Workers' Compensation - University Provided Benefits
Continuation of Benefits While on Workers' Compensation Leave
ISU benefits (sick leave, vacation, health insurance, etc) accrue normally for persons on modified duty or who are supplementing, but do not accrue when an employee elects to receive workers’ compensation payments only. These employees are considered on leave without pay (LWOP), will not accrue benefits and the date of merit review may be affected.
Payment of Regent institution's share of employee health insurance
- An employee on medical LWOP is notified by the institution's Benefit Office that the employee must pay by check for their portion of the medical insurance payment
- The Family Medical Leave Act (FMLA) requires the institution to continue paying the institution's portion of an employee's medical and dental insurance for 12 weeks following the notification of a serious health condition. (Note: An eligible employee is defined as an employee who has been employed at the institution for at least 1,250 hours over the previous 12 months (60% of time).
- State of Iowa Department of Administrative Services has an established procedure to pay an employee's medical and dental insurance for 4 months (16 weeks) after being designated on medical leave without pay. The 12 weeks of FMLA and the 16 weeks (DAS rule) are counted concurrently. (Allowing 16 weeks is designed to get the employee through the qualifying period for LTD.)
- If the employee chooses not to supplement (Election of Work Comp Only on the P-28 form), they will have 16 weeks’ total time for the institution to pay the institution share of medical/dental insurance.
- If the employee is supplementing, the institution's share of medical insurance is paid until they run out of vacation or sick leave. At that point the employee is allowed to start the 16 weeks.
Family Medical Leave
The Family Medical Leave Act requires ISU to continue paying the university's portion of an employee's medical and dental insurance for 3 months (12) weeks following the notification of a serious health condition.
When an employee misses more than three (3) consecutive work days whether work-related or not the department should notify the employee of FMLA rights. Questions concerning FMLA should be directed to Employee/Labor Relations Office of University Human Resources at 515-294-8917
A physician signed Work Status Report will serve in place of FMLA Medical Certification. Departments are to accept the Work Status Report as verification of need for absence when the work related injury does not permit the employee to work and the absence is an FMLA event. The intended duration of the absence will coincide with the next medical appointment as indicated on the Work Status Report.
In some cases, an employee may re-qualify for FMLA (12 weeks per calendar year, etc.) if the FMLA count goes into a new FMLA year.
Long Term Disability
Long term disability status may be approved after 90 days of continuous sickness or accident disability or the expiration of accrued sick leave, whichever is later. However, employees do not have to wait until all vacation and sick leave has been exhausted to apply for long term disability. Departments can assist employees with this process by either notifying University Human Resources directly when an employee has been on any medical leave for one month. This action will allow the Office of University Human Resources/Benefits Office to provide the employee with an application for long term disability in a timely manner.
Coordination of Benefits
It is important for departments to notify employees with workers’ compensation injuries that qualify as a serious health condition of their FMLA rights. In some cases, an employee's benefits under FMLA may be exhausted before the benefits required by the State.
Employees do not have to wait until all vacation and sick leave has been exhausted to apply for long term disability. Departments can assist employees with this process by either notifying University Human Resources/Benefits directly when an employee has been on any medical leave for one month or process an EPA to communicate this information to Benefits. This action will allow the University Human Resources/Benefits to provide the employee with an application for long term disability in a timely manner.
Medical Leave Without Pay
- After the first 90 day medical LWOP, the employer cannot unreasonably deny an extension, but is not obligated to extend LWOP.
- Union contract rules currently state that the maximum amount of time an employee can remain on medical LWOP per AFSCME contract is 1 year. Separation may occur at that time for employees under contract.
- The AFSCME contract does limit LWOP to 1 year total, but there could be circumstances where additional unpaid leave could be granted, even though the contract doesn't specifically provide for it. The contract provides the minimum, but management reserves the right to go beyond if they want to. In any case, it would be rare not to know the return to work status in a year.
- A notification letter must be sent to employees when they are close to running out of sick leave so that they may request LWOP. Failure to do so may delay the counting of the 90 days.
- In some cases an employee may re-qualify for FMLA (12 weeks per calendar year, etc.) if the FMLA count goes into a new FMLA year.
Payment of ISU's share of Employee Health Plan Insurance
State workers' compensation law requires ISU to continue paying the university's portion of an employee's medical and dental insurance for 4 months (16 weeks) after being placed on medical leave without pay.