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Regulations & Policies

Human Resources

I. OBJECTIVE & PURPOSE 

The purpose of this Policy is to explain how employees injured on the job can obtain quick and efficient disability and medical benefits and return to gainful reemployment as soon as medically possible through the State of Florida Workers’ Compensation program. 

This Policy is a general overview of Florida’s Workers’ Compensation program and describes the processes employees must use for reporting injuries and making a Workers’ Compensation claim.  This Policy should not be interpreted as providing different qualifications or benefits than those provided under Florida Statutes Chapter 440. To the extent there is a conflict between this Policy and Florida law, Florida law controls. In addition, this Policy is intended to complement applicable collective bargaining agreements; however, to the extent this Policy conflicts with the terms of an applicable collective bargaining agreement, that agreement’s terms will control so long as it is consistent with Florida law.

II. STATEMENT OF POLICY

1. ³ÉÈË´óƬ Workers' Compensation

   1.  Workers’ Compensation is a form of insurance coverage that includes payment for medical care, permanent impairment, and lost wages that result from an illness or injury incurred while in the course and scope of employment. All ³ÉÈË´óƬemployees are covered by this insurance from their first day of employment.
   2. Individuals injured on the job may also have rights under other University policies.  For example, employees eligible to take FMLA leave will have FMLA leave run concurrently with Workers’ Compensation absences. To inquire about other benefits and leaves that may be available in a particular situation, please contact Human Resources at (904) 620-2903.

2. Covered Accidental Injuries and Occupational Diseases

   1. Workers’ Compensation provides coverage for accidental injuries and occupational diseases arising out of and in the course and scope of employment. This includes diseases or infections resulting from such injuries.
   2. Workers’ Compensation covers death resulting from such injuries within specified periods of time

3. Certain Injuries Are Not Covered 

   Not all injuries are covered by Workers’ Compensation.  The following list provides some examples of injuries that would not qualify for Workers’ Compensation:

   1. The injury is caused by the employee's willful intention to injure or kill themselves or another.

   2.  The injury is caused primarily because the employee is intoxicated or under the influence of drugs.

   3. The injury occurs outside the course and scope of employment.

4. Duty to Report

   1. The injured employee has the primary responsibility for promptly reporting an injury.  The employee should notify their supervisor as soon as possible. Once it is safe to do so, the employee and supervisor should also report the injury to the University’s Workers’ Compensation administrator, Amerisys, at (800) 455-2079. If the employee does not report the injury within thirty (30) days, it may result in the denial of the Workers’ Compensation claim.
   2. If the supervisor learns that an employee has suffered a work-related injury or death, the supervisor must immediately report the injury to the University’s Workers’ Compensation Coordinator at benefits.retirement@unf.edu, but in no case later than twenty-four (24) hours from the time of knowledge of the injury or death.
   3. If the injury is serious and needs medical attention, call 911 immediately.
   4. Amerisys will assist with completing the First Report of Injury or Illness, also known as Form DWC-1. This report should be completed within seven (7) days of the first knowledge of the injury or occupational disease.
   5. In addition, the supervisor must submit the online accident and investigation form from the University’s Department of Health and Safety  (“EH&S”) within seven (7) days.
   6. Even if the employee or supervisor does not think an injury is covered, they must still report it to Amerisys and EH&S.
   7. For detailed instructions, please visit /hr/workers-compensation.html

5. Lost Income and Permanent Impairment Payments

   For the lost income benefits described below, at the employee’s option, the University allows employees to use accrued, unused paid leave to bring their pay up to full pay.

   1.  Temporary Total Disability

      If the employee cannot work at all, they may receive the following benefits:

      1. Payment of 66 2/3% of their regular wages to help replace lost income. The employee's benefit is paid to them beginning with the eighth day they lose time from work. 

      2. The University provides up to 40 hours of paid leave to bridge the first seven days waiting period before wage replacement benefits begin to be paid.

      3.  If the employee's injury is critical, they may receive 80% of their regular wages for up to six months after the accident.

      4. The employee can receive up to a total of 104 weeks of temporary total disability and/or temporary partial disability benefits. The State of Florida will charge the University for the first ten (10) weeks, which charge will then be passed to the applicable University department’s salary/benefits budget.

   2.  Temporary Partial Disability

      If the employee can return to work, but they cannot earn the same wages they earned at the time they were hurt, they may receive the following:

      1. The employee will receive money equaling 80% of the difference between 80% of what they earned before their injury and what they can earn after their injury.

      2.  The employee can receive up to a total of 104 weeks of temporary total disability and/or temporary partial disability.

   3.  Impairment Benefits

      1. The employee's physician may determine that the employee is at Maximum Medical Improvement, which means in the Doctor’s opinion, the employee’s health has improved as much as the physician expects them to improve.

      2.  At this point, the employee's authorized physician should evaluate them for possible permanent work restrictions and address a permanent impairment rating. If the employee receives a permanent impairment rating, they may be entitled to receive impairment benefits per Florida Statutes.

III. ROLES AND RESPONSIBILITIES

1. Injured Employee

   An injured employee must complete the reporting requirements set forth in Section II.D, above. In addition, the injured worker should also be aware of the following:

   1.  If it is a non-emergency, the employee should not go on their own to their private doctor for treatment or they may jeopardize Workers’ Compensation benefits. Amerisys must authorize the physician who is to treat them.

   2. The employee has the obligation to cooperate and speak with the Amerisys Workers’ Compensation adjuster assigned to their case as soon as possible.  Employees have the right to consult with their own attorney or advisor at any point in the Workers Compensation process, including before speaking with an adjuster or completing paperwork.  Failure to timely complete paperwork or respond to inquiries, however, may impact eligibility for benefits.

   3.  Once the employee receives the Workers’ Compensation claims packet, it is their responsibility to:

      1. Review their accident report or First Report of Injury or Illness (DWC-1) form to make sure the information is correct.

      2. Read, sign, and return the "Fraud Statement" as soon as possible, or benefits may be temporarily withheld until the employee does so.

      3.  If the employee chooses to sign the "Release of Medical Records" form, they must return it to the Florida Division of Workers’ Compensation (“DWC”) at the packet's provided address.  DWC is a separate State agency apart from the University.

      4. Complete the "Medical Mileage Reimbursement" forms after seeking medical treatment and send them to the claims adjuster if the employee wants to be reimbursed for travel.

   4.  When the employee visits with the Workers’ Compensation treating physician, they must:

      1.  Give a complete description of the accident or how they were injured.

      2. Answer all questions the physician may have about any past or current medical conditions or injuries.

      3.  Discuss with the physician if the injury is related to work or not. If related to work, find out if they can continue working.

      4. The employee must keep and attend all appointments with the authorized treating physician or benefits may be suspended.

      5.  The employee is responsible for coordinating treatment with the AmeriSys' nurse case manager.

      6.  The employee is responsible for communicating their work status regularly with the ³ÉÈË´óƬWorkers’ Compensation Coordinator.

2. Supervisor

1. Notify the Workers’ Compensation Coordinator as soon as possible at benefits.retirement@unf.edu or (904) 620-2903. 
2. Ensure attendance and leave are recorded on the employee's timesheet, where appropriate.

IV. PROTECTIONS AGAINST DISCRIMINATION AND RETALIATION

It is a violation of this Policy to discriminate or retaliate against another employee due to their exercise of rights under Workers’ Compensation. To report a concern regarding alleged discrimination or retaliation, please contact the Office of Equal Opportunity and Inclusion by phone at (904) 620-2507 or email eoi@unf.edu.

Authority: Florida Statutes Chapter 440.

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