Workers' Compensation

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Workers' Compensation

Last updated: January 11, 2007
Please direct questions to Meica Elridge at Melridge@admin.usf.edu or 974-5775
Division of Environmental Health and Safety

Exhibits

Exhibit DWC-1 First Report of Injury or Illness

Exhibit WC.1 Performance Standards for All USF Employees Related to Workplace Safety

Exhibit WC.2 Health Care Facilities Approved For Work-Related Injuries or Illnesses For USF Employees

Exhibit WC.3 Accident Investigation Report

Exhibit WC.4 Medical Release Statement

POLICY
This policy applies to volunteers and OPS employees, as well as, employees in authorized positions. Illnesses and injuries to non-employees are not addressed by this policy or the following procedures. However, they are addressed in the USF Policies and Procedures Manual Policy 06-011, Accident/Injury Loss Control Prevention, and Policy 05-013, Risk Management and Insurance Programs.
USF provides a safe and healthy work environment. When a work-related illness or injury occurs, USF will provide immediate medical attention and manage cases to minimize workers' compensation costs. USF is committed to returning employees to work, either light or regular duty, as appropriate, following a work- related illness or injury after the physician releases them to return to work. When an employee has a work-related injury or illness, the supervisor will take appropriate action to ensure that the employee promptly receives necessary medical attention and the required documents are processed to provide the employee with appropriate benefits.
An employee who becomes ill or injured as the result of a job-related incident is authorized to obtain medical attention from USF-authorized physicians, walk-in clinics, or hospitals. The supervisor is responsible for immediately reporting work-related illnesses or injuries to the Division of Environmental Health and Safety and taking corrective action to prevent the same or a similar injury from occurring. Supervisors are also responsible for completing the First Report of Injury or Illness form. Failure to timely report a work-related illness or injury may result in the employee's department being fined up to $500.
When an employee is out of work due to a work-related illness or injury and the absence meets the criteria, the absence counts toward the employee's Family and Medical Leave Act () entitlement.FMLA
OVERVIEW
1. The workers' compensation program is intended to provide medical treatment, disability leave, and supplemental wages, as necessary, to eligible employees in the event that they experience a work-related injury or illness. This program is administered by the Florida Department of Labor & Employment Security, Division of Workers' Compensation, with the Division of Risk Management acting as the carrier. At USF, the program is overseen by the workers' compensation coordinator in the Division of Environmental Health and Safety.
2. The workers' compensation coordinator in the Division of Environmental Health and Safety is responsible for providing supervisors and employees education and training on the proper procedures for reporting accidents, filing claims, and requesting, approving, and posting the use of leave in conjunction with workers' compensation claims. In addition, the workers' compensation coordinators serve as resource person/liaison for the reporting department, employee, physician, health care provider, and the Division of Risk Management in matters related to workers' compensation and in obtaining medical treatment, payment, and related benefits for job-related injuries and illnesses. Questions regarding workers' compensation should be directed to the workers' compensation coordinator in the Division of Environmental Health and Safety.
3. To reduce workers' compensation claims and costs, procedures regarding safety awareness have been created for supervisors and employees at USF. Refer to Exhibit WC.1, Performance Standards for All USF Employees Related to Workplace Safety.
4. Employees and supervisors of employees who are required to possess a commercial driver's license (CDL) as part of their official job duties should be familiar with the Post-Accident section of the Drug Testing for Employees Required to Maintain a CDL procedure in case the employee is involved in an accident while performing work-related duties.
ELIGIBILITY
1. All permanent and temporary University employees who are paid salary or wages by the State, regardless of the source of funds, including Faculty, A&P, and USPS employees, Graduate Assistants, Student Assistants, and OPS employees, are covered by the Florida Workers' Compensation Law. Under certain circumstances, volunteers hired in accordance with a formal Volunteer Employment Program are also covered by workers' compensation. Questions regarding eligibility when the employment status of the person making the claim is not clear should be directed to the workers' compensation coordinator in the Division of Environmental Health and Safety.
2. The Jones Act provides special liability insurance for seamen on board vessels. Illness or injuries to employees covered by the Jones Act, such as some of those assigned to the Florida Institute of Oceanography, are not compensable under the Florida Workers' Compensation Law. The Division of Purchasing, within Administrative Affairs, purchases a separate insurance policy and processes all claims. To report the injury, A First Report of Injury form is completed and forwarded to the Division of Environmental Health and Safety. Questions regarding eligibility may be directed to the workers' compensation coordinator in the Division of Environmental Health and Safety.
