Information for Supervisor/Department

As a supervisor, you are the key person who must take the kind of effective management action necessary to achieve the following:

1. Reduce Workers' Compensation claims by preventing injuries to your employees through daily safety awareness and action when hazards to your employees exist.
2. Prevent excessive costs and loss of productivity to your department, the institution, and the taxpayers of Texas by investigating injuries when they occur.
3. Report immediately through a Supervisor's First Report of Injury, the death of an employee, any injury, or occupational disease. All injury reports must be submitted immediately after the occurrence. A Supervisor's First Report of Injury is required to pay medical bills incurred due to the injury/illness. In addition, The U. T. System Office is required to report injuries with more than 1 day of loss time from work to the Texas Department of Insurance - Division of Workers’ Compensation within 8 days. Although an employee may choose to use their sick or vacation time UT is still required to report this to the Texas Department of Insurance - Division of Workers’ Compensation. Supervisor/Employer’s failure to report lost days, return to work, resignations/terminations within three (3) days of knowledge could result in fines up to $25,000.00 per day per occurrence issued by the Texas Department of Insurance –Division of Workers’ Compensation.  Fines will be passed on to the department causing the violation. Therefore, Risk Management & Insurance (RMI) must receive all First Report of Injury submissions within three calendar days.
4. Encourage the employee's return to work as soon as it is medically feasible.

Call the Workers' Compensation Advisor, at (713) 500-8127, if assistance is needed.

Supervisor's First Report of Injury - Insurance Claims

When an employee is injured on the job, the supervisor will prepare a Supervisor's First Report of Injury Report (Report) regardless if the injury does not result in lost-time. Each question on the Report should be answered thoroughly and accurately. Signing the Report acknowledges that the injury was reported and that the supervisor verified that the injury occurred on-the-job. If the legitimacy of the claim is questioned or if additional information is relevant, handwritten or typed comments (this includes any information from a supervisor, employee or witness) should be attached to the Report when it is submitted. For assistance, questions should be referred to Sondra Faul, Risk Management & Insurance ("RMI") (713-500-8127). Each time an employee reports a separate on-the-job injury or knowledge of such separate injury is made known, the information should be recorded promptly and a Report submitted to RMI.

RMI will send completed forms and bills to the U. T. System Office. Incomplete Reports may result in processing delays along with subjecting the University to the possibility of receiving a fine. **Fines will be passed on to the department.

Supervisors must remember that University policy prohibits separation and/or discrimination due to an employee who files a Workers' Compensation claim. However, an on-the-job injury does not "guarantee" a job with the University. An employee may be terminated for a number of valid reasons, including reporting of fraudulent statements concerning an injury or for other reasons, which would generally lead to discipline under stated University policy.

Medical Benefits

Injuries that occur during normal working hours (8:00 a.m. to 5:00 p.m.) may be referred to the U. T. Health Services at 6410 Fannin St, Suite 100, Houston, TX 77030 (UTPB 100) 713-500-3267, if the employee chooses. Arrangements can be made for the employee to be examined by a U. T. Health Services physician. The employee must take the indicated copy of the Report with him/her to U. T. Health Services. Injuries that occur before 8:00 a.m. and after 5:00 p.m. should be referred to Hermann Hospital Emergency Room.

Major eye injuries may be referred to Robert Cizik Eye Clinic (713-704-1777).

The injured employee may see any medical provider as long as the provider accepts workers’ compensation.  If the provider does not accept workers’ comp then the employee will be responsible for the bill unless it’s an emergency.  An employee should refer the physician to RMI (713-500-8127), for Workers' Compensation verification and billing instructions.

Employee Leave Election (Form 23) pdf

If an employee misses time the day of the injury the employee is paid in full by the department even if the employee misses time to see a doctor. When an injured employee misses any time other than the initial day of injury, an Employee Leave Election (Form 23) should be completed and signed by the injured employee and the supervisor of said employee. Starting with the next day missed, WCI will not pay for the first seven days. Form 23 must be submitted to determine if the employee has chosen to use sick leave, vacation or be docked for the first seven days. Even if the employee elects not to use paid leave in order to remain on the payroll this form must be completed and such an election should be noted on Form 23. Therefore, until the employee indicates on Form 23 that he/she wants to be paid sick/vacation time or the employee wants to be placed on workers' compensation pay, the employee will not be compensated. Every effort should be made to have Form 23 signed by the employee and the head of the department. If the employee is not able to sign the form then the employee should be contacted and the employee's decision documented on the form. It should be noted that it was approved by phone. The original should then be sent to RMI. The Employee Leave Election (Form 23) must be submitted to UT System within 7 days from the date that missed time begins or the University is subject to receiving a fine from the Texas Department of Insurance-Division of Workers’ Compensation.

