Contents

1. Definition
2. Eligibility
3. Responsibilities
4. Choice of Practicioner
5. Recurrent Injuries
6. Medical & Lost Time Benefits
7. Sick Time, Vacation and other Accrued Leave
8. Return to Work
9. Failure to Report Accident
10. Denials
11. Attachment A - Lost Workday Case

1. Definition

Chapter 102, the Wisconsin Worker’s Compensation Act requires the University to provide Worker’s Compensation coverage for employees who are injured by accident or who develop an illness which arises out of an is in the course of their employment.

2. Eligibility

All full-time, part-time, temporary and student employees on the University payroll are eligible to receive Worker’s Compensation benefits sho8ld they suffer an occupational injury/illness.

3. Responsibilities

3.1. Office of Risk Management
The responsibilities of the Office of Risk Management shall be as follows:

1. Develop and manage the University’s Worker’s Compensation Program and maintain the records of the Worker’s Compensation Program.
2. Maintain records of all Worker’s Compensation claims.
3. Review claims and determine compensability of all Worker’s Compensation Claims and, where necessary, provide status reports to appropriate University departments.
4. Assist University departments with Worker’s Compensation claims processing and coordinate employee’s timely return to light or active duty.
5. Answer question and respond to inquiries regarding Worker’s Compensation Claims.
6. Review and approve for payment all medical or disability claims.
7. Provide input, where necessary, to the Department of Human Resources relative to the determination of Lost Time, ADA and FMLA.
8. Coordinate the defense of contested claims with Legal Counsel.
9. Provide such other services as may be deemed necessary.

3.2. Departments
The responsibilities of each department shall be as follows:

1. Insure that all employees within their departments are aware of the procedures for reporting a Worker’s Compensation Claim.
2. Complete the Employer Report of Accident and forward it to the Office of Risk Management within 48 hours of any accident or claim for occupational injury or illness.
3. Forward immediately all medical bills or other correspondence received from an employee, physician or medical care facility to the Office of Risk Management.
4. Notify Office of Risk Management within 24 hours when an employee returns to work, either in light-duty or full-duty capacity.
5. Cooperate with the Office of Risk Management during investigation of claims and assist in back-to-work, light-duty (limited, restricted), and vocational rehabilitation programs.
6. Notify the Office of Risk Management immediately of any accidents resulting in catastrophic injuries or death.

3.3. Supervisors
The responsibility of each supervisor shall be as follows:

1. Direct employee to first aid immediately upon notice of injury to the employee and notify Department of Public Safety.
2. Forward, within 48 hours, all reports of occupational injury of illness to department personnel responsible for filing Worker’s Compensation Claims with the Office of Risk Management.
3. Provide the employee with Employee First Report of Accident. Complete the Employer Report of Accident within 48 hours and submit it to appropriate department personnel for forwarding it to the Office of Risk Management.
4. Maintain contact with injured employees during their disability. This will provide supervisors with information regarding the employee’s progress and will reassure the employees of their importance to the University.
5. Notify designated department personnel when an injured employee returns to work.
6. Cooperate with Office of Risk Management during investigation of all claims and in implementing back-to-work or light-duty programs.
7. Notify Department Head of their designees and the Office of Risk Management immediately of any accidents resulting in catastrophic injuries or death.

3.4. Employees
The responsibility of each employee shall be as follows:

1. Report (Employee First Report of Accident) any job-related accidents or injuries to their supervisor immediately.
2. Report any suspected occupational illness or potential injury causing condition to their supervisor immediately.
3. Cooperate with Office of Risk Management during their investigation of the Worker’s Compensation Claim. Initial investigation may include giving a recorded or written statement concerning the incident. Failure to cooperate could cause a delay in determination of compensability.
4. Cooperate with Office of Risk Management during their continued handling of the claim, including supplying additional information as necessary and keeping scheduled medical evaluations.
5. Keep department head and the supervisor advised of disability status while out on lost time.
6. Cooperate with vocational rehabilitation and return work efforts.
7. Submit medical bills, or other correspondence received from physician or medical care facility to the Office of Risk Management for processing.