BENEFITS
The following is a brief summary of the benefits available under the Workers' Compensation Law and provided by USF to eligible employees under compensable conditions:
1. Medical treatment for work-related illnesses or injuries (Refer to Exhibit WC.2 for authorized physicians and treatment facilities);
2. Medicines and supplies as determined by the physician, for the injury or illness for which the employee/volunteer does not have to pay;
3. Payment by USF or the insurance carrier for all fees or other charges authorized for treatment or service, except for payment from third parties who have been determined to be liable for such payment;
4. Use of up to 40 hours of disability leave for A&P, Faculty and USPS for an absence from work due to the work-related injury or illness when the absence is certified by an authorized workers' compensation physician to be necessary (refer to X. Disability Leave);
5. Time off from work to recover from the injury or illness;
6. Compensation at the rate of 66 2/3 of the employee's average weekly wage prior to the injury, not to exceed the maximum compensation rate set by the Florida Statutes (contact the Division of Environmental Health and Safety for current amount), when an employee is unable to return to work after the first seven days following the illness or injury. Refer to XI. Wage Loss Benefits Due to the Inability to Work;
7. Continuation in full pay status, in certain circumstances (refer to X. F. Requesting Extension of Disability Leave) for all employees except OPS and volunteers;
8. Payment of funeral expenses, subject to the maximum set by law, when death results from the accident within one year or following continuous disability as a result of the accident within five years, plus possible payment to the spouse or other persons dependent upon the deceased or a portion of the average weekly wage. (The beneficiary of law enforcement officers killed in the line of duty may be eligible for additional benefits. Contact Human Resources for additional information.); and
9. Return to part or full duty, with or without restrictions, when released by physician to resume work.
COSTS TO THE DEPARTMENT
1. The University may be fined by the Division of Risk Management up to $500 for any job-related incident which is not reported in a timely manner. The injured employee's department is responsible for payment of this fine. Therefore, it is essential that all incidents be reported according to the instructions in VIII. Reporting a Work-Related Injury.
2. After using disability leave to cover absences from the work site due to a work-related injury, the employee is eligible to receive 2/3 of his/her salary during the period of time that the authorized physician determines that he/she is unable to return to work. The University is required to reimburse the Division of Risk Management for the first 10 weeks of salary payments made to the employee who is totally temporarily disabled. This liability is the responsibility of the employee's department and is charged to the employee's department.
  1. When an employee is seriously injured and is unable to return to work, the employee's department should immediately budget this expense. The formula to determine the maximum amount the department can be charged is .6667 x the employee's weekly rate x 10 weeks.
  2. Many injured employees are able to return to work and perform limited work on a temporary basis. This process serves as an incentive for departments to quickly return employees to work even if it is for part time duty, since departments are only required to reimburse the Division of Risk Management up to 10 weeks of salary payments made to employees who cannot return to work on a full time basis.
3. When unable to work, an injured employee may elect to use accrued leave. An employee may only use the number of hours of accrued leave that represents the balance of wages due to bring the employee's salary benefits to 100%. To determine the number of leave hours that may be used, refer to XI.B. Using Leave In Conjunction With Wage Loss.
SUPERVISOR RESPONSIBILITIES
1. All supervisory personnel are expected to provide a safe work environment for their employees. By providing a safe work environment, costs incurred by workers' compensation claims and absenteeism should be reduced. In order to achieve this objective, all supervisors are to adhere to certain procedures with regard to safety matters.
2. Supervisors are to make every effort to improve communication and awareness of safety and workers' compensation issues among their employees. This will be done by:
  1. ensuring that all employees are aware of and are trained in the current University and departmental safety policies and procedures and the standards outlined in Exhibit WC.1;
  2. developing additional safety procedures, as appropriate, for the work being performed in their respective work units and providing employees with instructions regarding proper use of equipment and machines and ensuring that safety practices are regularly followed;
  3. developing job specific performance standards relating to safety in addition to those required in Exhibit WC.1;
  4. making all necessary and relevant safety procedures part of a new employee's orientation;
  5. ensuring that employees have and use all equipment necessary to perform their duties safely at all times;
  6. ensuring that all employees have been fully instructed in the proper and safe use of all job-related equipment and in the general performance of their duties in a safe manner;
  7. taking appropriate disciplinary action for all willful violations of prescribed safety procedures and for failure to use required safety equipment;
  8. soliciting suggestions from employees and encouraging their participation in making the workplace safer and responding promptly to any employee safety concern for him/herself or another employee which may require training, re-training, or disciplinary action;
  9. reviewing job descriptions (or other descriptions of job duties or assignments for Faculty, OPS, and volunteers) of all employees to determine if work being routinely performed has higher than normal potential for causing injury or disability and exploring ways of eliminating the situation;
  10. contacting the Division of Environmental Health and Safety promptly to eliminate any potential hazard(s) or safety concern(s) of a physical nature (i.e., work area hazard) identified by any employee, student, or visitor; and
  11. ensuring employees have appropriate licensure where required, such as valid driver's license.
