Meet with the employee to discuss the claim of injury/illness and appropriately complete the First Report of Injury form using the HR Self Service website. You must submit this document within 24 hours of the reported injury to Workers' Compensation in UI Benefits.
Direct the employee (and assist as needed) to obtain medical care from an approved provider.
Remind the employee to seek subsequent medical care related to this injury from an approved provider. All medical care (i.e., recheck appointments) related to this workers' compensation claim will be directed by approved providers as authorized by Sedgwick CMS.
Review with the employee information on the Patient Status Report (PSR) related to the indicated medical diagnosis, treatment plan, recommended physical restrictions, and next medical appointment date/time. This should take place within 24 hours of each medical appointment.
Review information on the current PSR with the employee to confirm indicated restrictions/capabilities and discuss the availability of appropriate temporary work.
Discuss appropriate work assignments and work schedule with the employee while considering indicated restrictions/capabilities.
Document restricted duty work assignment offers, and employee responses, in writing by email or written hard copy. The employee must respond within 24 hours of notification. If the employee does not respond within 24 hours, send a reminder e-mail. If the employee still does not respond within the next 24 hours, notify University Benefits.
Allow employee to work only when an updated PSR is provided following each medical appointment.You may discipline the employee for failure to provide the updated PSR from the authorized medical provider.
Complete the Missed Time Weekly Report and submit it weekly by 5:00 pm Monday to University Benefits.
Verify that the employee is placed on a leave of absence if they are missing time and choose not to supplement workers' compensation benefits with accrued leave.
Review the circumstances of the injury to determine if the provisions of the Family and Medical Leave Act (FMLA) apply. The provisions of the FMLA may apply in situations where workers' compensation missed time benefits are also involved.
Report knowledge of any irregularities to extenuating circumstances in the claim to the Sedgwick CMS representative in order to assist in the processing and investigation of the claim.
Yes. Make sure all relevant details are included in the report.
Any time there is an on-the-job injury, a report must be filed.
You should explain the employee responsibilities, in person, as well as direct the employee to the Employee section of this web site.
First Report of Injury Form – To be completed by the employee/supervisor on the Employee Self Service site under General Systems & Tools within 24 hours of report of injury. Submitted by the University to appropriate parties documenting the work injury.
Missed Time Weekly Report – To be completed by designated departmental staff if employee has missed work hours or is on restricted work hours. If employee will be missing at least a full day of work, the supervisor must notify Benefits within 24 hours of first absence, then weekly thereafter using the Missed Time Weekly Report. Form should be completed on the Employee Self Service site under General Systems & Tools/Workers’ Compensation. This information must be submitted to UI Benefits by 5 PM each Monday.
Restricted Work Assignment Form (pdf) - If necessary, to be completed by designated departmental staff and employee. Information outlines the restricted work assignment due to work-related illness/injury.
No Restricted Work Available Form (pdf) – If necessary, to be completed by department outlining that accommodations for current restrictions not available.
Under workers' compensation law, the employer is required to provide workers' compensation benefits to qualifying conditions. Please file a first report of injury on the Employee Self Service site. The next step is to be sure the employee makes an appointment with UI Occupational Health in Coralville. If the employee has medical documentation regarding the injury, please have the employee bring with them to their appointment. Once the employee has been seen, they are to provide you a copy of the Patient Status Report within one work day.
It can. FMLA leave and workers' compensation leave can run together, provided the reason for the absence is due to a qualifying serious illness or injury and the employer properly notifies the employee in writing that the leave will be counted as FMLA leave.
When an employee does not work due to a work related injury, the full workday is designated FMLA. When an employee works partial days, only the hours not worked are counted. Departments should use Code 56 FMLA Workers Comp to designate the absence as work-related FMLA.
An employee is eligible to transfer to another department or position while on temporary restricted work due to a work related injury if the following applies:
- the employee must be responsible for informing the other department of any temporary restrictions in place related to a work injury
- the hiring department must be able to accommodates the temporary work restriction in place at the time of the transfer