Family and Medical Leave (FML)

Once an employee is placed on WCI or misses time due to a work related injury, the department needs to contact Employee Relations about placing the employee on FML. The needed forms can be obtained from Human Resources. It is the supervisor's responsibility to communicate with the department timekeeper and WCI to indicate that the employee has been placed on FML. A completed copy of the forms should be forwarded to WCI along with the dates that FML begins and ends. Once on FML the employee's state portion of the premium share will be paid by the component for 12 weeks, so when UT System figures the weekly workers' compensation check the premium share is not included. The WCI check is based on 70% of the employee's average weekly wages (not exceeding the maximum rate for current year). Thus the employee's WCI check is lower than what it would be if FML were not taken. Once FML ends the employee no longer receives the premium share. It is the supervisor's responsibility to let the employee know that his/her benefits will end when the FML exhausts. The employee should be directed to Benefits to make arrangements concerning their benefits.

If the employee is not eligible for FML this should be communicated to RMI, so that when UT System calculates the weekly workers' compensation check the premium share is added in; thus the weekly check is more.  

Weekly Compensation Benefits

An employee who sustains an on-the-job injury that prevents him/her from working may receive weekly compensation benefits equal to seventy percent (70%) of his average weekly wage, not to exceed the maximum weekly benefit for the current year. This weekly compensation benefit will begin to accrue after the first week, or after the paid leave designated for use on Form 23 is exhausted, if the latter period exceeds seven (7) days:

An employee who does not have a sufficient amount of paid leave to remain on the payroll for the seven (7) day waiting period may exhaust what paid leave time he/she has. The employee then must be placed on personal leave for the remainder of the waiting period. Weekly compensation will begin on the eighth day. The U. T. System Office in Houston makes compensation payments. All compensation checks are mailed directly to the employee using the address in Peoplesoft.

Payroll

An employee who is unable to work for one day or longer cannot remain on the payroll unless he/she uses paid leave. A supervisor must give prompt notice to Payroll to assure that the individual's regular paycheck is prepared in a timely manner.  If the employee chooses to use WCI benefits, the time report should reflect that the employee is on personal leave so that the employee will not continue to receive regular paycheck along with a check from WCI. The "General Comments" panel should reflect that the employee is off due to a WCI claim. The department must complete a PA transaction for any employee who is on a leave of absence without pay in excess of 80 hours.

Other Employee Benefits

Group Insurance programs will lapse when a disabled employee is placed on leave without pay for a full calendar month and he/she fails to make a premium payment. The employee should be reminded to contact Benefits to make arrangements to retain their insurance benefits. Premium sharing stops when an employee is on leave without pay. The only exception to this, as noted above, would be if the employee were placed on FML.

The employee should be reminded to keep his/her department advised of his/her current mailing address as all checks are mailed out by the address listed in Peoplesoft.

If the employee is out for more than ninety (90) days, he/she should be advised to contact Benefits to file a long-term disability claim, if applicable. Workers' compensation insurance weekly payments are offset against long-term disability payments.

An employee may be eligible for Social Security disability benefits if it is anticipated that he/she will be off for a year or longer. Social Security benefits offset long-term disability payments.

Contact with Disabled Employee

The supervisor should contact the injured employee frequently to determine his/her medical status. The contact enables the supervisor to learn when the employee may return to work, but also it is an expression of the University's interest and concern about the employee's health.

Attorneys

An employee may retain an attorney to represent him/her in obtaining Workers' Compensation benefits. On-the-job inspections, investigations, and other contacts from claimants' attorneys must be referred promptly to RMI.