3. All supervisors should review with their employees the procedures for reporting a work-related injury or illness outlined in VIII. Reporting a Work-Related Injury, and the leave provisions outlined in X. Disability Leave and XI.B. Using Leave In Conjunction With Wage Loss, when an authorized physician certifies that an employee is unable to return to full duty.
4. If a work related injury occurs, supervisors are to:
  1. report promptly all problems which present a potential risk for causing injuries and/or harm to equipment and/or property and request that they be corrected as soon as possible;
  2. report promptly all accidents/incidents (including those which do not result in injury) which occur in their work area;
  3. investigate the circumstances of all injuries that occur in their work area and use them as learning opportunities to prevent future injuries;
  4. confirm all claims of injury and provide all needed assistance to University personnel responsible for investigating workplace injuries and related claims;
  5. maintain communication with the injured employee as to his/her condition and anticipated return-to-work date, if unable to return immediately;
  6. provide light duty work to the employee within the restrictions determined by the physician where feasible; and
  7. ensure that three or more absences from the workplace due to the injury/illness are counted toward the 12 week entitlement under the Family and Medical Leave Act (FMLA).
5. When an employee has sustained a work-related injury and is unable to return to work, the supervisor will:
  1. ensure that attendance and leave records are accurately maintained;
  2. ensure that salary payments and workers' compensation benefits paid to the injured employee do not exceed the salary received prior to the injury;
    1. Should an overpayment occur, notify the Payroll Office in the Division of Finance and Accounting, for making an adjustment in accordance with the State of Florida Bureau of State Payroll's procedures for reclaiming an overpayment.
    2. The supervisor should notify the workers' compensation coordinator in the Division of Environmental Health and Safety of any overpayment and the actions taken by the college/division to reclaim such overpayment.
  3. maintain contact with and provide updated information to the workers' compensation coordinator in the Division of Environmental Health and Safety assigned to the case; and
  4. review the employee's prognosis at least every 12 weeks in order to be prepared for:
    1. the employee's return to full duty,
    2. the employee's request for an accommodation to perform essential duties of the position,
    3. the employee's resignation or disability retirement, or
    4. the termination of the employee for inability to perform the essential functions of the position with or without reasonable accommodation.
6. Upon being released to full-time or part-time duty with or without restrictions, a supervisor does the following:
  1. reviews XII. Return to Work After a Work-Related Illness or Injury.
  2. makes every effort to facilitate the return to work of an injured employee. If supervisor is unable to modify job duties to accommodate the injured employee, then the supervisor should call the Division of Environmental Health and Safety for assistance in accommodation or placement, as appropriate.
  3. works with the employee to determine the most effective way to carry out job tasks so as to prevent any re-injury. This may include additional training, purchase and use of related safety equipment, etc.
  4. considers reassignments or other changes in either actual job tasks or the method by which tasks are accomplished for employees who, although following appropriate safety procedures, suffered repeated injuries in the performance of the duties of any particular job.
  5. takes appropriate disciplinary action when the employee does not follow safety procedures, use prescribed safety equipment or devices, etc.
EMPLOYEE RESPONSIBILITIES
1. Learn the proper use of safety devices and observe safety rules and practices. The employee's failure to use a safety device or observe safety rules may result in a 25% reduction in workers' compensation benefits and/or discipline.
2. Review and observe performance standards outlined in Exhibit WC.1.
3. Immediately report all job-related illnesses or injuries to the supervisor or department head. Failure to report an illness or injury and to complete the First Report of Injury or Illness may result in denial of benefits under the Workers' Compensation Law, and/or discipline, as well as a fine assessed to the employing department. See VIII. Reporting a Work-Related Injury, regarding reporting practices.
4. Maintain contact with the supervisor regarding claim status and scheduled physician's appointments and submit regular reports from physician to the supervisor, who will forward them to a coordinator in the Division of Environmental Health and Safety when treatment is ongoing.
5. Provide the workers' compensation coordinator in the Division of Environmental Health and Safety with receipts for drugs, documentation of visits to a physician, and future medical appointments.
