Quick Facts Concerning Paperwork for

Workers Compensation and Related Employee Personnel Action Processes

1.      First Report of Injury

All accidents and injuries occurring at work or in the course of employment with Iowa State University (inculding students who are injured while employed by ISU) must be reported to the employee's supervisor as soon as possible, even if no medical attention is required. Supervisors or the injured employee will need to log into AccessPlus, go to the Employee's Tab, select Work Injury, and then select Continue to view the FROI home page. After completing the FROI, the Supervisor must send the report electronically to the Workers Compensation Office. If the employee completes the FROI, it must be reviewed and submitted by the Supervisor.

2.      PIQ, Essential Functions and Accident Report

When arranging an initial appointment for an employee with a work place injury specific to repetitive motion, back injuries or strains and sprains at Occupational Medicine, give the employee a copy of the position description (PIQ/PDQ and/or the Essential Functions document) and instruct him/her to take this to the appointment and give to the treating physician. If you do not have a position description (PIQ/PDQ) available for the initial appointment you will need to follow-up and provide it by mail or fax (515-239-4767) to Occupational Medicine as soon as possible. Accident reports should also be provided to the physician when appropriate.

3.      Forms Specific to Workers Compensation

§         Benefit Election P-28 form.   After an employee has missed three calendar days, the supervisor mails or gives a copy to the employee of the letter referencing supplemental workers compensation benefits along with the Benefit Election P-28 form and requests that the form be completed and returned to the Workers' Compensation office as soon as possible. The P-28 form is available on the HRS/Workers Compensation website at http://www.hrs.iastate.edu/workerscomp/benefit_election.shtml.

§         Mileage and Prescriptions Expense Reimbursement form.  This is provided to the employee for reimbursement of expenses related to the injury or illness specified on the First Report of Injury. This form is available on the HRS/Workers Compensation website. http://www.hrs.iastate.edu/workerscomp/mil_reimb.shtml.

§         Work Status Report.   Employees with work-related injuries must provide their supervisor with a Work Status Report completed/signed by the treating physician within 1 business day of each medical appointment. Supervisors have a responsibility to review this document and consider all restrictions given by the physician when assigning work to the employee. Whenever possible, reasonable accommodations will be implemented to assist the employee in a timely and appropriate return to work. Supervisors must forward copies of all Work Status Reports to the Workers Compensation Office as quickly as possible.

§         Return to Work/Transitional Employment.  When a department is accommodating multiple restrictions for an employee, a Transitional Employment Plan is prepared and reviewed by the medical provider. This document clarifies indicated medical restrictions/limitation, reasonable accommodations, etc. and identifies the duration of these temporary arrangements. Transitional employment assignments are temporary (short term until maximum healing is reached) and are not permanent. This is available on the HRS/Workers Compensation website at http://www.hrs.iastate.edu/workerscomp/workplan.shtml.

§         Lost and Restricted Time Report - Lost and restricted time must be reported for each employee that has missed work or been restricted from performing regular duties due to a work related injury or illness. The Lost and Restricted Time form is completed electronically via Access Plus and submitted to the Workers' Compensation office each week (by 5:00pm Monday for the preceding week) for the duration of the recovery.

4.      Payroll for employee’s missing time due to a work-related injury:

A percentage of an employee’s weekly earnings will be paid as long as the employee’s claim has been accepted as work-related, the injury results in more than 3 calendar days missed and the time missed is for:

§         the occupational medicine physician places the employee off work

§         work restrictions from the physician cannot be accommodated on the job

Injured employees who are unable to work in any capacity (full or partial work days) are entitled to approximately 2/3 of their normal salary. However, employees may elect to supplement (Benefit Election P-28 form) with their university benefits in order to receive a full paycheck.

Recording lost or restricted work hours for employees with a work related injury:

·        Injured/ill employee is paid by ISU a full day of pay on the day of injury (regardless of what time they leave work) and no vacation or sick leave is used.

·        Date of injury is not counted as part of the 3-day waiting period.

·        The definition of the 3-day waiting period is "3 calendar days of full or partial incapacity" (Iowa Code 85.27).  Time missed must be physician directed for the employee as follows:

o        may not return to work

o        off work a portion of the day, along with work with specific restrictions for work duties for a portion of the day

o       restricted length of work time

Employee Personnel Action Form (EPA).  All of the personnel actions listed below should be done according to the employee’s pay status, i.e. every two weeks or on a monthly basis.  An election form P-28 should be completed by the employee indicating:

·                    Employee chooses to receive a check from workers compensation only.  Department should process a medical LWOP for the entire time period the employee is gone.

·                    Employee chooses to supplement with their vacation or sick leave. The adjusted sick leave amount will appear in a routed EPA from the Worker's Compensation Office and will document workers compensation payment for the employee. The department follows-up with a corrected leave form when the employee has been gone more than 14 days. At that point workers compensation will reimburse the employee for the first 3 calendar days absent. Those days should then reflect use of an adjusted rate instead of a whole day of vacation and sick leave use. (EPA Type of Action: W)

·                    Employee comes back to restricted duty, but not for a full day and supplements.  The adjusted sick leave amount will appear in a routed EPA from Workers' Compensation and the department will modify the amount based on actual time worked.

5.  Reporting Vacation/Sick Leave Use/Accrual:

Does an employee have to use personal leave for time missed due to work-related illness or injury?

The 3-day waiting period is credited back only if the disability exceeds 14 calendar days; after 14 days the sick leave or vacation time used during the first 3 days should be credited back. 

(Note:  When crediting back, if the employee is supplementing, the first three days should then reflect use of an adjusted rate instead of a whole day of vacation and sick leave use.)

Payroll supplementing (Benefit Election form P-28): 

·        When an employee elects to supplement or use their sick leave or vacation to make their pay "whole",  they must supplement until benefits that were elected to be used (i.e. sick leave and/or vacation) are exhausted; however, if an employee elects workers compensation only, they may choose to supplement later.

·        When an employee elects to supplement, Workers' Compensation will calculate the adjusted rate of vacation or sick leave to be used per day.  The adjusted rate for vacation and sick leave for employees supplementing may change as their rate of pay from the institution is changed (i.e. each FY, merit increases, etc.)

Benefit Accrual:

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 compensation payments only.  These employees are considered on leave without pay, will not accrue benefits and the date of merit review may be affected.

6.  Time off for medical appointments policy.  The State of Iowa Department of Administrative Services (DAS) establishes the state’s policy on use of leave. The Attorney Generals' office provides interprets the law and advices as to whether DAS policy meets the minimum requirement of the code. The following rules apply:

If an employee is required to miss work to attend physician appointments due to a work related injury/illness (that cannot be scheduled outside his/her normal work schedule) the employee is to be paid by ISU as if he/she were working. Personal leave is not charged/used.

Physician appointments include appointments for physical therapy.

·        Any day of full or partial incapacity from work will count as a day of waiting period. Hours away from work are not added together toward the waiting period.

·        Time off for a medical appointment on the day of injury should not be charged to either sick leave or vacation, but will be paid by ISU as if the time was worked.

7.   Notification of FMLA (Family Medical Leave Act)

When an employee starts missing time for an injury or illness,  the employee must be notified of their FMLA rights.  If you have further questions concerning FMLA, contact the Benefits Office in the Department of Human Resources at 294-7680. (A form is available at the HR website to track time taken for FMLA)

8.  Medical LWOP

·        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 if 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.

9.  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.