Disability Management: Concepts & Definitions

Workers' Compensation is a state-mandated benefit that requires all employers to pay for approved expenses resulting from a work-related injury or illness. This includes, for example, the employee who slips and falls on the job resulting in a broken ankle; the employee who, over the course of years, injures their back from repeated lifting; and the employee who develops a rash from exposure to chemicals. This benefit is designed to be no-fault (blame is not assigned).

The University is self-insured for Workers' Compensation. Each campus contributes to a trust fund from which claims costs are paid. The University's third party administrator, Octagon Risk Services (ORS), determines whether a claim is compensable and, if so, pays appropriate costs, including medical care, temporary and permanent disability, and vocational rehabilitation. The University also provides benefits to supplement the state-mandated temporary disability payments.

When the employee is off work for a compensable injury, he/she will be receiving temporary disability payments directly from ORS; these payments can be used in conjunction with their sick and, if chosen, vacation leave. Thus an employee who has an injury and has a great amount of sick leave might stay on full pay status for an extended period. Once the employee's sick and/or vacation leave is exhausted, the employee is entitled to Extended Sick Leave (ESL) for up to six months, as long as he/she remains disabled. The difference between the Workers' Compensation benefit and 80% salary paid during ESL is made up from departmental funds.

To be eligible for the 80% ESL benefit, an employee must first exhaust their own sick leave. Vacation leave may also be used, but this is not required to be eligible for ESL. If the employee chooses to keep the Workers' Compensation checks and not use sick leave, they will not be on pay status and will be responsible for paying for all of their own health benefits.

Because the employee is on pay status and receiving salary checks, any checks from ORS that the employee cashes will be deducted from a future paycheck. This sometimes occurs after the employee has returned to work. It is strongly recommended that you have the employee call the Workers' Compensation Benefits Assistant to arrange to endorse these checks to the University to avoid an overpayment and thus a future deduction from their salary.

While on pay status, the employee's benefits continue as normal. Sick/vacation leave is also accrued at the normal rate and service credit is accrued according to the percentage of salary received (i.e., on 80% pay, 80% service credit is accrued). When the employee goes onto leave without pay status, they continue to accrue sick/vacation leave (to be credited only if he/she returns to work) and have their medical insurance premiums paid as long as they are receiving temporary disability payments.

The University Vocational Rehabilitation Program is designed to help disabled faculty and staff members (for work-related and non-work-related injuries) stay on the job through accommodation or find other work consistent with their medical limitations.

Services for employees can include:

• Vocational assessment
• Job-seeking skills
• Interview and resume preparation
• Job search

For supervisors, the Vocational Rehabilitation Counselors:

• Help get medical clarification of an employee's restrictions
• Perform medical separation reviews
• Provide resource information about adaptive equipment and services and accommodation

The University began a campus-wide modified work program in January 1991, following a successful pilot program. Providing modified work has several advantages:

• It is an effective way for employees to return to full duty. It is cost-effective for both the department - which pays for work vs. sick leave - and the campus in overall claims cost
• It is psychologically advantageous to the employee
• In this program, restrictions on an employee's work may be accommodated for up to 60 days with a possible 60-day extension. The employee may be accommodated in the previously held position (through eliminating tasks outside the restrictions, performing tasks in a different manner, or reducing time) or assigned duties other than their usual responsibilities. The employee will be expected to work a productive schedule for the time they are assigned. The salary remains the same (even if in a lower position) or is increased (if in a higher level position).