State of Florida DEP 450 Department of Environmental Protection Effective: September 8, 2011 WORKERS COMPENSATION AND RETURN-TO-WORK PROGRAM

Transcription

1 State of Florida DEP 450 Department of Environmental Protection Effective: Administrative Directive Approved by the Secretary WORKERS COMPENSATION AND RETURN-TO-WORK PROGRAM 1. Purpose The purpose of this directive is to establish procedures for administering Workers Compensation, disability leave, and return-to-work guidelines for employees and volunteers of the Department of Environmental Protection (Department) for workrelated injury or illness in accordance with state laws and rules. The State of Florida as an employer is self-insured for Workers Compensation insurance coverage. The program is administered by the Department of Financial Services, Division of Risk Management. The Division of Risk Management is the "insurance carrier" for the purpose of paying benefits and fulfilling the state's obligation to provide Workers Compensation insurance to its employees. 2. Authority 3. Policy Chapters 284 and 440, Florida Statutes (F.S.), Sections and (2)(b)2, F.S. and Rules 60L and 69H-2.007, Florida Administrative Code (F.A.C.) a. All Department employees, Career Service, Selected Exempt Service, Senior Management Service, Other Personnel Services (OPS) and volunteers are covered for Workers' Compensation. Coverage is not extended to contracted employees, independent contractors or vendors who provide services to the Department. b. Employees and volunteers have the responsibility to immediately report a work-related injury to their direct supervisor. As soon as they are notified, supervisors are required to report the injury to the managed care provider contracted by the Division of Risk Management. In a medical emergency, the injured employee or volunteer should be taken to the nearest medical facility or 911 should be called to summon an ambulance to transport the employee. Otherwise, medical care must be arranged and authorized through the managed care provider prior to sending the employee or volunteer for care. c. Employees and volunteers shall familiarize themselves with requirements

2 Page 2 of 22 and procedures to follow in the event they are unable to return to work due to a work-related injury. This includes updating their immediate supervisor regarding the employee s medical status following each medical visit. d. For employees who sustain a workplace injury, the Return-to-Work Program provides modified duty and alternate duty assignments that accommodate the functional restrictions and limitations as determined by the authorized treating physician in order to bring the employee back to work as quickly as medically possible. 4. Definitions a. Accident. An unexpected or unusual event or result that happens suddenly. It does not include a mental or nervous injury due to stress, fright or excitement exclusively. The term accident also does not include a disease that expresses itself in the fear or dislike of an individual because of the individual s race, color, religion, sex, national origin, age or handicap. b. Adjuster. Division of Risk Management employee with overall responsibility for the handling of Workers Compensation claim files including coordinating lost-time benefits when an injured person is unable to work and an employer resource for questions and issue resolution. c. Agency Location Codes. Four digit numeric identifiers for each division, district and other specific offices. d. Alternate Duty. Temporary duties established away from the employee s regular work area/responsibilities and within the functional limitations and restrictions stated on the Florida Workers Compensation Uniform Medical Treatment/Status Reporting Form, DFS-F5-DWC-25. Alternate duty is evaluated with each subsequent physician visit when functional restrictions are updated. e. Authorized Treating Physician. A physician authorized by a nurse case manager or adjuster to provide medically necessary treatment to an employee who sustains a job-related injury. f. Compensation Benefits and Indemnity Benefits. Money paid to an injured employee for part of lost wages if the injury or illness disables the employee for more than seven calendar days and the employee is unable to earn the

3 Page 3 of 22 same wages in the same or any other job as the employee earned at the time of the injury. g. Director. A deputy secretary, division or regulatory district director or any member of senior management in a position with a comparable level of responsibility. h. Disability (due to a work-related injury or illness). The inability of an employee to earn the same wages in the same or any other job as the employee was earning at the time of injury. The different types of disability benefits are temporary total disability benefits, temporary partial disability benefits, permanent impairment benefits, wage loss benefits, impairment income benefits, permanent total disability benefits and death benefits. i. Disability Leave. Refers to leave taken by a Career Service, Selected Exempt Service or Senior Management Service employee who sustains a job-connected injury or illness that is compensable under Chapter 440, F.S. j. First Report of Injury or Illness Form, DFS-F2-DWC-1. The Division of Workers Compensation form used to report a worker-related injury or death. k. Functional Limitations and Restrictions. Identification of the employee s ability or lack of ability to perform stated activities and the degree to which these activities may be performed. Functional limitations and restrictions as documented on the DWC-25 form are identified by the authorized treating physician based upon objective relevant medical findings. Consideration shall be given to upgrading or removing the functional limitations or restrictions with each employee exam, based upon the presence or absence of objective relevant medical findings. l. Injured Worker or Employee. An employee who sustains a job-related injury or illness, and who has the responsibility of meeting all scheduled medical appointments and returning to work following each appointment, except when the authorized treating physician provides a medical diagnosis that prevents the employee from returning to work as documented on the DWC-25 form.

