Sedgwick CMS is the Workers’ Compensation Administrator for The University of Iowa.  Sedgwick is responsible for investigating, determining compensability, and performing various functions related to handling of the claim.  This includes authorization of medical care providers and issuing benefits to employees based on lost work time and permanent impairment related to the covered injury/claim as required by Iowa Workers’ Compensation Law. The Senior HR Specialists in the Benefits Office work closely with Sedgwick in the day to day case management of workers’ compensation claims.

Injury Occurs

Notify supervisor/complete First Report of Injury (FROI) on Self Service website and submit to the Benefits Office within 24 hours.  Department will also conduct a safety investigation, if appropriate. For severe injuries, contact wc@uiowa.edu immediately for all fatalities, in-patient hospitalizations, amputations, and loss of an eye. 

Step 1. Complete First Report of Injury (FROI)

Complete First Report of Injury form on Self Service website and submit to the Benefits Office within 24 hours.

Step 2. Depending on the type and severity of the injury, one of the following pathways will be used:

• No Medical or Lost Time

Injury/Illness was minor, no care or follow-up care is required, employee returns to work.

OR

• Medical Only/Care Directed to Provider

Injury/Illness resulted in the need for medical attention. Employee should be directed to UI Occupational Health. If true emergency and/or injury/illness takes place outside of business hours, M-F, (8a-5p), employee should be directed to the Emergency Treatment Center.

Back to Work (may or may not have restrictions)

Employee returns after medical appointment with a PSR. Supervisor and employee review the information on the PSR. If restrictions are given, discuss appropriate work assignments/schedules while considering indicated restrictions and capabilities. Document restricted work offer, and employee response.

OR

• Medical and Lost Time/Care Directed to Provider

Injury/Illness resulted in the need for medical attention. Employee should be directed to UI Occupational Health. If true emergency and injury/illness takes place outside of business hours, M-F, (8a-5p), employee should be directed to the Emergency Treatment Center.

Restricted and/or Missing Time

Employee returns with a PSR. PSR indicates restrictions or no return to work. Department cannot accommodate restrictions and employee is taken off work.

Missed Time and Pay

By law, missed time benefits begin after a waiting period of 3 calendar days of absence. If your employee misses work for more than 14 calendar days, missed time benefits will also be paid for the 3 day waiting period.

Missed time benefits typically represent approximately 2/3 of the employee’s pay. This check will be mailed directly to the employee’s home address from Sedgwick. These benefits are received only during the healing period or when the department is unable to accommodate restrictions and provide restricted work. If the employee is able to work a full shift of “restricted duty” during the healing period, he/she will receive their full salary instead of workers’ compensation missed time benefits.

Employees may elect to supplement workers’ compensation missed time benefits with accrued leave. The combination of workers’ compensation benefits and accrued leave should approximate the employee’s regular weekly salary. Receipt of the first missed time benefits check from workers' compensation is dependent on the completion time of the Sedgwick CMS investigation.  Once a claim is approved, missed time is paid weekly. 

Back to Work (may or may not have restrictions)

Employee returns after medical appointment with a PSR. Supervisor and employee review the information on the PSR. If restrictions are given, discuss appropriate work assignments/schedules while considering indicated restrictions and capabilities. Document restricted work offer, and employee response.

Refusal to accept return to work offer may result in suspension of workers' compensation benefits and require use of personal leave accruals.