4. Choice of Practicioner

Where the employer has notice of an injury and its relationship to the employment, the department shall offer to the injured employee his or her choice of any physician, chiropractor, dentist, or podiatrist licensed to practice and practicing in this state for treatment of the injury. By mutual agreement, the employee may have the choice of any qualified practitioner not licensed in this State.

In case of emergency, the department may arrange for treatment without tendering a choice. After the emergency has passed, the employee shall be given his or her choice of attending practitioner at the earliest opportunity.

The employee has the right to second choice of attending practitioner on notice to the Office of Risk Management. Any further choice shall be by mutual agreement. Partners and clinics are deemed to be one practitioner. Treatment by a practitioner on referral from another practitioner is deemed to be treatment by one practitioner.

5. Recurrent Injuries

Employees, who believe that they sustained a recurrence of medical problems related to a prior occupational injury/illness, must submit written notification to the Office of Risk Management.

Departments must complete and submit the Resumption Form, which should be sent within 48 hours to the Office of Risk Management for determination of compensability.

Employees should return to the physician who treated them for their original occupational injury/illness. The physician should be requested to send a report to the Office of Risk Management outlining the cause and nature of the current medical problem.

The employee shall be notified in writing if it is determined that the problems do not appear to be related to a prior injury/illness. If it is determined that a new injury has been sustained, the procedures outlined in Section 4 shall be followed.

6. Medical and Lost Time Benefits

Medical bills are compensable under the Act for claims due to work related injury. When the injured employee receives hospital or medical bills for treatment due to a work related incident, they should send them to the Office of Risk Management. We shall forward them to the appropriate claim manager for handling and payment. Employees may instruct their physicians to directly forward bills or other correspondence to the Office of Risk Management, if the incident is work related and the claim has been reported.

Lost time benefits are also available under the law when an employee has been off work after a three-day waiting period. After seven days, the waiting period is paid and sick leave, if used, is restored (See Attachment A). Lost time benefits are calculated subject to maximum weekly benefit. In general, benefits include two-thirds of an employee’s average weekly wage based on a six-day week. Benefit levels are set by the State and are reviewed and modified every two years through an advisory council composed of representatives from organized labor, employers, insurance companies and the administrator of the State Worker’s Compensation Division. Recommendations from the council are forwarded to the State legislature and passed into law.

Lost time benefits, called temporary total disability or TTD, are paid directly to the employee. In addition, payroll may continue for a disabled support staff employee to the extent that accumulated sick leave may be applied. Payroll for disabled faculty and administrators will continue in accordance with the provisions or the short-term disability program, if available. The Payroll Office is furnished with copies of these payments and makes adjustments to subsequent payroll checks based upon the indemnity paid and advises the employee and the Human Resources Department of any sick leave that is reinstated. This coordination of payroll, sick leave and disability benefits, and workers compensation payments assures that an injured employee receives as much compensation as possible when unable to work, yet no more that what would be received, if no injury occurred. It is the supervisor’s responsibility to immediately inform the Office of Risk Management when the employee returns to duty (See Attachment A).

Failure to report an accident within 48 hours may result in a delay or denial of compensation.

7. Sick Time, Vacation and other Accrued Leave

In the case of Workers Compensation injuries to employees, it is against the Wisconsin Statue 102, Worker’s Compensation, and Administrative Code to penalize another benefit that is accrued to an injured employee. An exception to this policy for “use of vacation time” may have to be made in some select circumstances.

The first example is when an employee has accrued vacation time and is injured before the can use it providing the injury is compensable and the employee is off work on temporary total disability. While the employee is off work and collecting Worker’s Compensation benefits, their vacation cannot be taken away since they are unable to use it without losing their Worker’s Compensation benefits.

The second situation is when an injured employee is on a return-to-work program where they may work a part of day and collect remainder’s day pay from Worker’s Compensation Temporary Total Disability. They may also accrue additional vacation time for the time at work, but they cannot lose use vacation pay while on a return-to-work program without losing Worker’s Compensation benefits. To lose the accumulated vacation in these circumstances would be penalizing another employee benefit. These types of situation should occur infrequently, and hopefully can be accommodated by exception.

