Documents
Resources
Learning Center
Upload
Plans & pricing Sign in
Sign Out

Workers Compensation Policy

VIEWS: 250 PAGES: 6

This is a template that provides employees with c company’s workers’ compensation policy. This particular template is drafted for a university, but it can easily be customized by a user in any industry. The policy covers the procedure to claim workers’ compensation, and instructions on reporting accidents. This document also provides an accident reporting kit. This template can be used by small businesses or other entities that want to provide their employees with a workers’ compensation policy.

More Info
									This is a template that provides employees with c company’s workers’ compensation
policy. This particular template is drafted for a university, but it can easily be
customized by a user in any industry. The policy covers the procedure to claim workers’
compensation, and instructions on reporting accidents. This document also provides an
accident reporting kit. This template can be used by small businesses or other entities
that want to provide their employees with a workers’ compensation policy.
                      WORKERS’ COMPENSATION POLICY
Policy Statement:

This University provides Workers’ Compensation insurance to all employees for work-related
illnesses and injuries. Employees who are injured or become ill arising out of or in the course of
their employment should follow the guidelines and procedures in the University’s Workers'
Compensation Program.

Reason for Policy:

To provide employees with information concerning insurance coverage as an exclusive remedy
for accidental injury, occupational disease, or death arising out of and in the course of
employment and to comply with local, state, and federal laws.

Who Needs to Know This Policy?        All Faculty and staff.




© Copyright 2011 Docstoc Inc.                                                                        2
Table of Contents

Policy Statement ...............................................................................................1

Reason for Policy/Purpose

 ......................................................................................1

Who Needs to Know This Policy

 ...........................................................................1

Table of Contents

   ...................................................................................................1

Policy/Procedures

................................................................................................2



Instructions

      ............................................................................................................. 3

Accident Reporting Kit........................................................................................4




© Copyright 2011 Docstoc Inc.                                                                                           3
                                WORKER'S COMPENSATION POLICY

Policy/Procedures

Work-related injuries or illnesses may be covered under the University’s Worker's Compensation
Program. To be considered work-related, the injury or illness must arise from and occur in the
course of employment. When authorized by a physician, medical expenses related to the
treatment of a work-related injury or illness (including doctor, hospital, surgical, physical
therapy, prescription medication, medical equipment, and any out-of-pocket medical expenses),
are covered. Vocational benefits may also be provided.

Worker's Compensation also pays for wages lost as a result of an employee injury or illness,
provided that the absence from work is related to a work injury or illness and is authorized by a
doctor. Worker's compensation disability payments are approximately 66 2/3% of an employee’s
average weekly wages and are non-taxable income. If an employee is out on workers
compensation for more than 30 days, than the employee has an obligation to continue paying
his/her voluntary benefits. Employees in this situation should contact Human Resource Services
for further information regarding payment of benefits.
The [Office of Risk Management] [Substitute in the relevant office at your university, if your
institution uses a differently-named office for this task.] administers the University’s
Worker's Compensation
Program for the University. Lost-time worker's compensation cases are handled by a third party
claims adjustment service provider.

Instructions

Following an accident, employees should notify their supervisor as soon as possible to complete
an Accident Reporting Form, as well as the required _______________ [Provide name of state,
as well as the names of the specific forms that your jurisdiction uses] forms. Upon
completion, these forms should be returned to the Office of Risk Management. If possible,
employees should have their supervisor sign an Authorization for Medical Treatment Form and
take it to their medical appointment.
Employees involved in serious injuries requiring immediate medical attention should be treated
at ________________________________ [Instruction: Provide the name and location of the
place authorized to treat these types of medical cases.] or you may seek treatment with your
primary care physician.
Non-serious injuries should be treated at ____________________________ [Instruction:
Provide the name and location of the place authorized to treat these types of medical
cases.]. For all other injuries, refer to the Common Questions about Worker's Compensation.
Please try and limit receipts for out–of- pocket expenses, such as prescription medication and
medical equipment and contact the Office of Risk Management as soon as possible so that we
may direct you on how to obtain these products through our medical provider which will limit
your out-of-pocket expenses. If you should need reimbursement, you may still contact the Office

© Copyright 2011 Docstoc Inc.                                                                    4
of Risk Management for reimbursement under the Worker's Compensation Program. Any
absence from work must be authorized by the employee’s treating physician. The employee must
be out of work for three days (excluding the day of injury) before workers’ compensation pays
for work time that has been lost.
Modified duty may be provided by certain departments within the University for employees that
can come to work but must temporarily alter their tasks. Modified duty is handled on a case-by-
case basis depending on the recommendations of the treating physician. Employees on modified
or restricted duty are not eligible for paid overtime work.
Employees on worker's compensation are responsible for keeping their supervisor and Risk
Management informed of their work status. All disability documentation from the Physician
noting the employees dates absent from work and the diagnosis of the injury or illness must be
provided to the supervisor and Risk Management immediately.
If this documentation is not provided to Risk Management, the employee’s continued absence
from work will be considered unauthorized and the worker's compensation benefits will be
suspended. When an employee is able to fully return to work, written clearance from the treating
Physician documenting that the employee is fully capable of performing regular job duties must
be provided to Risk Management and the Supervisor.
Worker's compensation claims are subject to investigation by the University’s claims adjuster.
Cooperating with the claims adjuster is essential for the effective and timely management of
employee claims.

Accident Reporting Kit
Authorization for Medical Treatment Form
Employee's Notice of Accidental Injury or Occupational Disease



Contacts

        Subject's Name _________________

        ____________________________________________________________________
        Contact Person                      Contact's Phone #             E-mail address
        ____________________________________________________________________
        Contact Person                      Contact's Phone #             E-mail address
        ____________________________________________________________________
        Contact Person                      Contact's Phone #             E-mail address




© Copyright 2011 Docstoc Inc.                                                                    5

								
To top