4 Page 4 of 22 m. Injury. Personal injury or death by accident arising out of and in the course of employment and disease or infection that naturally or unavoidably result from such injury. n. Light Duty. Modification of an employee's regular duties required by physical restrictions to include a portion of the employee's regular duties, part-time or other modifications involving the work site or equipment. o. Loss Control Committee. A committee that reviews and acts on lost time claims, monitoring medical and indemnity payments issued. The committee meets regularly to determine if employees are able to return to work and perform the regular, modified or alternate duty assignments that accommodate the functional restrictions and limitations as determined by the authorized treating physician in order to bring the employee back to work as quickly as medically possible. This committee consists of the Department s Workers Compensation Coordinator, the Safety Officer, and Division of Administrative Services, Program Administrator Agency-wide Programs. p. Maximum Medical Improvement (MMI). The date when an injured employee is no longer in the process of recovery and will not medically improve any further. q. Medical Case Management Provider. The vendor selected by the Division of Risk Management responsible for receiving reports of work-related injury or illness, producing the First Report of Injury, Form DFS-F2-DWC- 1, arranging for and scheduling appointments for medical treatment and coordinating the prescription drug program. The current Medical Case Management Provider can be found at r. Medical Emergency. Conditions which are severe enough that the lack of immediate medical attention would result in the patient s life or health being in serious jeopardy; vital bodily functions being seriously impaired; and/or serious and permanent dysfunction of a bodily organ or part. s. Modified Duty. Temporary duties established within the employee s regular position and within the functional limitations and restrictions as reflected on the DWC-25 form. Modified duty is evaluated with each subsequent visit to an authorized treating physician when functional restrictions and limitations are updated.

5 Page 5 of 22 t. Nurse Case Manager. Registered Nurse(s) or Licensed Practical Nurse(s) employed by the Medical Case Management Provider who coordinate the injured worker s related medical care. The Nurse Case Manager will schedule and authorize all necessary physicians appointments, answer medical related questions and assist an injured worker in staying at work or in some cases, returning to work after treatment/care. u. Permanent Impairment Rating. Any anatomic or functional abnormality or loss which results from the injury, determined as a percentage of the body as a whole that exists after the date of maximum medical improvement. v. Program Administrator Agency-wide Programs. Responsible for managing the DEP Workers Compensation Program and promoting the Return-to- Work Program by analyzing claims/costs and providing regular reports to leadership; in consultation with the Safety Officer, reviewing outcomes and recommending improvements to reduce claims. w. Return-to-Work Employee Notification Letter. An acknowledgement between the employee, applicable supervisor and Workers Compensation Coordinator that provides for the specific standard alternate/modified duty tasks within the limitations and restrictions established on the DWC-25 form; provides time frames for execution and completion of the program; delineates the roles of all persons involved with the program; makes clear to the employee that he or she must actively participate in the program, perform all duties assigned, keep all clinician appointments as scheduled and that failure to comply may result in termination from the program and appropriate agency action. x. Return-to-Work Program. The Return-to-Work Program will provide modified duty and alternate duty assignments that accommodate the functional restrictions and limitations as determined by an authorized treating physician, and will bring the employee back to work as quickly as medically possible. y. Safety Officer. Responsible for the development, implementation and administration of the Department's Safety and Loss Control Management Program. Loss control management involves prevention, reduction and control of occupational injury and illness, property damage (including fire and explosion), security breaches (thefts), liability (auto, general, civil rights and Workers Compensation), exposures (heat, noise, chemicals and

