Workers' Compensation - Complete Manual

Table of contents


UNIVERSITY POLICE . . . . . . . . . . . . . . . . . . . 2-2222

PROVO POLICE . . . . . . . . . . . . . . . . . . . . . . . . . 911

FIRE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 911

AMBULANCE . . . . . . . . . . . . . . . . . . . . . . . . 911

Immediately notify the Risk Management and Safety Department, ext. 2-4468, of all fatalities, serious injuries, and occupational illnesses. Call 801-240-3669 for questions about Workers' Compensation benefits.

Foreword

This manual provides all supervisors with information pertaining to the Workers' Compensation Program at Brigham Young University.

This manual should be kept in each work area for reference, as needed.

Although this manual will be updated periodically, supervisors should also consult the University Policies under Risk Management and Safety for the most current Workers' Compensation policy information.

For purposes of this manual, "supervisor" designates any individual who manages University personnel, and   "accident" includes occupational illnesses.

Introduction

The Workers' Compensation Program was created during the early 1900's as an answer to the rising number and cost of injuries resulting from the development of new machinery, and an influx of workers to the larger businesses. The primary purpose of this insurance is to encourage employers to be more safety conscious and provide financial assistance to injured/ill personnel until they are able to return to full work capacity.

The present Workers' Compensation system features a mutual compromise under which the employer assumes full liability for all work-related injuries/illnesses, regardless of who was at fault, and the worker gives up the right to sue at common law if the employer was negligent.

Each state has its own system of Workers' Compensation, although some laws are similar. All employers in the State of Utah are required to purchase Workers' Compensation insurance through an insurance carrier or provide the coverage themselves.

The Labor Commission of Utah serves as an information source. This agency provides essential facts about the rights and responsibilities of the worker, employer, and insurance carrier under the Workers' Compensation law. The Labor Commission is also responsible for monitoring the processing of industrial claims to ensure that medical and compensation benefits are promptly and properly paid.

As a self-insured entity, the University is allowed by state law to process and pay its own industrial claims. The LDS Church Risk Management Division is responsible for managing the Workers' Compensation Program at Brigham Young University.

Explanation of Benefits

Workers' Compensation provides the following benefits to all full and part time personnel in compliance with regulations established by the Industrial Commission of Utah for work-related injuries/illnesses:

1. Lost time compensation

2. Medical benefits

3. Permanent partial/total disability benefits

4. Death/Burial benefits


Lost Time Benefits

Lost time compensation is based on a full seven-day week and is dependent on the treating doctor's determination of when an individual is unable to work.

Three-Calendar-Day Waiting Period

The department will pay the normal wage/salary for the incident date that the employee was regularly scheduled to work.

According to the Utah Labor Commision, if the employee has been released from work by the treating physician, a wage replacement will be given after a three-calendar-day waiting period. If the employee is released from work for 15 days or more, then they will be compensated for the three-calendar-day waiting period.

Accrual/Use of Sick Leave and Vacation Days

Full-time personnel continue to accrue sick leave and vacation days while they are receiving lost time compensation until or unless they are accepted on the DMBA Disability Program. At that time, accrual of sick leave and vacation days is suspended until the individual returns to work.

Personnel may use accrued sick leave or vacation days to receive income for the non-compensable, three-day waiting period (if applicable), but CANNOT use sick leave or vacation days to supplement the compensation payments.

Calculation of Benefits

Compensation is based on 66.67 percent (approx. 2/3) of the individual's average gross weekly income. An additional benefit is allowed for each dependent (up to 5), if applicable.  Dependents include spouse and children under 18 years of age.

The individual's weekly compensation rate is calculated according to the income received at the time of the accident and does not change thereafter for that accident claim.

The Workers' Compensation Program was not intended to replace all lost income, since benefits are tax-free, and it is believed that a strong incentive for returning to work should be preserved.

Holiday Pay

Full-time personnel do NOT receive holiday pay while receiving lost time benefits as the lost time compensation is considered income for that time period.

Payment of Benefits

The compensation check(s) is paid according to normal paycheck schedules and checks are processed by Sedgwick Insurance.  Checks are mailed to the employee's home address. 

Termination of Benefits

Lost time compensation benefits are terminated when the treating doctor releases the individual to return to work.

Medical Benefits

When involved in a work-related injury/illness, the insurance coverage is provided by Sedgwick Insurance.  Expenses incurred for treatment of work-related injuries/illnesses are paid 100%, according to limits set by the Labor Commission.

Travel Expense Reimbursement

Personnel who sustain a work-related injury/illness may be eligible for reimbursement of travel expenses for medical care. To apply for reimbursement, a record of the dates of medical care and the roundtrip mileage should be submitted to Sedwick for review.

