613: Injury on the Job and Workers' Compensation

Statement

Employees of Georgetown University may be eligible for coverage of medical expenses and a percentage of lost wages resulting from a work related injury or occupational illness.

Philosophy

The University strives to provide a safe work environment for all employees.

In the event of a work-related injury or occupational illness, employees may be eligible for coverage of medical expenses and a percentage of lost wages. The information in this policy is based on the District of Columbia workers’ compensation laws. Employees injured on the job in another state or country should contact the Office of Risk Management for information regarding applicable laws.

Procedures

1.  Medical Treatment

If an employee experiences an injury on the job or occupational illness, the employee should seek treatment from a licensed healthcare provider of his/her choice.

2.  Notifications

The employee should immediately notify the supervisor of a work-related injury or occupational illness.

Upon learning of a work-related injury or occupational illness, the supervisor should immediately notify the Office of Risk Management. The supervisor should complete a Supervisor’s Report of Injury or Occupational Illness Form and fax it to Risk Management. All required forms are available online at the Office of Risk Management Web site.

3. Workers’ Compensation Leave

An employee who has a medically authorized absence and receives workers’ compensation pay is considered to be on workers’ compensation leave for the period of time the employee is away from work. Any absence from work due to a work-related injury or occupational illness requires written documentation from the employee’s licensed healthcare provider explaining the reason for the absence, the period the absence is to cover and, if possible, a projected return to work date.

4. Workers’ Compensation Payments

Workers’ compensation benefits provide payments, calculated as a percentage of the employee’s pay, for approved claims supported by medical documentation.

By University policy, the date of the accident is considered a regular work day and the employee will be paid for all the time he/she is scheduled to work on that day during their regular work day, regardless of when the incident occurs or whether the employee returns to work on that day.

Workers’ Compensation disability insurance payments usually equal two-thirds of an employee’s average weekly pay. The payments are tax-free and subject to limits set by the District of Columbia.

If the employee is absent less than14 days, temporary workers’ compensation payments will begin with day four. The first three calendar days of an absence, including weekends and holidays, will not be paid by workers’ compensation (the “waiting period”).  (Three days is the waiting period in the District of Columbia; the waiting period may be longer or shorter if another state’s law is applicable.)  During the waiting period employees may elect to use accrued leave or leave without pay.  In the case of union-represented employees, different rules may apply; consult with the appropriate Human Resources Generalist.

If the employee is out 14 consecutive days or more, workers’ compensation payments will begin with day one of the absence.  If the employee had elected to use accrued leave during the three day waiting period, the employee may elect to have the leave restored. Consult with Payroll for instructions to restore leave.

Workers’ compensation payments are made directly to the employee by the University’s third-party administrator and are not subject to payroll deductions.  Employees who are absent for 14 days or more (or one month for monthly paid employees) are responsible for contacting the appropriate departments to make payment arrangements for their share of benefit premiums or other services that are paid through payroll deductions (parking, child care, etc.).

Workers’ compensation also pays for medical expenses related to the treatment of a work-related injury or illness (including doctor, hospital, surgical, medication, medical devices), when authorized by a physician. Vocational rehabilitation costs may also be covered.  

4(B) Pay and Other Restrictions While on Workers’ Compensation

4(B)(i) Leave Restriction

Employees on workers’ compensation leave may not use accrued leave in lieu of workers’ compensation pay. Paid leave for staff (Policy 602), paid leave for AAP’s (Policy 612), sick leave for staff (Policy 605), and continued income for periods of illness or disability (“Disability Leave” section of Benefits Summary for Faculty and AAP’s) may not be substituted for workers’ compensation disability pay.  The only exception is the permitted use of accrued leave during the three-day waiting period.

4(B)(ii) Double Pay Restriction

Employees on workers’ compensation leave may not receive their regular pay (including holiday pay) and workers’ compensation disability pay for the same period of time.  If an employee receives regular pay while also receiving workers’ compensation pay, the employee must reimburse the University the amount of the regular pay.

4(B)(iii) Non Georgetown Work-Related Injury Pay Restriction

Employees may not receive workers’ compensation payments from the University for an injury or illness attributable to employment elsewhere.

4(B)(iv) State Compensation Payment Restriction 

Under District of Columbia law, an employee is forbidden from receiving workers’ compensation payments in the District of Columbia while also receiving payments under the Workers’ Compensation Act of any other state for the same injury.

4(B)(v) Other Legal Restrictions

The University will restrict or modify workers’ compensation payments as required by any applicable law or regulation.

4(C) Workers’ Compensation Leave and University Benefits

To the extent that an employee is eligible for benefits at the time of an injury or occupational illness, accrued paid leave and retirement credits will continue unless an employee is terminated (see Section 6, below, for Termination procedures). An employee receiving workers’ compensation payments is not eligible for holiday pay.