6. Make available to the attending physician and pharmacy the pink copy of the First Report of Injury or Illness form for billing purposes. In no case should the employee pay the bill or submit the claim to his/her personal health insurance plan. If after review of the claim it is determined that the illness or injury is not covered under the Workers' Compensation Law, the employee will be responsible for payment of medical expenses and may submit the claim to his/her personal health insurance plan, if applicable.
7. Request use of leave in writing when unable to return to work as a result of a work-related illness or injury. Follow departmental procedures for reporting absences to ensure receipt of benefits.
REPORTING A WORK-RELATED INJURY OR ILLNESS
It is the responsibility of an employee to immediately report to his/her supervisor/designee any work-related injury or illness. It is the supervisor/ designee's responsibility to ensure the injury is reported to the Division of Environmental Health and Safety.
The steps for reporting an incident and obtaining treatment for an injured employee are the same for Workers' Compensation and Jones Act (injuries occurring at sea) incidents.
1. EMERGENCY - STEPS TO FOLLOW
  1. Call 911 - the University Police dispatcher will ask about the severity of the injury or illness and will contact the appropriate emergency medical service.
  2. Notify a workers' compensation coordinator in the Division of Environmental Health and Safety.
  3. Complete the entire First Report of Injury or Illness (DWC-1), in accordance with the accompanying instructions, and the Incident Investigation Report, sign both forms, and submit to the Division of Environmental Health and Safety within one workday after being notified of the incident. If the supervisor is unavailable to sign the form, another department employee may sign it. Do not delay forwarding the First Report of Injury or Illness to the Division of Environmental Health and Safety due to inability of employees to sign the form; failure of the Division of Environmental Health and Safety to receive the form within 2-3 workdays may result in a fine being assessed to the injured employee's department (refer to V.A. Costs to the Department).
  4. As soon as feasible, review the employee's rights and provide the employee with a copy of his/her First Report of Injury or Illness (DWC-1).
  5. As soon as possible, request that the employee sign the Authorization to Release Medical Information form.
  6. Forward any medical/physician's statements to a workers' compensation coordinator in the Division of Environmental Health and Safety.
2. NON-EMERGENCY: STEPS TO FOLLOW
  1. Request that employee complete the employee information section of the First Report of Injury or Illness (DWC-1). Complete the employer information section of the First Report of Injury or Illness and the Incident Investigation Report, sign both forms, and submit them to the Division of Environmental Health and Safety within one workday after being notified of the incident.
  2. Provide the employee with a copy of his/her First Report of Injury or Illness and review with the employee his/her rights and responsibilities. If the employee requests medical treatment, this copy should be used to provide proof to the physician/pharmacy that the injury/illness is work-related.
  3. Determine if the employee wants/needs medical treatment.
    1. If the employee requests or needs medical treatment, the supervisor, appropriate authority, or employee is to:
      (1) select one of the authorized medical facilities listed on Exhibit WC.2, depending on the injury/ illness and time of day;
      (2) call the selected medical facility and make an appointment for the employee;
      (3) arrange transportation for the employee, due to an emergency or due to employee's physical needs, if necessary;
      (4) notify the workers' compensation coordinator in the Division of Environmental Health and Safety; and
      (5) forward any medical/physician's statements to the workers' compensation coordinator.
    2. If the employee accepts medical treatment, request that the employee complete the Authorization to Release Medical Information form, Exhibit WC.4.
    3. If the employee refuses medical treatment, document the refusal and instruct employee to notify you immediately if medical treatment is needed later.
3. FORMS
  The following forms may be obtained from the Division of Environmental Health and Safety upon request:
  1. First Report of Injury or Illness (DWC-1)
    This form is used for reporting work-related injuries or illnesses of employees (USPS, A&P, Faculty, and OPS) to the Division of Environmental Health and Safety and the Division of Risk Management. It is to be completed and signed by both employee and supervisor. (If the employee does not speak English or is illiterate, all processes should be translated and/or read to the employee. A notation shall be made on the First Report of Injury or Illness form that special procedures were instituted to ensure that the employee was informed effectively as to his/her rights and responsibilities.)
  2. Workers' Compensation Incident Investigation Report (Exhibit WC.3)
    This form is used for reporting possible causes of work-related injuries or illnesses and any actions taken to prevent recurrence. A supervisor should investigate the cause of the accident and implement safety practices to prevent future accidents. The form is to be completed and signed by the employee's supervisor.
  3. Authorization to Release Medical Information (Exhibit WC.4)
    This form is used to secure the injured employee's authorization for the University to receive medical information from a treating physician.