What Happens When an Employee is Ready to Return to Work

The supervisor is responsible for ensuring that any injured employee does not return to work unless he/she has a doctor's release to return to duty. The University does have a light duty program. The arrangement for modified duty is looked at on a case-by-case basis. Please contact RMI when modified duty is requested. If an employee returns to work without any type of release, the employee should be told to obtain the release from his/her doctor.  The return to work release should be sent to RMI (via the department supervisor).  RMI will submit a copy to U. T. System. It is important that RMI is notified as soon as possible after an employee returns to work because a supplementary report must go to Texas Workers' Compensation Commission within 3 days after the employee returns. A new PA must be generated for any employee who has been on a leave of absence without pay.   Any employee whose insurance has lapsed may contact Benefits regarding their options to obtain coverage again.

If an employee is released by a doctor to return to work in a temporary modified duty capacity, you should provide the employee with a bona fide offer of employment that meets the requirements of DWC Rule 129.6 (see attached sample letter which needs to be placed on your letterhead.)   In order to be valid, the offer must comply with the rule below.

Rule 129.6 Bona Fide Offers of Employment

1. In determining whether an offer of employment is bona fide, the commission shall consider the following:
   • the expected duration of the offered position;
   • the length of time the offer was kept open;
   • the manner in which the offer was communicated to the employee;
   • the physical requirements and accommodations of the position compared to the employee's physical capabilities; and
   • the distance of the position from the employee's residence.
2. A written offer of employment which was delivered to the employee during the period for which benefits are payable shall be presumed to be a bona fide offer, if the offer clearly states the position offered, the duties of the position, that the employer is aware of and will abide the physical limitations under which the employee or his treating physician has authorized the employee to return to work, the maximum physical requirements of the job, the wage, and the location of employment.
3. Employment is "geographically accessible" to the injured employee if it is within a reasonable distance from the employee's residence unless the employee establishes through medical evidence that the employee's physical condition precludes travel of that distance. (Effective Date:   Feb 1, 1991)
   Be sure to send the written offer to the employee by certified mail, return receipt requested. Please send a copy of the letter to Risk Management & Insurance (OCB 1.330).   See HOOP 100 for more instructions.

Summary

Supervisors must file the following with Risk Management Insurance:

1. Supervisor's First Report of Injury (attach additional comments if necessary.)
2. Medical narratives and invoices (if received by your department.)
3. Employee’s Leave Election, Form 23 (if time other than the day of injury is lost, even if the employee does not plan to receive a workers' compensation check.)
4. The department must complete a PA transaction for any employee who is on a leave of absence without pay in excess of 80 hours.

In addition, supervisors should:

1. Inspect the work area regularly and report potential unsafe working conditions to the appropriate safety department. (Environmental Health & Safety)
2. In the case of an injury, arrange for the employee to obtain medical treatment at U.T. Health Service or a medical provider of their choice.
3. Keep in touch with an employee who is out due to an on-the-job injury.

Safety-Accident Prevention

The supervisor should conduct safety inspections regularly. Any unsafe condition should be reported and corrected. The following offices may be contacted to assist in inspections: 

Needle Sticks and/or Blood Borne Exposures

What the SUPERVISOR/ DEPARTMENT should do if an infectious disease exposure occurs:

1. You have freedom of choice as to which medical provider to use for medical care. Medical providers include off campus physicians or clinics. For your convenience, the UT Health Service is available for the initial visit. Because timely treatment is essential, the medical provider should be called ahead of time to be advised of your condition.
2. Advise the employee to notify the medical provider that the exposure is work related. If time permits, complete the form, SUPERVISOR'S FIRST REPORT OF INJURY, for the employee to give a copy to the medical provider.
3. All infectious disease exposure incidents must be reported. Complete the SUPERVISOR'S FIRST REPORT OF INJURY. This form is required whether or not there is lost time. Fax a copy and send the original to Risk Management & Insurance within 24 hours from the time of the injury. The fax number is 713-500-8111
4. The employee should provide his or her supervisor with a work status report (DWC 73) as soon as possible.
5. It is important that the employee follow the medical provider's instructions or treatment plan. Workers' compensation insurance may cover part of the cost of the treatment of the injury or exposure. For law enforcement officers, the cost of baseline testing will be covered only if done within 10 days of an exposure to a reportable disease. For other state employees, the cost of baseline testing will be covered only if done within 10 days of an exposure to HIV. This provision applies to baseline testing and not to follow-up testing or prophylactic treatment.
6. The unsafe condition which caused the injury should be corrected. If assistance is necessary, call the Environmental Health and Safety Office at 713-500-8100.
7. If there are any questions, contact the Workers' Compensation Advisor in Risk Management & Insurance at 713-500-8127.