Work Related Disability (Workers’ Compensation)
If the disability is work-related, read this section.
If the disability is not work-related, see the section on Non-work Related Disability.
Definition
Workers' Compensation is a group of insurance benefits provided to employees who become injured or ill as a result of their work.
The Disability Management Services unit of Human Resources manages the Workers' Compensation Program at UCSF. The University utilizes an outside company, Sedgwick CMS, to administer the benefits.
State law prohibits employers from discriminating in any manner against employees who become injured or ill as a result of their work.
Application
Workers' Compensation is a "no-fault" system. Eligibility for benefits is not affected by fault or negligence on the part of the employee or the employer.
To be eligible for Workers' Compensation benefits at UCSF, one must:
- Be a UCSF employee;
- Sustain injury or illness within the course and scope of UCSF employment;
- Have the claim accepted by Sedgwick CMS.
Workers' Compensation benefits run concurrently with the 12 weeks of FMLA.
Workers' Compensation benefits only partially replace lost wages. The University's Personnel Policies and Contract Provisions permit an employee to supplement Workers' Compensation payments with University paid leave.
If the employee elects to use paid leave to supplement the Workers' Compensation payments made by Sedgwick CMS, then the employee's department pays the employee:
Sick Leave (at a reduced rate, until exhausted),
Vacation Leave (at a reduced rate, until exhausted),
Extended Sick Leave (up to a maximum of 26 weeks).
The department pays Sick Leave and Vacation Leave at a reduced rate, because only just enough is used to supplement the Workers' Compensation payments made by Sedgwick CMS.
If these UC paid leaves become exhausted, and the employee is still receiving Workers' Compensation payments from Sedgwick CMS, and the employee is enrolled in the University's Supplemental Disability Insurance Plan, then the employee may be entitled to further supplemental payments from Liberty Mutual up to an additional 52 weeks.
In addition, if the UC paid leaves become exhausted, and the employee is still receiving Workers' Compensation payments from Sedgwick CMS, then the employee's department makes monthly arrangements for the University to pay the full cost of the employee's Medical insurance premium (but not the Optical premium, nor the Dental premium). The Medical premium is paid by the UC Contingency Fund.
Supervisor's Checklist
- Keep a safe work-environment.
- Make "Safety" a standing agenda item at every staff meeting.
- Strive to prevent injury.
- If injury occurs, strive to prevent disability.
- Provide transitional work to prevent or minimize temporary disability.
- Provide job accommodation to prevent or minimize permanent disability.
What to Do If an Injury Occurs
For greater detail, click here
- Refer the employee to UCSF's designated medical provider.
- Emergency: Nearest Emergency Facility (call ambulance if necessary)
- Non-Emergency: Employee Health Services (415) 885-7580
- Remove, tag, and store any broken equipment that caused injury.
- Call Environmental Health & Safety for inspection (415) 476-1300.
- Complete the Supervisor Report of Employee Injury (SRI) form, and
report the injury within 24 hours:
- CAMPUS Employees: Fax SRI to DMS at (415) 476-2328.
- MED CENTER Employees: Fax SRI to Employee Health Service at (415) 771-4472.
The SRI form is available online.
If the Employee Loses Time from Work
- Initiate the Workers' Compensation Payroll Procedures.
- Send FMLA materials to the employee, if the employee meets the eligibility criteria.
- Provide transitional work.
- Provide reasonable accommodation.