Process for Loss Time Work Injuries

Report of Injury

The College carries workers' compensation insurance to reimburse medical expenses and to continue wages in the event of occupational illness or accident incurred in the course of employment. Any employee must immediately notify their supervisor(s) of any work injury. Within 24 hours, supervisors are expected to report to Human Resources any injury incurred by employees on forms provided for this purpose. The law requires that A First Report of Injury be filed immediately with the insurance carrier.

Workers' Compensation Pay (Non-union and Union employees)

The State of Minnesota has a three-day period in which the employee does not receive income through Workers' Compensation (WC). For the first three days following an injury, an employee will use their accrued sick, vacation or floating holidays.

If an employee is unable to return to work after three days, the Workers' Compensation agent will issue a check to the employee for all authorized continuing loss time. With an approved medical leave, benefits will continue to be in effect while an employee is losing time due to a Workers' Compensation injury for up to a six month period. HR will be responsible for calculating and adjusting vacation, sick and floating holiday accruals accordingly.

Payroll does not need time sheets filled out for any whole pay period that an employee paid time through the Workers’ Comp agent and not through Carleton.

The only exception is loss time from work due to a Workers’ Comp injury in the middle of a pay period, then payroll would need a time sheet reflecting regular hours worked to process a paycheck. If an employee is exempt, HR will make an adjustment reducing that month’s paycheck.

During a loss time claim, HR will be responsible for:

1)Forwarding the doctor’s “release from work” for an employee on to the Workers’ Comp agent.

2)If loss time involves a whole 2-week pay period, HR will create and forward a manual time sheet to the Workers’ Comp agent for their file. The Workers’ Comp agent will in turn process and mail the loss time checks to the employee’s home for all authorized continued loss time.

3) Adjusting vacation, sick and floating holiday accruals for the employee during this loss time period.

During a loss time claim, Employee will be responsible for:

1)Forwarding to HR the physician's "release from work" and "return to work" slips.

2)If before or after authorized time off, a pay period has part of the week worked and part of the week not worked,the employee will need to fill out a time sheet for payroll indicating the hours worked and hours unpaid (sample is available from HR).

3) Faxing a copy of their pay stub,involving part of the pay period worked and part of the pay period not worked, to Workers’ Comp agent (952) 897-1988. (cc: the HR department).

4) Insurance and absence accrual benefits will continue to be in effect.

5) If premiums are missed, HR will need to be contacted by the employee. The employee will have a choice of either paying their missed benefit premiums by personal check each pay period to HR or wait to have the balance due deducted from their next payroll check from Carleton College.

Workers’ Comp Loss Time Payment Options for Union Staff

The choice to use or not use accrued absence time for loss time due to a work injury remains the same. However, the process of recording that choice has now changed. The College created a new system of recording loss time due to a work injury in order to ensure that the correct amount of Workers’ Comp pay benefit is not taxed.

The process involved in the two options is described below.

Notable highlights about loss time payments also remain unchanged:

• Any loss time the first three calendar days after the date of injury are not compensable according to the State of MN Workers’ Compensation regulations. All loss time during these first three days will be paid by using your unused absent accruals (sick, vacation or floating holiday).
• In both options, absent benefits (sick and vacation) will accrue as normal.
• The 2/3rds workers’ comp pay is excluded from taxation.

Option #1 –

To NOT use your absent accruals for loss time.

• You will indicate on your time sheet “unpaid W/C hrs” under the “other hours” column. (When totaling at the bottom, do not include these hours in the “paid hours” column.)
• Your Carleton payroll check will be reduced by those hours and you will receive a check directly from the GAB Work Comp agent.
• HR will fax the GAB Work Comp claims representative a copy of your time sheet and you will need to send a copy of your paycheck stub showing the loss time.
• GAB Work Comp will then issue a check directly to your home address for your loss time.

Option #2 –

To USE your absence accruals for PART of the loss time.

