Medical benefits only

6 What is Covered? Accidental work injuries Occupational diseases arising out of employment Injuries that occur as a result of a new accident while traveling to/from health care provider for the purpose of treatment WC may be reduced by 25% if injury caused by the knowing refusal to use safety gear or observe safety rules

7 What is Not Covered? Employees engaging in social/recreational events Employees coming to work or going home (unless performing special duties required by employer) Injury cased primarily by employee’s intoxication or influence of non-prescribed drugs Employees hired as independent contractors

8 Employee Responsibilities Reports injury to supervisor immediately Provide needed information Follow OptaComp instructions Sign/acknowledge forms from OptaComp

9 Employee Responsibilities Follow treatment guidelines –Go to doctor appointments/rehab Provide department/supervisor documentation from doctor’s office confirming visit or next appointment Inform department of any work restrictions or when restrictions have been lifted (reached MMI)

10 Employee Responsibilities Request Leave appropriate 40 hours of disability leave is granted for leave eligible positions Leave can be used when going to medical appointments/rehab Keep supervisor/department informed

11 Consequences Late Reporting –May deny Workers Comp Case Knowingly file a false claim –Punishable (Felony) –Repayment Investigation – DSR routinely reviews cases where it is not obvious the injury is job-related

12 Supervisor Responsibilities Call OptaComp and complete Supervisor’s Accident & Investigation Form Oversee recovery of injured employee –Approve leave –Ensure employee provides documentation Provide a light-duty program, if needed Ensure timesheets are completed appropriately

13 Supervisor Responsibilities Coordinate Salary benefits (Pay Certs notes) if appropriate –Employee continues to accrue leave at regular rate prior to injury even if in a cut pay status Do not advise employee that accident is or is not covered – up to DRM to determine Correct safety hazard(s) if appropriate

14 Consequences Fine Due to Late Reporting Employee may be denied WC Benefits

15 Procedure –Employee reports Injury to supervisor or department designee If emergency, call 911 –Employee/supervisor calls OptaComp prior to obtain medical treatment (non-emergency) OptaComp will assist in seeking an appropriate medical provider (24/7, 365 days a year) Provide requested information

16 Procedure Be prepared to provide following info to OptaComp: Employee name, home address, phone, birth date, class title, class code, location of accident, date/time and description of accident, description of injury 4-digit location code –Location code based on funding category of USFSP employee E&G - 0283 Auxiliary - 0297 Contract/Grants – 0298 Local funds – 0299

17 Procedure Social Security Number Required for OptaComp (F.S. 440) Submit Supervisor’s Accident Investigation Report to USFSP HR within 24 hours of accident (USFSP HR will log in and forward to Tampa HR) Forward/copy all incoming documentation to USFSP HR for monitoring EH&S may visit to review area and/or require safety improvements

18 Procedure Reminder - Accident/Injury should be reported immediately –Employee has two years from date of injury to file a claim

19 Wage Loss First 7 Calendar days – –State/University employees receive 40 hours of disability leave –OPS employees receive disability payment for first 7 days only after 21 days of disability.

20 Wage Loss If employee has not been able to return to the workplace (must be certified by physician) –On 8 th day, employee is eligible for Wage Loss –66 2/3 salary of pre-injury wages (up to max) –Based on average of previous 13 weeks –Second job could be counted –Employee may use 2.7 hours of leave to keep them at 100% pay –Certify and make note in Pay Certs

21 Wage Loss University will continue payment of employer premiums Employee must continue payment of employee premiums –If leave doesn’t cover employee portion, employee must make other arrangements

22 Recap Workers Comp – State regulated insurance to provide benefits to employees who sustained a work related injury/illness OptaComp – Medical Case Management Employee should document any injury Employee should follow all OptaComp instructions Employer needs to provide light duty if at all possible in order to facilitate back to work

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