4. INVESTIGATION OF A WORK-RELATED INJURY/ILLNESS
  Upon receiving a First Report of Injury or Illness, the Division of Environmental Health and Safety (EH&S) may conduct investigations of work-related incidents and recommends methods to prevent them from occurring in the future.
  At times, the workers' compensation coordinator may request that the Division of Risk Management conduct an investigation.
  Supervisors should not hesitate to contact EH&S at any time to request a review of work practices to ensure safe practices and a safe workplace.
DENIAL OF A WORKERS' COMPENSATION CLAIM
1. DENYING A CLAIM
  Occasionally, a reported injury may be denied as work-related based on the Division of Risk Management criteria due to the nature of the incident. When that occurs, related expenses will be handled as follows:
  1. When a workers' compensation coordinator in the Division of Environmental Health and Safety or an adjustor at the Division of Risk Management has authorized treatment at a medical facility, the medical expenses, use of disability leave and salary benefits are approved up until the date the claim is denied. After that date, the injury is considered personal and the employee is responsible for medical bills.
  2. When an employee seeks to have a claim accepted under workers' compensation and a workers' compensation coordinator in the Division of Environmental Health and Safety or an adjustor at the Division of Risk Management determines that treatment should not be authorized under workers' compensation, the injury is considered as personal and the employee is responsible for medical bills until such time the employee is able to provide proof that the injury or illness is work-related.
2. RECOURSE FOR A DENIED CLAIM
  When a claim is denied for workers' compensation coverage, the employee may request a mediation hearing. The employee and representatives from DRM may appear before a mediator who will attempt to resolve the issue. Failing resolution by the mediator, the employee may request a hearing before the claim appeals judge. Specific instructions for the process are available from a workers' compensation coordinator in the Division of Environmental Health and Safety.
DISABILITY LEAVE
1. ELIGIBILITY
  USPS, A&P, and Faculty employees, including Phased Retirees, who are unable to work due to a work-related injury/illness may be eligible to use up to 40 hours of disability leave if medical documentation is provided to support the absence(s). OPS employees and volunteers are ineligible.
2. BENEFIT
  Disability leave may be approved and used to cover employees' absences during work hours to receive medical treatment for a work-related injury/illness from an authorized medical practitioner and during periods of disability as certified by an authorized physician.
3. FMLA ENTITLEMENT
  More than 3-days from the workplace due to a work-related injury is counted towards an eligible employee's entitlement under the Family and Medical Leave Act of 1993 (FMLA). An eligible employee is entitled to up to 12 weeks of FMLA entitlement.
4. GRANTING DISABILITY LEAVE
  It is the responsibility of the supervisor to approve the appropriate use of disability leave and ensure its use is posted to the time sheets and/or leave record based on the medical documentation provided by the employee.
  Up to 40 hours of disability leave may be granted to eligible employees for each work-related injury or illness when a physician certifies that an employee is unable to work.
  Such leave is granted continuously or intermittently for the first 40 hours of absence from work due to the employee receiving medical treatment or due to the employee's medically certified inability to work.
  The supervisor must immediately notify a workers' compensation coordinator in the Division of Environmental Health and Safety if an employee begins using disability leave and advise of the estimated date that disability leave will be exhausted in order to assure the employee will begin receiving salary benefits from the Division of Risk Management in a timely manner, if eligible.
  If an employee is unable to return to work or if the employee is required to use accrued leave to continue to receive medical treatment, such absences from the work place for such treatment, are to be counted as part of the FMLA 12-week entitlement for the year.
5. RECORDING USE OF DISABILITY LEAVE
  When the supervisor approves the use of disability leave, its use is indicated on the time sheets and/or leave record each biweekly pay period by the supervisor/designee.
  1. USPS Record the number of hours used each day under Leave With Pay Used column on time sheet, specifying type of leave as "DL". Record the total number of hours used under Administrative Leave Used column on Leave Record and specify "DL". Record the request for use of leave under Leave Request section of the time sheet.
  2. A&P/Faculty Record the total number of hours used during the pay period on the right side of Leave Record in the "Admin Leave" column and specify "DL". Record the request for use of leave on Leave Request form. Forward copies of the USPS time sheets or A&P/Faculty Leave Request Form to a workers' compensation coordinator in the Division of Environmental Health and Safety while the employee is using disability leave in order to assure the employee, if eligible, will begin receiving salary benefits from the Division of Risk Management in a timely manner.