6 Page 6 of 22 hazardous materials) and recognition and elimination of hazards through safety awareness. z. Safety Program Manager. Appointed by the division/district director, the Safety Program Manager is responsible for assisting management in establishing and maintaining a healthy and safe working environment and providing management with the information, advice, and assistance needed to formulate the Division/District/Office Health and Safety policies, directives, procedures and standards. aa. bb. cc. dd. ee. ff. gg. Temporary Partial Disability. A partial disability that is temporary in duration and allows the employee to work in a limited capacity during the recovery period. Temporary Total Disability. A disability that prevents an employee from working in any capacity during a temporary period of time. Triage Nurse. A nurse employed by the Medical Case Management Provider who performs the initial employee assessment following a reported injury, determines the most appropriate medical care, and arranges the initial medical treatment. This is not the Nurse Case Manager and does not manage cases on an on-going basis. Wage Loss. Wages an employee loses when an injury or illness incurred in the course and scope of employment disables the employee for more than seven calendar days. Waiting Period. The first seven calendar days (40 hours) of an employee s disability. Employees are granted 40 hours of Administrative Leave (code 0065) during this period. OPS employees are not compensated for this period unless they are medically disabled for more than 21 days, at which time the Division will pay the employee retroactively. Work Restrictions. The authorized physician s description of the work an employee can and cannot do based on functional limitations and restrictions as outlined on the DWC-25 form. Work restrictions help protect employees from further or new injury. Work Status. Time an employee performs on-the-job duties during regular office hours or approved after-hours activities when on official approved state business.

7 Page 7 of 22 hh. ii. Workers Compensation Benefits. Coverage provided to all Department employees and volunteers by the Division of Risk Management, Workers Compensation program. This program coverage pays all medicallynecessary and approved care to treat an employee or volunteer that suffers a work-related injury or exposure. The program also pays employees for part of their lost-wages due to a work-related injury or exposure. Workers Compensation Coordinator. Refers to the representative in the Bureau of Personnel Services responsible for coordinating Workers Compensation claims and, based on the information from the DWC-25 form, coordinates with the Nurse Case Manager, supervisor and Loss Control Committee to make a determination as to whether the employee is able to return to their regular job, a modified job, an alternate job, or is unable to work. 5. Procedures a. Reporting Injuries. When an employee or volunteer sustains a jobconnected, life-threatening injury or illness during normal work hours, on job-related travel or while working special events, call 911 immediately. For all other non-life-threatening emergencies, the incident should be reported as soon as possible to the employee s supervisor or the supervisor on duty and request first aid or medical treatment if needed. It is the supervisor s responsibility to follow set procedures for reporting an on-the-job injury or illness. The OptaComp Orientation Booklet for Injured Workers, provided by the Medical Case Management Provider, outlines procedures for reporting an on-the-job injury or illness. This informational booklet is provided to each employee filing a Workers Compensation claim. The booklet contains basic facts about Workers Compensation, how to get medical care and benefits and types of benefits available. b. Reporting Death. If a job-connected injury or illness results in the death of an employee, the supervisor in charge shall notify the Workers Compensation Coordinator in the Bureau of Personnel Services by telephone or immediately. Florida law requires that the death be reported to the Department of Financial Services, Division of Risk Management, Workers Compensation Section, within 24 hours by telephone at (850) or fax (850) Death claims should also be reported to the Medical Case Management Provider just like any other claim. Additionally, the Workers Compensation

8 Page 8 of 22 Coordinator will ensure the DEP Safety Officer and Program Administrator Agency-wide Programs are notified of such an event. 6. Roles and Responsibilities a. Employee or Volunteer Responsibilities. The employee or volunteer is responsible for: (1) Notifying his/her supervisor or the supervisor on duty and requesting first aid or medical treatment if needed for job-connected, non-lifethreatening emergencies. (2) Calling 911 for job-connected, life-threatening injury or illness during normal work hours, on job-related travel or while working special events; or if incapacitated, a supervisor or co-worker should call 911 immediately. If the supervisor is not available, the incident should then be reported as soon as possible to the supervisor. (3) Attending all appointments with the authorized treating physician and for returning to work after each appointment except when the authorized treating physician provides a medical diagnosis that prevents the employee from returning to work and that the physician has properly documented on the DWC-25 form. The employee is not responsible for the cost of medical treatment, medical supplies or drugs. These are submitted by the treating medical provider directly to the Medical Case Management Provider. (4) Providing the supervisor with the Medical Treatment and Work Status form, DFS-F5-DWC-25, after each visit for medical treatment. The Medical Case Management Provider will give the form to the employee and Nurse Case Manager after each visit for medical treatment. (5) Reading and signing the Employee Notification Alternate/Modified Duties Form if given modified or alternate duty assignments due to functional limitations by a treating physician; performing assigned duties satisfactorily and if the employee has difficulty performing duties, he or she must discuss this with their supervisor immediately.