8. Return to Work

8.1. Full Duty

An injured employee must return to work as soon as she/he is released to duty by the treating physician. A medical release from the physician will be required of any employee returning to work. Supervisors shall not allow any employee to return to work without the proper release or prior to the release date. The supervisor will also forward a copy of the release to the Office of Risk Management and the Human Resources Department within 48 hours of the employee’s return to work.

8.2. Temporary Light Duty

Employees who are temporarily unable to return to regular duties may be placed in light-duty positions compatible with their physical restrictions. Every effort will be made to place employees in light-duty positions within their own department/division, by modification of the regular position or reassignment to another position. If there is not position available within the department/division, the Office of Risk Management will request the department and the Department of Human Resources to identify compatible positions outside the department.

Prior to placement a job description of the targeted job will be developed by the responsible supervisor based on physical restrictions as outlined in the Medical Status Report. The job description will be sent for approval by the treating physician. The employee will be notified regarding a return-to-work date. Failure to return to light-duty work, when offered, may jeopardize continued Worker’s Compensation benefits.

All placement efforts will be coordinated by the Office of Risk Management with the Department of Human Resources and the appropriate department.

8.3. Vocational Rehabilitation

If a position is not available within the University, vocational placement assistance will be provided by an independent vocational counselor, who will assist in actual job placement in compliance with the Worker’s Compensation Act.

9. Failure to Report Accident

Failure of any employee to report an accident within 24 hours may result in a denial of injury leave.

Failure to report an accident, as required by law, may jeopardize eligibility for Worker’s Compensation benefit. Supervisors should ensure that all employee occupational injuries/illnesses are reported within 48 hours after the notice is received from the employee. Supervisors should not attempt to decide whether an injury or illness is covered by Worker’s Compensation. This responsibility rests with the Office of Risk Management.

10. Claim Denials

Wisconsin Worker’s Compensation Act states that in order to be eligible for Worker’s Compensation benefits, an employee must prove that their injury or illness was caused by their employment.

If the University determines that a claim did not arise out of and was not in the course of employment, a written statement will be sent to the employee, the Department Head stating the reason for denial and appeal procedure as required by the Wisconsin Worker’s Compensation Act.

Attachment A - Lost Worday Case

The following information applies when an employee can NOT work due to a work-related injury.

Worker Compensation Payments

All medical bills, medical status reports, return to work statements, work restriction forms, etc. received by the employee or department should be forwarded to the Office of Risk Management immediately.

Marquette University pays employee wages on the day of the work-related injury as a full workday, despite time of injury.

If a treating practitioner authorizes the employee to be off work for a work-related injury:

• 3 days or less, MU will pay for those days if employee has accrued sick time.
• 5 days or more, the supervisor is required to obtain a ‘Request for Medical Leave of Absence’ form from the Human Resources Department.
• for up to seven days, the 4th through 7th day is compensated in accordance with Wisconsin Statute 102 with the first 3 days covered by any accrued sick time.
• for eight days or more, all lost work pay beginning from the day after the injury is compensated in accordance with Wisconsin Statute 102 until the employee returns to work.

Wages are compensated in accordance with Wisconsin Statute 102 at two-thirds of the injured employee’s wage at the time of injury (subject to a legislated weekly maximum). An employee may use their accrued sick time for the remaining one-third pay.

If the injured employee does NOT wish to use their accrued sick time for the remaining one-third pay by Marquette University, they must make the request in writing immediately to the Human Resources Department.

Reporting of Lost Work Days

The employee is required to present to the supervisor, a doctor’s release to work, outlining any restrictions, if applicable, that affect the employee’s ability to perform work duties. The employee’s supervisor must send the release to the Office of Risk Management and inform the offices of Risk Management and Human Resources of the date of return and the total scheduled workdays missed. If work restrictions continue, a physician’s restriction notice must be presented to the supervisor and sent to the Office of Risk Management. Similarly, when the employee is released from work restrictions, contact the Office of Risk Management and send them the restriction release.

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