6. REQUESTING EXTENSION OF DISABILITY LEAVE
  1. An employee appointed to a position may request that his/her case be reviewed and that he/she be carried in full-pay status beyond the initial seven calendar-day period if the following criteria are met:
    1. the employee has used at least 100 hours of accumulated sick, annual, or compensatory leave or leave without pay (In the case of an employee who has not had enough continuous State service to accumulate 100 hours of sick leave, the employee must exhaust all accrued sick, annual, and compensatory leave [not to exceed 100 hours] before becoming eligible to request to be carried in full-pay status.);
    2. the disability is not permanent in nature;
    3. the employee has not been released to return to work by the attending physician but is expected to return to work within one year of the date of the incident; and
    4. the disability was the result of one of the following:
      (1) an act of violence by a co-worker, patient, client, student, or any other person while employee was performing assigned job duties;
      (2) an assault under riot conditions;
      (3) a high-speed vehicular pursuit authorized by the employee's supervisor while employee was engaged in law enforcement duties; or
      (4) undue negligence on the part of the University to provide a safe physical working environment to employees.
  2. The employee's request is submitted in writing to the immediate supervisor, who recommends approval/disapproval to the Director of the Division of Human Resources. The employee must also include a written justification for the request, citing the applicable criteria from X.F.1. above, and may provide written statements from witnesses or any other documentation which may help justify the request.
  3. The Division of Human Resources' Director/designee reviews the employee's request and accompanying documentation, the physician's medical assessment and evaluation, the report of the incident, the employee's workers' compensation file, and the employee's leave record and requests any additional information necessary to make a determination.
  4. The Division of Human Resources' Director may request that the employee's condition be reviewed by a physician selected and paid for by the college/division, if the current medical assessment and evaluation in the employee's workers' compensation file provide insufficient information.
  5. The Division of Human Resources' Director provides the employee and the dean/director and appropriate vice president with a copy of the written approval/disapproval of the request within 30 calendar days from the date the written request is received from the employee or, in the event an additional medical assessment is requested from a physician, within 30 calendar days from the date the physician's medical assessment is received in the Division of Human Resources. Disapproval of the request must include written justification. The Division of Human Resources' Director's decision is final.
  6. Approval for extension of disability leave with pay may be for up to the duration of the disability, as certified by the physician, or one year from the date of the incident, whichever comes first. Business needs may result in an approval for a lesser period to time.
  7. A copy of the written approval/disapproval for extension of disability leave with pay will be included in the employee's personnel file and leave record file.
  8. If the request is approved, the employee is required to reimburse the University for weekly workers' compensation payments received from the Division of Risk Management while in a full-pay status with the University.
WAGE LOSS BENEFITS DUE TO THE INABILITY TO WORK
An eligible employee (except volunteer) who is certified by an authorized workers' compensation physician as disabled and unable to return to work after seven calendar days or after the allotted disability leave has been exhausted is eligible to receive salary benefit payments (wage loss). These payments are equivalent to 66.67% of the employee's average weekly salary prior to the incident, but may not exceed the maximum compensation rate (MCR), which is established by Florida Statutes and is subject to change.
1. FULL WAGE LOSS BENEFITS
  An employee who is appointed to a position and who is certified by an authorized workers' compensation physician as totally disabled and unable to return to work after the 40 hours of disability leave has been exhausted is eligible to receive benefit payments (wage loss). These payments are equivalent to 66.67% of the employee's average weekly salary prior to the incident, but may not exceed the maximum compensation rate (MCR), which is established by Florida Statutes and is subject to change.
  Although OPS employees are not eligible to use disability leave, they are eligible to receive wage loss benefits as follows if certified by an authorized workers' compensation physician as totally disabled and unable to return to work:
  1. Day 1 through 7 - not eligible to receive wage loss benefits.
  2. Day 8 through 21 - eligible to receive full wage loss benefits in an amount equivalent to 66.67% of the employee's average weekly salary prior to the incident, not to exceed the maximum compensation rate (MCR), which is established by Florida Statutes and is subject to change.
  3. Day 22 and beyond - eligible to continue receiving full wage loss benefits (66.67% of salary) plus eligible to receive retroactive wage loss benefits in the same amount for the first seven days after the incident occurred. The employee's department is required to reimburse the Division of Risk Management for the first 10 weeks of liability from wage loss benefits paid to an employee who is totally temporarily disabled. A representative from the Division of Environmental Health and Safety will notify the department of the amount to be reimbursed. Refer to V. Costs To The Department.
2. PARTIAL WAGE LOSS BENEFITS
  Upon returning to work on a part-time basis, an employee who is certified by an authorized workers' compensation physician as being partially disabled may be eligible for partial wage loss benefits. Contact a workers' compensation coordinator in the Division of Environmental Health and Safety for additional information.