9 Page 9 of 22 (6) Accepting all reasonable alternate duty offerings. If the employee refuses alternate duties, they will be required to use their own personal leave or leave without pay until released to full duty by their treating physician. (7) Communicating regularly with their supervisor and notifying the supervisor of any changes in their ability to work in order to promote returning to work as quickly as possible when placed on out-of-work status. b. Supervisor s Responsibilities. The supervisor is responsible for: (1) Immediately contacting OptaComp at to report the claim, even if the incident is not an emergency, with the employee present if possible. (2) Notifying the director of their division by , and copying their Deputy Secretary, and the Program Administrator Agency-wide Programs, of any Workers Compensation accident or injury within 24 hours or the next working day. (3) Reviewing any restrictions outlined in the DWC-25 form provided by the employee after medical treatment and coordinating with the Workers Compensation Coordinator to first determine if the employee s condition is temporary or permanent and whether or not sufficient information has been provided to determine if the employee s restrictions can be accommodated. Supervisors are required to make every possible effort to find alternate duties for the injured employee. (a) (b) If needed, completing an Employee Notification of Alternate/Modified Duties, Form DEP outlining the temporary work assignments when restrictions can be accommodated by modified or alternate duty assignments. If the alternate duty requires the employee to report to a different work location and/or supervisor, this information will be included on the Employee Notification of Alternate/ Modified Duties, Form DEP , providing the specific date and time of the assignment, the location and supervisor (if different from immediate supervisor), the work schedule for

10 Page 10 of 22 the assignment, and some reference to the effective period of the assignment, i.e., until the employee can assume work duties of the permanent position or until the employee reaches Maximum Medical Improvement. The supervisor is responsible for providing the Workers Compensation Coordinator with the completed Employee Notification of Alternate/Modified Duties Form. (c) If it is determined that the supervisor is unable to accommodate the restrictions by providing alternate or modified duties, the Workers Compensation Coordinator will notify the Nurse Case Manager and Risk Management Adjuster. (4) Communicating regularly with the employee when they are placed on out-of-work status to promote the employee returning to work as quickly as possible. Alternate or modified duties should be reviewed by supervisors on a weekly basis and concerns should be discussed with the employee as soon as possible. If the employee appears to be unable to perform assigned duties, a follow-up examination should be scheduled by the Nurse Case Manager. Supervisors must keep the Workers Compensation Coordinator informed of any issues that may arise. (5) Coordinating with the Workers Compensation Coordinator on proper timesheet completion and payroll processing. (6) Coordinating with the Workers Compensation Coordinator when an employee reaches Maximum Medical Improvement by the authorized treating physician or the current functional limitations and restrictions no longer prevent the employee from performing his or her normal job. When the supervisor is notified of the employee s official returnto-work date, the supervisor will notify the employee in writing of their exit from the program and return-to-work date by completing the Employee Exit from Alternate/Modified Duties, Form DEP If it is determined that an employee cannot return to their position or there are permanent limitations, the Workers Compensation Coordinator will coordinate determining the employee s options and notification process. The supervisor is responsible for providing the Workers Compensation Coordinator with the completed Employee Exit from Alternate/Modified Duties Form.