5.  Employee and Supervisor Responsibilities Following a Work-Related Injury or Occupational Illness.

Both the employee and the supervisor have responsibilities following a work-related injury or occupational illness that results in the employee’s absence from work, as follows:

5(A).  Employee’s Responsibilities.

5(A)(i) Employee’s Responsibility – General Principle

In the case of a work-related injury or occupational illness that results in an absence from work, an employee must keep his/her supervisor informed of his/her work status; promptly report a return to work date or submit a new physician’s authorization that extends the work absence. Failure to comply may result in the termination of workers’ compensation benefits and/or disciplinary action which could affect continued employment with Georgetown University. 

5(A)(ii) Employee’s Responsibility – Medical Certification

If an employee cannot return to work, the employee must provide the supervisor with written documentation from a licensed healthcare provider explaining the reason for the absence, the period the absence is to cover and, if possible, a projected date for return to work.  New authorizations are required if the specified time expires and the absence is extended. Failure to provide current, written documentation may result in denial of a claim.

5(A)(iii). Employee’s Responsibility – Family and Medical Leave Policy

(HR Policy 603). 

For Family and Medical Leave eligible employees, if the absence from work qualifies the employee for Family and Medical Leave under Policy 603, the employee must fill out a regular Leave Request Form. See Section 6 below regarding the coordination of workers’ compensation leave and Family and Medical Leave.

5(A)(iv) Employee’s Responsibility – Medical Clearance Prior to Return to Work

Prior to returning to work, the employee must provide the supervisor with a licensed healthcare provider’s written clearance, with or without restrictions. 

If the clearance specifies restrictions, the employee should consult with the supervisor to discuss possible accommodations.

5(B) Supervisor’s Responsibilities.

5(B)(i) Supervisor’s Responsibilities – General Principles.

The supervisor is responsible for having a current medical authorization on file at all times.  If an authorization expires and the employee has not spoken with the supervisor, it is the responsibility of the supervisor to contact the employee during his/her absence concerning the employee’s medical status and, if possible, a projected date for returning to work.

The supervisor is responsible for ensuring that an employee’s work absence is reported correctly to payroll as workers’ compensation leave.  Additionally, the supervisor is responsible for ensuring that the correct payroll processes for recording leave and restoring leave are implemented where appropriate.

5(B)(ii) Supervisor’s Responsibilities – Correctly Reporting Leave

When an employee’s work absence is less than one full pay period, use the standard department payroll forms and procedures for recording leave. Contact Payroll for assistance.

When an employee’s absence exceeds one full pay period, process the Workers’ Compensation Leave Form. Forward the form to the appropriate personnel responsible for handling human resources transactions.

The purpose of this form is to deactivate an employee in the Genesys system so that University paychecks are suspended and the employee continues to accrue leave.  When the employee returns to work at the University, use the Workers’ Compensation Form to reactivate an employee in the Genesys system and resume University paychecks. 

5(B)(iii) Supervisor’s Responsibilities – Medical Authorization Forms. 

The supervisor will obtain copies of the medical authorization and medical clearance forms from the employee. These forms must be kept in a separate file from other personnel documents.

6.  Coordination with Family and Medical Leave Policy (HR Policy 603)

This provision will apply in the case of employees eligible for Family and Medical Leave (HR Policy 603).  Leave that qualifies as workers’ compensation leave that also qualifies as medical leave under the University’s Family and Medical Leave policy is counted against the employee’s Family and Medical Leave entitlement. Approval of Family and Medical Leave does not guarantee that workers’ compensation disability benefits will be paid.

7.  Termination of Employment

An employee may be terminated if he or she is unable to perform his or her job, even with reasonable accommodation, as a result of a work-related injury or occupational illness.  Reasonable accommodation to enable the employee to return to work will be considered when applicable by the appropriate department head, Risk Management, Human Resources and IDEAA.  Any change in employment status or termination of an employee receiving workers’ compensation benefits must be reviewed with the appropriate Human Resources Generalist. 

Any termination decision must be in accordance with applicable federal, state or local law. Termination of employment does not affect an individual’s right to continue receiving workers’ compensation benefits, if the individual is otherwise entitled to receive these benefits. 

Responsibility

It is the responsibility of each employee to report any injury on the job or occupational illness to his/her supervisor. If the employee is unable to work, the employee must follow all the reporting provisions of the policy and keep his/her supervisor informed of his/her status. It is the responsibility of the supervisor to ensure that each work-related injury or occupational illness is reported to the Office of Risk Management and to comply with other responsibilities under this policy.

Resources

Questions concerning reporting of injuries, the length of an employee’s absence, or concerning the payment of a claim should be directed to the Office of Risk Management. Questions concerning termination of employment or other changes in an employee’s status should be directed to Human Resources. Questions concerning continuation of benefits during the employee’s absence should be directed to Faculty and Staff Benefits. Issues concerning the safety of working conditions should be directed to the appropriate safety office.