3. USING LEAVE IN CONJUNCTION WITH WAGE LOSS
  Generally, a full-time employee receiving full wage loss benefits is paid for 5.3 hours per day through workers' compensation (8 hours per day x 66.67%) and can supplement that by using 2.7 hours of leave per day to receive an amount equivalent to his/her salary prior to the incident. This will vary, if after multiplying the weekly salary X 66.67%, the employee's regular weekly salary exceeds the MCR.
  In lieu of being placed on partial leave without pay and receiving only workers' compensation salary payments (wage loss), an employee appointed to a position may elect to use a sufficient amount of accrued personal leave (sick, annual, or compensatory) to coordinate with the workers' compensation salary payments in order that he/she will continue to receive an amount equivalent to his/her salary prior to the incident.
  The sum of the wage loss benefit payments and the employee's salary from USF may not exceed the employee's regular salary prior to the incident. An employee may only use the number of hours of accrued leave that represents the balance of wages due to bring the employee's salary benefits to 100% of the salary received prior to the injury or illness. To determine the number of leave hours that may be used, perform the following calculations:
  1. Determine the employee's hourly rate of pay: divide 80 into the biweekly rate of pay.
  2. Determine the USF weekly salary rate of pay: divide 2 into the biweekly rate of pay.
  3. From the weekly rate, subtract salary benefits received from DRM; divide the hourly rate into this difference; the ending figure represents the number of leave hours that the employee may use in a week to bring the employees salary to 100%.
  4. Divide the number of leave hours from 3. above, by 5, in order to determine the number of hours of leave hours to use per day.
  5. Multiply this number by the number of days in the pay period that the employee was out of work and receiving wage loss, to determine the number of leave hours that should be certified for payment on the biweekly salary certifications.
4. RECORDING USE OF LEAVE
  1. Report the actual hours of leave used on the Leave Request form, Leave Record, and for USPS, on the time sheet. Do not include the hours compensated through workers' compensation benefit payments. Annotate "WC Wage Loss" on the USPS time sheet.
  2. Forward copies of the employee's time sheets and/or leave record to a workers' compensation coordinator in the Division of Environmental Health and Safety while the employee is using accrued leave while receiving wageloss benefit payments.
5. ACCRUAL OF ANNUAL LEAVE AND SICK LEAVE
  While receiving such workers' compensation benefits, an employee continues to accrue annual and/or sick leave at the rate accrued prior to the incident whether or not the wage loss payments are supplemented by the use of accrued leave.
6. SALARY CERTIFICATIONS
  Annotate on the payroll certification the reason the regularly certified hours are being reduced (workers' compensation). This annotation advises the staff in the Payroll Office that the employee is eligible to continue receiving the employer contributions for the state insurance programs. If the number of hours being certified is not enough to cover various deductions, the employee is notified by the staff in the Payroll Office to submit the amounts due by personal check or money order to ensure that premiums are paid.
7. CONTINUING INSURANCE PREMIUMS
  Generally, insurance premiums are deducted from the pay received at USF if the employee uses leave in conjunction with receiving wage loss benefits.
  If the number of hours certified for payment by USF is not enough to cover the premiums deducted, of if the employee is placed on leave without pay, the employee should contact the Payroll Office in Finance and Accounting to make arrangements to continue paying premiums. Failure to pay the premiums when due will result in cancellation of the insurance.
8. CHANGE IN STATUS
  When an employee who is receiving full or partial wage loss benefits is released by the attending physician to return to full- or part-time work (with or without restrictions), the employee, the employee's supervisor, or a contact in the department, must notify a workers' compensation coordinator in the Division of Environmental Health and Safety in order to adjust the salary benefits from the Division of Risk Management and prevent an overpayment.
RETURN TO WORK AFTER A WORK-RELATED ILLNESS OR INJURY
The workers' compensation program strives to provide prompt treatment and adequate recovery periods for employees following a work-related injury or illness, and prompt return to work to perform duties that will not exacerbate the injury when the employee is released by the physician. An employee may be returned to work with limitations (i.e., it is not required that the employee be able to perform 100% of his/her former duties). These objectives support USF's policy of ensuring a safe working environment for employees and minimizing workers' compensation costs.
