51爆料网

When an employee sustains a work-related injury, they must notify their supervisor immediately and complete an Injury/Illness Report 听within twenty-four hours. Part A of the Injury/Illness Report should be completed by the injured worker. Their supervisor should review and complete Part B. If the injured worker is unable to complete the form, his/her supervisor should complete the form to the best of their knowledge. A copy of the completed form goes to Health & Safety and to the Director of Workers鈥� Compensation.

For serious injuries requiring immediate medical attention Call 911.

• Loss of Consciousness
• Head or Spine Injury
• Broken Bones
• Heavy Bleeding

If an ambulance is not necessary, an injured worker can seek medical attention at the nearest emergency room or urgent care facility, if they are able to operate a vehicle safely. A supervisor, co-worker, or family member can transport when necessary.

For non-emergency medical treatment, injured workers can see any medical professional who is an Ohio BWC certified provider. Be sure to ask provider if they accept workers鈥� compensation insurance when making an appointment. For a list of local occupational health facilities contact the university鈥檚 Director of Workers鈥� Compensation.

To ensure proper processing of Workers鈥� Compensation claims, an injured worker must tell the provider or medical facility that the medical treatment is for an occupational injury or illness at the time of service.

Completing the Employee Injury/Illness Report DOES NOT initiate a workers鈥� compensation insurance claim. Packets for workers鈥� compensation Insurance claims are available in the Workers鈥� Compensation office located at Suite 3800 of University Hall or download forms from the menu to the right.

The correct packet required for your claim is dependent upon where your payroll is budgeted, NOT where you physically work:

• Packet 10003148 is for employees budgeted to the Medical College.
  • Download your ID Card.听
• Packet 10003149 is for employees budgeted to Main Campus.
  • Download your ID Card.听
• Packet 10003161 is for employees budgeted to UTMC.
  • Download your ID Card.听

If you are not certain where your payroll is budgeted, check with your supervisor, Human Resources, or the Director of Workers鈥� Compensation.

Some medical providers will have a First Report of Injury Form for you to complete however; they will not have all of the documents you find in the packet.

Out-Of-State Employee Injuries

Employees who are non-Ohio residents and whose regular work situs (>than 90 days) is outside of Ohio, are governed by the workers鈥� compensation laws of their home state. The University maintains out-of-state worker鈥檚 compensation insurance through Zurich American Insurance Company. Contact the Director of Workers鈥� Compensation for state specific claim information. Claims can be reported to: Zurich Claims Services 1-800-987-3373.

**Note: In most states, the injured workers鈥� claim must be filed within one year from the onset of injury or illness.

Please complete all forms as thoroughly as possible to reduce unnecessary delays in claim processing. Return completed forms to the Director of Workers鈥� Compensation. The completion of these forms does not guarantee entitlement of benefits. Ohio BWC makes the determination for claim allowance.

If an injured worker or an employer disagrees with the decision of Ohio BWC, they have the right to file an appeal with BWC within 14 days of receipt of the Order. Failure to file a timely appeal may result in the loss of your right to challenge the decision, making the order final and permanently barring you from collecting disputed benefits or compensation for that specific decision.

The Managed Care Organization for the University鈥檚 workers鈥� compensation insurance claims is Sheakley UniComp. They are an extension of Ohio BWC to process claims, authorize treatment and procedures, provide medical management, pay approved bills, and to serve as a liaison between the injured worker, employer, medical providers, Ohio BWC, and authorized representatives. Every injured worker is assigned to a dedicated medical management team to assist them with the medical aspects of their claim.

Reporting Process

Main Office Line: 1.888.743.2559
Main Fax Line: 1.888.626.2667

New claims can be submitted to: unicompfroi@sheakley.com

The injured worker must call his/her supervisor each day of absence until a provider鈥檚 certification of time off from work due to the work-related injury or illness is received by the supervisor.

For messages left on an absence line, be sure to clarify the absence is due to a work injury and not just 鈥渟ick.鈥� The supervisor should notify the Director of Workers鈥� Compensation of the absences. If an injured worker is admitted to an overnight stay in any hospital at the time of the initial visit, the Director of Workers鈥� Compensation and Health & Safety must be notified immediately in compliance with OSHA/PERRP rules.听

The injured worker may return to work full duty without any additional requirements if absent one full workday or less.

If the employee misses more than one full day of work due to a work-related injury or illness, a doctor鈥檚 certification of the disability is required. A MEDCO-14 form is the preferred document however a doctor slip which includes date(s) to be off, diagnosis (why taking off work), restrictions (if any) AND estimated return to work date. 听Absences without a doctor鈥檚 certification of work-related disability are subject to points.

Unless the treating physician indicates otherwise, it is presumed that the injured worker will return to work full duty at their next scheduled shift. If the treating physician completed a MEDCO-14 form with an estimated full duty release date, it is the injured worker鈥檚 responsibility to notify their supervisor of expected return to work date for scheduling. If the doctor is extending the disability, the worker must notify the supervisor of the new estimated return to work date.

A work-related injury requiring the absence of more than 3 consecutive days is a qualifying event for FMLA protected leave, if otherwise eligible. FMLA leaves are processed concurrently through the Office of Human Resources.

For the first seven days of disability, an injured worker must use sick, vacation, personal or comp time to be compensated for the time off. If no time is available to cover the absence, the time is to be reported as leave without pay.

The time off must be reported by the employee/supervisor in pay period/in the time frame for which it is due. For assistance recording the time off, contact the payroll office. Contact the Director of Workers鈥檞age compensations for lost wage options.

Ohio BWC鈥檚 MEDCO-14 form is the preferred documentation when an injured worker has been released to return to work full duty by their physician. If the injured worker is released to return to work under modified/transitional/restricted duty, section 3C of the MEDCO-14 should be completed by the physician outlining the injured worker鈥檚 limitations. It is the injured worker鈥檚 responsibility to know and adhere to those limitations and provide a copy of the limitations to their supervisor. Likewise, the supervisor should not ask the injured workers to perform tasks under restriction. The Director of Workers鈥� Compensation will coordinate work activities with the injured worker and supervisor prior to the return to work. If the worker feels they can return to full duty activities prior to the date given by the physician they must obtain clearance from the doctor.