Workers' Compensation

Purpose

Any University employee who is injured or incurs an occupational disease or death, normally without regard to fault, as a result of University employment, is covered by the Kentucky Worker’s Compensation Act, the University's Workers' Compensation Program, and the University of Kentucky Worker’s Care Program Managed Care Organization.

Policy

1. The University, on a self-funded basis, funds this program which provides benefits to include payment of medical expenses, compensation, and death indemnities appropriate to the particular case.
   1. Under this program, the University may contract with a Third Party Administrator (TPA) or Managed Care Organization (MCO) to provide medical treatment, case management and other related services.
   2. An employee shall be seen by a medical provider designated by the MCO.
   3. Failure of an employee to see a designated medical provider shall result in denial of payment, unless the injury is life threatening and requires immediate medical attention.
   4. The name/location of an approved medical provider shall be furnished when an injury or occupational disease is reported.
2. Additional time off or pay is not authorized for holidays or special holidays which occur during a compensable workers' compensation absence.
3. This policy applies to all cooperative extension employees on federal appointment who were previously covered by the benefits of the Federal Employee’s Compensation Act.
4. In the event an on-the-job injury results in total disability and the employee is approved for benefits under the University’s long term disability plan, the employee shall receive the total amount of the greatest single benefit.
5. Injury as a result of horseplay while at work is not a work-related injury.

Light Duty Work

1) Employees injured during the course and scope of employment may be offered light duty if an MCO medical provider assigns temporary physical restrictions.

2) If the employee's regular department can accommodate the temporary physical restrictions, the employee is required to perform light duty work to the best of his/her ability within the restrictions established by the MCO medical provider. Departments are under no obligation to provide work to any employee if the department has appropriately documented the failure by the employee to make a good faith effort to perform such work.

3) If the employee's regular department is unable to accommodate the temporary restrictions, the employee may be assigned to the Light Duty Program.

4) The Light Duty Coordinator is charged with oversight of the Light Duty Program.

5) The Light Duty Coordinator shall make a good faith effort to match the work type and work hours to the employee's normal job duties and schedule. If work type and/or work hour matches are unavailable, the Light Duty Coordinator may assign the best match possible taking into account the skills, abilities, and education of the employee.

6) UK HealthCare On-Call and Pool nurse employees in the Light Duty Program shall work a number of hours per week approximately equal to the average number of weekly hours worked in the twelve months prior to sustaining the work injury.

7) Employees normally working under a special program, such as, but not limited to, Weekend Premium Pay Plan nurses, shall be paid only for hours actually worked if the department is unable to accommodate the temporary restrictions and the employee is placed in the Light Duty Program.

8) Employees assigned Light Duty Work who normally receives shift premiums, shift differentials, or other special pay over a base rate shall continue to receive this type of premium pay if the light duty work performed would normally earn such pay.

9) Overtime assignments for an employee performing light duty work must be pre-approved by the Disability Benefits Manager as excessive activity may interfere with recovery.

10) Light duty work assignments shall not exceed 180 consecutive calendar days unless authorized by the Disability Benefits Manager.

11) An employee may refuse a light duty assignment. If an employee refuses a light duty assignment, accrued Vacation Leave may be used for this absence. Temporary Disability Leave shall not to be used for this type of absence.

12) If a light duty assignment is refused and the employee has insufficient Vacation Leave to cover these absences, the absence will be unpaid and may be considered unauthorized.

Employee’s Rights and Responsibilities

1) A worker’s compensation absence shall not be charged against the employee’s vacation or temporary disability leave (TDL) if a suitable work excuse is provided by a MCO physician.

2) If an employee is off work due to a work-related injury without a suitable off-work statement from an MCO physician or if the temporary restrictions secondary to a work-related injury can be accommodated and the employee elects to remain off work, the employee shall use Vacation Leave for this absence. If the employee is not eligible to use Vacation Leave, or has insufficient accrued Vacation Leave, the absence will be considered an unpaid and unauthorized absence and these absences may be subject to corrective action.

3) An employee may choose to utilize accrued vacation or temporary disability leave (TDL) when the worker’s compensation pay is less than the employee’s regular pay. This shall not exceed the regular compensation amount.

4) A period of absence under worker’s compensation does not constitute a break in service.