1. RETURN TO FULL DUTY WITHOUT RESTRICTIONS
  When an employee is released by an authorized workers' compensation physician to return to his/her regular duties:
  1. the employee provides the supervisor with a written release statement that indicates that the employee may return to full duty;
  2. the supervisor immediately returns the employee to work;
  3. the supervisor notifies the workers' compensation coordinator in the Division of Environmental Health and Safety in order to ensure that all use of disability leave is properly recorded and/or to suspend the salary wage loss benefits that may have been received by the employee from the Division of Risk Management; and
  4. any temporary employee hired to perform the employee's job while he/she was on leave is terminated, appointed OPS, or moved/returned to another position, as appropriate.
2. RETURN TO DUTY WITH RESTRICTIONS
  When an employee is released by the attending physician to return to work with restrictions on a temporary basis:
  1. the supervisor reviews the position description to determine the essential functions of the position that must be performed;
  2. the supervisor, in consultation with a workers' compensation coordinator in the Division of Environmental Health and Safety may submit a request to the treating physician to review the essential functions in order to determine which functions can be performed by the employee;
  3. the supervisor identifies work that the employee can perform based on the restrictions established by the physician;
  4. the supervisor contacts a workers' compensation coordinator in the Division of Environmental Health and Safety to ensure that all use of disability leave is properly recorded and/or to suspend the salary wage loss benefits that may have been received by the employee from the Division of Risk Management; and
  5. any temporary employee hired to perform the employee's job while he/she was on leave is terminated, appointed OPS, or moved/returned to another position, as appropriate.
    If the employee refuses to work with restrictions, the employee may take time off, if eligible, within the criteria established by the Family and Medical Leave Act (FMLA).
3. INABILITY TO PROVIDE LIGHT DUTY WORK
  If the employing department is unable to temporarily modify the job functions to provide light duty assignment for the employee, contact the workers' compensation coordinator in the Division of Environmental Health and Safety for assistance.
  1. The workers' compensation coordinator may provide assistance and/or suggestions to the employing department for accommodating the restrictions required by the physician.
  2. If appropriate duties cannot be found within the employee's department, the supervisor should work with his/her supervisor to find temporary work for the employee within the division/college.
  3. The employee's original department is required to continue paying the employee at the employee's regular rate of pay when the employee is temporarily returned to work in another unit as an accommodation to the light duty restrictions.
  4. As the employee's condition improves and restrictions are reduced, the job duties are re-evaluated. The employee may be returned to perform his/her regular job duties, as appropriate.
4. INABILITY TO RETURN TO FULL DUTY AFTER 12 WEEKS
  If after 12 weeks, and at least every 12 weeks thereafter, the employee is still unable to return to full duty, a review of the case is to be made by the employee's supervisor in order to assess the employee's improvement rate. The review provides a smoother transition period and ensures that the supervisor is prepared for:
  1. the employee's return to full duty,
  2. the employee's request for an accommodation to perform essential duties of the position,
  3. the employee's resignation or disability retirement, or
  4. the termination of the employee for inability to perform the essential functions of the position with or without reasonable accommodation.
5. REACHING MAXIMUM MEDICAL IMPROVEMENT (MMI)
  If the physician determines that the employee has reached MMI with no restrictions, return the employee to full duty in accordance with XII. A. Return To Full Duty Without Restrictions.
  If the physician determines that the employee has reached MMI and that permanent restrictions must continue, action is required by the employee's supervisor:
  1. The supervisor/department head may consult with the coordinators in Employee Relations, Division of Human Resources, regarding accommodations.
  2. The supervisor writes to the employee that he/she has been notified that the employee has reached MMI, and requests feedback from the employee regarding his/her ability to perform the essential functions of the job with or without an accommodation.
    1. If the employee responds that he/she can perform the essential functions of the position without a reasonable accommodation, the employee is returned to regular work.
    2. If the employee responds that he/she is unable to perform the essential duties of the position without a reasonable accommodation, it is the employee's responsibility to identify and request the reasonable accommodation through the supervisor.
      (1) If the employee requests a reasonable accommodation, the supervisor contacts an Employee Relations Coordinator in the Division of Human Resources for assistance.
      (2) If the employee does not request a reasonable accommodation, the supervisor contacts Employee Relations in Human Resources for assistance.
    3. If the supervisor and department head cannot reasonably accommodate the employee's disabilities, the supervisor/department head should contact Employee Relations in Human Resources for assistance.
    4. If Employee Relations in Human Resources, in consultation with the Director of Human Resources, determines that reasonable accommodations cannot be made, the employee will be advised that he/she will be demoted or terminated for inability to perform assigned duties, may resign or, if eligible, may apply for retirement, as appropriate.
    5. If the disability is not covered under the ADA, and the employee claims he/she cannot fully perform the job duties, the supervisor contacts Employee Relations in Human Resources, regarding moving the employee from the position.

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