Transcript No Slide Title

North Carolina
Department of Correction
Workers’ Compensation
And
Salary Continuation Programs
Tracy Ashworth
Program Manager
Tonya Marlin
Program Assistant
Phone - 919/716-3700
Fax - 919/716-3960
(Revised August 1, 2003)
Benefits Representative/Supervisory
Responsibilities
• FORM 19
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Must be typed
Treatment by physician must be completed
Fax to the Personnel Office, Benefits Section within 24 hours
Mail the original Form 19 to the Benefits Section in Personnel
Do not send to the Industrial Commission
Address Will Remain the Same
NO Wage Information
Return To Work?
Sought Medical Treatment?
Don’t Forget!
Does Not Apply
Form DOC-WC-4
Every question must be answered
in the employees handwriting
Back of Form should ONLY be completed by
facility nurse
Mail the original
Catastrophic Injuries
• Notify the Benefits Section and Key Risk
Management Services
• Examples Include:
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Death Caused by a job related injury
Amputation of a major extremity
Gun shot wound
Second or third degree burns over 25% of
the body
Third Party Automobile
Accidents
Forward the following
documents to the Benefits
Section:
• A copy of the investigating
police officer’s report
• A copy of the Motor Fleet
Management report
• Insurance information for
the other vehicle
Employee
Responsibilities
Immediately report injury to supervisor
Follow prescribed medical treatment
provided by Key Risk Management Services
Provide management with medical
restrictions and out of work medical excuses
Contact supervisor on a weekly basis while
out of work
Salary Continuation
(Injury Leave)
•Who’s Covered?
•Employees that are in certified classes
•Non-certified employees injured by direct and deliberate act of
an offender/inmate
•Employees are required to use accumulated leave
•Benefit Reps/Supervisors must submit
•Out of Work Notes
•Time Sheets
•Memorandum requesting Injury Leave Approval at the end of
each 28 day work cycle
•MUST REQUEST SPECIFIC DATES
Salary Continuation
(Injury Leave)
• After receiving injury leave approval,
reinstate leave to the employee’s
CURRENT DC-113
– Auditors request that the leave taken be
struck through and replace with an “I” for
injury leave
Shift Premium
 Employees whose position entitled them to shift premium pay
prior to the injury shall continue to receive shift premium pay
while out of work due to a compensable job related injury
 it is the facility’s responsibility to make sure eligible employees receive
shift premium pay while on approved “Injury Leave”
 Must submit, to payroll, a memorandum requesting shift premium pay
along with the employee’s time sheet.
Workers’ Compensation
Who’s Covered?
All Department of Correction employees including some
temporary/contractual employees.
• Leave Without Pay Due to Workers’
Compensation
•required 7-day waiting period
•Employee placed on LWOP after the required waiting period
•Employee will receive 66 2/3% of their average weekly wage for the
52 weeks prior to the date of injury
Workers’ Compensation
vs.
Family Medical Leave
• When the employee is receiving Salary Continuation
(Injury Leave)
– If the employee is eligible, then designate Family Medical Leave
• When the employee is receiving Workers’ Compensation
(Leave Without Pay due to Workers’ Compensation)
– Do no designate Family Medical Leave (Per Office of State
Personnel)
Medical Treatment
• The facility shall:
– refer injured employees to a
CompCare Provider physician
– if EMERGENCY medical treatment is
required, refer employee to the closest
medical facility for treatment
• Payment/Status of Medical Bills
– contact Dana McCormick, KRMS
at 1-800-942-0225 ext. 388
Transitional Return to
Work Program
• The Department of Correction accommodates
temporary medical restrictions for an employee who
has suffered a compensable job related injury
• The purpose of the Transitional Return to Work
Program is to provide work to employees who are
restricted from performing their normal job duties
• There is no limit of how long an employee can
participate in the Transitional Return to Work
Program
Goal of Transitional Return to
Work Program
• To help employees during the healing
process by:
– returning employees to a normal lifestyle
sooner
– focusing on abilities instead of disabilities
– improving employee morale
– encourage cross training within Department
of Correction
Transitional Return to
Work Program Rules
• Employee must have sustained a compensable job related
injury
• Employee must provide supervisor with a medical note
from the treating physician that list the temporary medical
restrictions and the duration of the restrictions
• Every attempt should be made to place the injured
employee in a transitional job
• If a transitional job cannot be identified the supervisor
must contact the Benefits Section immediately
Transitional Job Placements
• Examples Include:
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clerical duties: filing, data entry, receptionist
control rooms
towers
any position short staffed where
accommodation can be met
Return to Regular Duty
• The employee must submit a return to work
note from the treating physician stating that
the employee may return to regular duty
Americans with
Disabilities Act
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Requirements
– The employee’s treating physician must advise that the
employee has reached maximum medical improvement
– The employee must have permanent medical restrictions
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Process
– The Benefits Section will send a copy of the employee’s
essential job functions to the treating physician
– If the employee cannot perform all of the essential job
functions, the Benefits Section will ask the employee to
complete the DC-730 (Request for Reasonable
Accommodation)
– The Benefits Section will forward the essential job
functions and the DC-730 to the Division and await a
decision regarding the accommodation
– The Division will notify the employee and work location of
the decision
Work Status
• Employee Participating in the Transitional
Return to Work Program
– the employee will continue to work light duty until
the Division makes a decision regarding the
accommodation
• Employee Not Working
– the employee will remain out of work
– the employee will continue to receive Salary
Continuation or Workers’ Compensation until a
decision has been made by the Division regarding
the accommodation
Any Questions?