5) An employee receiving treatment/evaluation for a work-related injury is required to submit a copy of any return to work authorization to his/her immediate supervisor within two working days. This authorization shall list any work restrictions and be completed by the treating health care provider.

6) When an employee returns to work for 10 consecutive working days, they are entitled to full credit for vacation and TDL that accrued during the period of absence from the job. An employee may be required to change medical appointment times if the appointment time is within normal work hours and the employee's absence may cause an undue hardship on the department. Departments wishing to change appointment times should contact the Employee Disability Benefits Office for further instruction.

7) An employee returning to work from an accepted worker’s compensation claim shall be given time with pay for follow-up medical care relative to the work-related injury.

8) An employee who has a work-related injury or exposure shall refrain from any activity that may negatively impact recovery and/or delay a return to work.

9) During a worker’s compensation absence, the employee shall make arrangements with the Human Resources Office of Employee Disability Benefits (Employee Benefits) to pay for any employee paid portion of benefits (i.e., optional life insurance, health care coverage, etc.).

University Rights and Responsibilities

1. The University may investigate all accidents in which a worker’s compensation claim is filed.
2. The University may require an employee to submit to an independent medical evaluation (IME) and/or vocational assessment.
3. The University may take appropriate corrective action and/or deny benefits in cases where an employee
   1. Falsifies documents,
   2. Refuses to cooperate in claims processing, or
   3. Acts in a fraudulent manner.
4. The University shall continue to pay for an employee’s basic life insurance coverage and the health credit during a compensable worker’s compensation claim so long as they remain in an employed status eligible to receive these credits.
5.  If an employee sustains a work-related injury and is unable to return to full duty within six months of the date of injury, the employee may be separated for health reasons.
6. Human Resources, with the approval of the Executive Vice President of Finance and Administration, shall designate areas at highest risk of incurring a work-related injury based on historical trends, the type of work performed, or related factors. This designation for these unit areas shall occur prior to the beginning of the employee evaluation year (calendar year or fiscal year) These identified unit areas shall be required to allocate at least 10% of the Performance Evaluation score for each unit employee in the following calendar or fiscal year, as appropriate, solely to meet risk reduction goals. Once an area is identified, a comprehensive plan to reduce work-related injuries shall be developed by the area in conjunction with Environmental Health & Safety, and submitted by the appropriate areas to the Executive Vice President of Fiscal Affairs, or designee within 30 days.

Process

Administration of the University’s Worker’s Compensation Program is a function of Employee Benefits.

1. Any work-related injury or hazardous exposure shall be immediately reported to the supervisor.
2. All work-related injuries or exposures shall be immediately reported by calling the Worker’s Care Program at 1-800-440-6285.
   1. When an employee returns to work, the supervisor or employee shall immediately telephone or send written notice to Employee Benefits. The report should include exact date and time the employee returned to work.
   2. Failure to report a work-related injury or exposure within 3 days may result in denial of a claim and/or appropriate corrective action for the responsible employee and/or supervisor. For repetitive motion and similar injuries, the injury must be reported within 3 days of learning the injury is work-related.
3. Cost Distribution of Compensation Payments
   1. For regular employees, the first seven calendar days of any compensable work-related absence shall be paid by the employee’s department.
   2. For temporary employees, the first seven calendar days are not compensable, unless the employee is absent for 14 or more days. In this case, the first seven days will be paid by the worker’s compensation program.
   3. Beginning on the eighth calendar day of a work-related injury or disease, statutory benefits, as provided by state law, shall be paid and charged to the University's miscellaneous fringe benefits accounts.
   4. Temporary disability and vacation leave, if utilized, shall be charged to the employee's department account.
   5. The payroll cost for an employee working in the light duty program (whether temporary accommodations are provided by the department or assigned by the Light Duty Coordinator) shall be the responsibility of the department for the first 90 calendar days. STEPS employees payroll costs shall be the responsibility of the department employing the individual at the time of injury. After 90 days, the wages for an employee working in the light duty program shall be paid by the Miscellaneous Fringe Benefits Pool.
4. An employee on federal appointment shall comply with the provisions of the Federal Employee’s Compensation Act.
5. Payments of statutory benefits to employees for work-related injuries and disease are excluded from taxation.
6. Family Medical Leave shall run concurrently with worker’s compensation absences as applicable.