Permanent Disability Benefits

Permanent Disability Award

Some work-related injuries/illnesses may result in a permanent impairment. The term "impairment" refers to the impact of the injury/illness on the individual's physical abilities. The term "disability" refers to the impact on the individual's occupational capabilities.

When the individual's condition has reached maximum medical improvement, the treating doctor may set permanent physical restrictions and determines a permanent impairment rating from which a permanent disability award is calculated. Permanent disability award benefits are tax-free and, are sent to the individual's home.

Return to Work

If it is determined by the treating doctor that you are unable to return to your former job duties, management will review the specific details of your situation to make a determination regarding continued employment.

Medical, lost time, and permanent disability benefits are NOT affected by the individual's employment status.

Death/Burial Benefits

When a work-related death occurs, Workers' Compensation benefits are paid to the spouse and/or dependents.

Supervisors' Responsibility

Accident Prevention Investigation

An accident prevention investigation is NOT designed to find fault or blame. The primary purpose of an investigation is to develop information that leads to changes and prevents similar accidents from occurring.

Supervisors should investigate ALL accidents since both serious and minor accidents result from the very same causes.

Responsibility for Conducting an Investigation

Supervisors are responsible for investigating and determining the cause of every accident since they are familiar with the work area, equipment, and hazards involved. But, most importantly, they know the people working under them--their job duties, behavior patterns, work habits, and attitudes.

Risk Management and Safety Department personnel are available to assist supervisors in these investigations, and will conduct their own investigation of accidents which result in serious injuries or fatalities.

Conducting an Investigation

Accident prevention investigations should be made AS SOON AFTER THE ACCIDENT AS POSSIBLE. Delays--even those of only a few hours--may permit information or items of interest to be removed, destroyed or forgotten.

Supervisors should compile the facts from the investigation, identify the causes, and take the necessary action to prevent similar accidents from occurring.

Accident Reporting

Supervisors are responsible to report every accident.

When a fatality or serious injury (hospitalization, amputation, or major bone fracture, etc.), occurs, the supervisor must immediately report the accident

Personnel who sustain minor injuries which do NOT require treatment at a medical facility may record the accident information on the first aid kit accident log.

Supervisor's Report of Accident

The supervisor is responsible to complete the "Supervisor’s Incident Investigation Report" for all reported on-the-job injuries/illnesses experienced by full and part-time personnel. This form should be submitted on line to Risk Management, Safety, and Compliance within 24 hours of the accident. The form can be accessed at the following link: Secure Incident Report.

Reports should be completed only by the injured employee's supervisor.  The report will be sent electronically to Risk Management, Safety, and Compliance.   By completing the e-mail addresses at the bottom of the form, the report can also be sent to three additional sources.  Once the form is submitted, instructions will be given for the employee to complete the claims process.  The employee is then responsible to submit the completed forms to the Workers' Compensation office.
   

Submission and receipt of the accident report does NOT constitute approval for Workers' Compensation benefits. Workers' Compensation benefits are only extended when the accident and injury/illness details have been reviewed and determined by Sedwick to comply with the guidelines for a work-related injury/illness as set by the Industrial Commission.

If the individual's immediate, full-time supervisor is NOT available, the next direct line of supervision may submit the "Supervisor's Incident Investigation Report."

Blood Borne and Environmental Exposures

A "Supervisor's Incident Investigation Report" should be completed for all incidents which represent a potential exposure to the HIV or hepatitis virus.

Questionable Claims. Supervisors who believe an individual's accident claim is NOT legitimate should call the LDS Church Risk Management Division (801-240-3669).

First Aid Kits

First aid kits are recommended for all work areas. Supervisors are responsible to determine and obtain the first aid kits and supplies needed by the personnel in their work areas.

Only medication needed for on-the-job injuries/illnesses should be included in department first aid kits.

Supervisors should inspect the first aid kit supplies and review the first aid kit accident log on a periodic basis.

Each first aid kit accident log sheet may be destroyed after four (4) years from the last accident entry date.

Departments interested in purchasing or obtaining supplies for first aid kits should contact the Purchasing Department.

The Risk Management, Safety, and Compliance Department can assist supervisors in determining the first aid kit contents.


Lost Time Compensation

Communication with Individual

It is important to maintain regular contact with injured/ill personnel to determine their status of return to work and express your concern on the behalf of the University and your department for the individual's absence and well being.

