PG-27 Workers' Compensation

ELIGIBILITY:

All types of University employment, full-time or part-time, are covered by the provisions of the Kentucky Workers’ Compensation Act and Morehead State University Worker’s Compensation Program if an occupational injury or illness arises out of and in the course of employment, unless self-inflicted or due to willful misconduct or intoxication.

POLICY:

The University contracts with a managed care organization to provide medical treatment, case management and other related services. An employee who suffers an occupational injury or illness shall be seen only by a physician or other medical provider designated by the managed care organization.  Failure to see a physician or other medical provider designated by the managed care organization shall result in denial of payment, unless the injury is of such severity and urgency that it requires immediate medical attention.

The name and/or location of an approved physician or other medical provider shall be furnished when an occupational injury or illness is reported.

EMPLOYEE RESPONSIBILITY:

It is the legal responsibility of any employee involved in an occupational injury or illness to report the injury or illness to the supervisor, or another supervisor if the employee's supervisor is not available, as soon as practicable after the occurrence of the accident.

An employee receiving medical treatment or evaluation for a work-related injury required is to provide a copy of the return-to-work authorization to the immediate supervisor and the Office of Human Resources.  The return-to-work authorization lists any work restrictions and shall be completed by the attending physician or other medical provider.

INVESTIGATION OF ACCIDENTS:

Supervisors have the responsibility for reporting the injury or illness by calling Morehead State University's Workers Compensation Administrator.  Failure to report a work-related injury or disease exposure may result in a denial of claim and/or appropriate discipline for the responsible supervisor.

The University may require an employee to submit to an independent medical evaluation and/or a vocational assessment.  Generally, and independent medical evaluation and/or a vocational assessment shall be given presumptive weight in making decision on workers' compensation claims.

The University may take appropriate disciplinary action and/or deny benefits in cases where an employee (a) falsifies official documents, (b) refuses to cooperate in claims processing, or (c) acts in a fraudulent manner.

COVERAGES:

Medical expenses normally shall be paid in full for hospital, surgical, doctor and nursing services, and medicines and drugs, for treatment related to an occupational injury or illness. If an employee is unable to work for an extended period of time because of the job-related injury or illness, indemnity payments normally are paid for the work-time lost.

The first seven (7) calendar days of any work absences resulting from occupational injury or disease is generally ineligible for indemnity payments under the Morehead State University Workers' Compensation Program.  However, if the work absences exceed seven (7) calendar days, the employee is eligible for indemnity payments retroactive to the first day employee was off work due to the covered incident.  If the disability does not exceed seven (7) calendar days, the employee may use accrued sick or vacation time for the period of disability. In the event sick or vacation time is used and the total period of disability is less than seven (7) calendar days, the cost of the absence is budgeted to the employee's unit.  Otherwise, payments shall be paid and charged to the worker's compensation accounts that are administered by the Office of Human Resources.

These payments represent a percentage of the employee's average weekly wage. An employee may elect to use accumulated sick and/or vacation leave instead of receiving these payments.  In such instances, the employee shall endorse the workers' compensation benefit check to the University. The amount of the workers' compensation check will be used to reinstate any vacation days and/or sick days used in that order.  Calculations for reinstatement will be at the daily rate paid by the University to the employee during his/her absence.  In the event of death, there may be certain survivor benefits for eligible dependents.

Absences for workers' compensation will be designated as Family Medical Leave (FMLA), i.e., workers' compensation time off and FMLA run concurrently, until one expires.

ACCIDENT PREVENTION:

Management at all levels has the responsibility for every operational activity of the department, and each supervisor must accept his or her share of the responsibility for the safety of employees.

It is a basic principle of the University's safety philosophy that each department is responsible for safety and that each employee, in accepting employment, assumes a personal responsibility for working safely. Each employee must accept the principle that compliance with safety requirements is a condition of employment.