• You will indicate on your time sheet “W/C” next to the hours written in under the “sick or vacation or floating holiday” column. (When totaling at the bottom, these hours will be included in the “paid hours” column.) Since Work Comp tax-free payments cover 2/3 of your gross pay, 1/3 may be covered by using your taxable absent (sick, vacation, floating holiday) accruals. This will result in no reduction in pay on your paycheck.
• HR will fax to the GAB Work Comp claims representative a copy of your time sheet.
• You will need to send GAB a copy of our paycheck stub showing use of Work Comp pay and absent accruals used for the loss time.
• Work Comp will issue a check for the work comp loss hours to your home.
• You will need to endorse the Work Comp paycheck and turn that check/pay back to HR to reimburse the pay you have received from Carleton. (Any mileage or prescription reimbursements are to be kept by the employee.)

I choose Option #1 _____

By choosing Option #1, my Carleton paycheck will be reduced and I will be paid through GAB Workers’ Comp tax-free for 2/3 of my gross pay. I understand that I am still responsible to make up any missed premiums from my payroll (ie. health insurance). Arrangements for payment of these missed premiums will be made with Samantha Malecha at x7142 in Human Resources.

I choose Option #2 _____

By choosing Option #2, I understand that when I receive payment for loss time through GAB Workers’ Comp agent, I am to endorse the Work Comp check and turn the check back to Carleton’s HR to reimburse the pay I received through them. I also understand that for 1/3 of my loss time, I will be using my absent accruals.

Click here for Sample time sheets for your reference.

_____________________________________________

Employee’s Signature

_____________________________________________

Human Resource Representative

Date___________________

Revised 7/2008

Contact Karyn Jeffrey, Assoc. Director of HR, at x4174 or at kajeffre@carleton.edu for questions or additional information.

Minnesota Workers’ Compensation System Employee Information

What does workers’ compensation pay for?

• Medical care for the work injury, as long as it is reasonable and necessary.

• Wage-loss benefits for part of your lost income (there is a three-calendar-day waiting period before these benefits start).

• Benefits for permanent damage or loss of function of a body part.
• Benefits to your spouse and/or dependents if you die of a work injury.
• Vocational rehabilitation services if you cannot return to your pre-injury job or to your pre-injury employer.

How are workers’ compensation benefits paid?

Your workers’ compensation benefits are paid by an insurance company or your employer, if your employer is self-insured. State law sets the benefit levels. Please note: pursuant to statute, the insurer can obtain medical information specific to your work injury without your authorization.

If the insurer accepts your claim for wage loss benefits and you have been disabled for more than three calendar days:

• The insurer will send you the Notice of Insurer’s Primary Liability Determination form stating your claim is accepted.

• The insurer must start paying wage-loss benefits within 14 days of the date your employer knows about your work injury and lost wages. The insurer must pay benefits on time. Wage-loss benefits are paid at the same intervals as your work paychecks.

If the insurer denies your claim for wage loss benefits:

• The insurer will send you the Notice of Insurer’s Primary Liability Determination form stating it is denying primary liability for your claim. The form must clearly explain the facts and reasons why the insurer believes your injury or illness did not result from your work.

• If you disagree with the denial, you should talk with the insurance claims adjuster who is handling your claim. Your employer’s insurance company can answer most questions about your claim.

Insurer name: GAB Robins
3601 Minnesota Drive, Suite 600
Minneapolis, MN 55435-5248
Phone: (952) 897-9356 (Patsy Clark)
Fax: (952) 897-1988

• If you are not satisfied with the response you receive from the insurer and still disagree with the denial, you should contact the Department of Labor and Industry at one of the numbers listed below to see what to do next.

If you have other questions or need more help, call the Minnesota Department of Labor and Industry Workers’ Compensation Hotline:

Twin Cities and Southern Minnesota: (651) 297-4377
or (800) 342-5354 TTY (651) 297-4198

Duluth and Northern Minnesota: (218) 723-4670 or (800) 365-4584

Your call will be answered by experienced workers’ compensation specialists, who will provide instant, accurate information and assistance. Additional workers’ compensation information is available on the department’s web site at http://www.doli.state.mn.us/

Your employer is required by law to give you this information. This material can be made available in different formation, such as large print, Braille or on audiotape, by calling the numbers printed above.

Dated June 2003.