Recording and Reporting Lost Time

Supervisors are responsible to:

  1. Accurately record the specific days and/or hours for all personnel (including faculty and individuals on contract) who lose work time as a result of an on-the-job accident.
  2. Inform the LDS Church Risk Management Division of the individual's first date of lost time and the actual return-to-work date.
  3. Send the original return-to-work slip to Risk Management, Safety, and Compliance and retain a copy in the department file with the individual's accident information.

Return to Light Duty Work

If the treating doctor approves a return to transitional work, the supervisor is responsible to identify, approve, and coordinate transitional duty work assignment(s) until the individual is released to full duty work.

Return-To-Work Slip

Before an individual is allowed to assume job duties, the supervisor should require that the individual submit a return-to-work slip from the treating doctor.

Medical Care/Transportation

Supervisors are responsible to assist injured/ill personnel in obtaining appropriate medical care, BUT MUST NOT PROVIDE MEDICAL ASSISTANCE BEYOND THAT WHICH IS PRUDENT BASED ON THEIR TRAINING AND/OR ABILITY. PERSONNEL SHOULD ALSO NOT ADMIT LIABILITY FOR THE UNIVERSITY FOR ANY INCIDENT.

Procedure for Obtaining Medical Care

Supervisors should refer personnel who are exposed on the job to a transmittable disease (hepatitis, HIV, etc.) to the Student Health Center, and immediately identify and isolate the source of contamination, if possible.

Personnel who sustain minor injuries may use first aid kit supplies.

Personnel who experience minor injuries requiring more than first aid should report to the BYU SHC Urgent Care. If the SHC is not open, the employee should go to the nearest Urgent Care or InstaCare clinic. Personnel should only go to the Emergency Room if the Urgent Care clinics are closed. For serious injuries that require emergency care, personnel should report to the emergency room at Utah Valley Hospital or the nearest emergency room.

Exception: Dental--Personnel who sustain a work-related injury resulting in the loss of or injury to teeth should consult with their dentist and receive the necessary emergency treatment to preserve the normal function of the injured teeth. Additional dental care requires pre-authorization from Sedwick.

Personnel who are injured in a locale that prevents them from obtaining medical care at the Student Health Center, Utah Valley Hospital, or other designated facility, should report to the nearest emergency facility and inform their supervisor of the accident at the earliest opportunity.

Transportation to Medical Facility

For Emergency Transportation of Serious Injuries/Illnesses, Immediately Call "911."

The supervisor is responsible for making arrangements for transportation of the injured/ill individual to an approved medical facility, if needed.

For minor injuries or illnesses, supervisors may transport the individual by department vehicle.

Purchase of Prescriptions

All approved prescriptions must be filled at the BYU Student Heath Center pharmacy. The SHC pharmacy will bill the prescriptions directly to Sedgwick and personnel will not have any out-of-pocket costs. Any exceptions must have prior authorization and approval from the LDS Church Risk Management Division.

Work Time Taken for Medical Care

Supervisors should encourage injured/ill personnel to arrange medical appointments or treatments outside their work schedule. If this is not possible, the individual's department is responsible to pay for the time taken from work for medical treatment, as approved by the treating doctor.

Supervisors may require that the individual submit a doctor's note for any work time taken for treatment of work-related injuries/illnesses.

Worker's Compensation Education

Supervisors are responsible to:

  1. Establish, implement, and maintain training procedures to inform personnel of the individual's responsibilities in the Workers' Compensation Program.
  2. Inform their personnel of the proper procedures for reporting on-the-job accidents and obtaining medical care.

Supervisors should be sensitive to levels of literacy and language barriers, and should present their instruction in a way that is easily understood.

Personnel Responsibilities

The individual's responsibilities in the Workers' Compensation Program include the following:

  1. Immediately report any on-the-job injury/illness to the immediate, full-time supervisor.
  2. Record the accident information and assist the supervisor in the completion of the "Supervisor's Incident Investigation Report" if possible.
  3. Determine the extent of medical care needed.
  4. Obtain first aid kit supplies (for minor injuries) OR medical treatment (for minor injuries/illnesses which require more than first aid or serious injuries/illnesses) at an approved facility--Student Health Center Urgent Care or Utah Valley Hospital emergency room.
  5. Inform the full-time supervisor if the treating doctor has recommended lost time.
  6. Follow the doctor's recommendations regarding medical care, lost time, exercise, medication, etc.
  7. Submit related medical bills to Sedwick for review for payment.
  8. If unable to perform job duties for an extended period of time, report to the full-time supervisor on a frequent basis regarding health status and availability for work.
  9. Submit a return-to-work slip to the supervisor upon return to work.
  10. Report the use of prescription drugs which may impair the ability to perform job duties.