11 Page 11 of 22 c. Workers Compensation Coordinator Responsibilities. The Workers Compensation Coordinator is responsible for: (1) Furnishing the First Notice of Injury to the Safety Officer and Program Administrator Agency-wide Programs, to assist in determining any trends and monitoring agency costs. (2) Reviewing weekly Division of Workers Compensation Data Reports to ensure all listed employees are correctly identified as agency employees and ensuring employees receiving indemnity payments are actually off from work. (3) Meeting with members of the Loss Control Committee weekly to determine if employees are able to return to work and perform the regular, modified or alternate duty assignments that accommodate the functional restrictions and limitations as determined by the authorized treating physician in order to bring the employee back to work as quickly as medically possible. (4) Participating in quarterly Safety Advisory Board Committee meetings to provide updates on current lost time, return-to-work and claim reporting issues. (5) Filing a Wage Statement, Form DFS-F2-DWC-1a, for the employee with the Division of Risk Management for Wage Loss Benefits. Benefits are paid to an injured employee when the authorized Workers Compensation physician, selected by the Medical Case Management Provider, places the injured employee on leave for more than 40 hours. (6) Having the employees that reach Maximum Medical Improvement and return to work for a full 31 days additional retirement contributions processed for the period they were on out-of-work status and receiving benefit payments. (6) Reviewing the first notice of injury file for each claim and coordinating with the Medical Case Management Provider to ensure that the DWC-25 form is completed accurately and that the authorized treating physician provides the functional limitations and restrictions with sufficient detail.

12 Page 12 of 22 (7) After reviewing the DWC-25 form, coordinating with the employee, supervisor, Nurse Case Manager and Risk Management Adjustor to determine if the employee is able to return to their regular job, a modified job, an alternative duty job, or is unable to work; notifying the employee, supervisor, Safety Officer, Program Administrator Agency-wide Programs, Nurse Case Manager and Adjuster when the employee is unable to work. (8) Assisting supervisors and employees with timesheet and benefit questions. (9) Reporting lost time and return to work data to the Division of Risk Management on a monthly basis. Assisting with the annual evaluation of the Department s Return-to-Work Program as needed. d. Program Administrator Agency-wide Programs. The Program Administrator is responsible for managing the Department s Workers Compensation Program. Responsibilities include: (1) Reviewing and tracking initial compensability decisions made by Risk Management, reviewing all medical and indemnity payments issued, reviewing files of each employee listed as receiving indemnity payments, analyzing lost time claims and cost data monthly and ongoing during the fiscal year to determine any trends and making recommendations to management to address these trends. (2) Meeting with members of the Loss Control Committee weekly to determine if employees are able to return to work and perform the regular, modified or alternate duty assignments that accommodate the functional restrictions and limitations as determined by the authorized treating physician in order to bring the employee back to work as quickly as medically possible. (3) Providing Department leadership regular reports related to Workers Compensation and specifically the Return-to-Work Program including loss time claims, First Report of Injury Reports and incident reports; providing information to assist them in making strategic decisions to reduce lost time claims. (4) Coordinating promotion of the employee Return-to-Work Program, promoting employee awareness and program accountability

13 Page 13 of 22 necessary agency wide for managers and supervisors to reduce lost time cases. (5) Developing a comprehensive Return-to-Work Program evaluation process to assess outcomes and adjust program operations accordingly. (6) Coordinating the development and update of directives related to the Return-to-Work Program. (7) Preparing Workers Compensation and Return-to-Work Program articles or memos. (8) Updating New Employee Orientation and other training to familiarize supervisors and employees on Workers Compensation and the Return-to-Work Program. e. Medical Case Management Provider. All charges for medical treatment, medical supplies or drugs should be submitted by the treating medical provider directly to the Medical Case Management Provider. (1) The Triage Nurse is responsible for receiving the initial injury call from the supervisor, assessing the injury from information provided, arranging initial medical referral and thereafter turning the claim over to the assigned Nurse Case Manager. (2) The Nurse Case Manager is responsible for providing the DWC-25 form to the Risk Management Adjustor and Workers Compensation Coordinator; arranging and authorizing appointments to meet the treatment plan outlined by the authorized treating physician, including but not limited to, referrals to specialists, testing and therapies; ensuring functional limitations and restrictions listed on the DWC-25 form are clear and measurable and assisting employees with instructions when the employee receives a bill in error. (3) The physician is responsible for examining and treating the employee or volunteer and completing the DWC-25 form after each medical appointment with a degree of reasonable medical certainty based on objective relevant medical findings and discussing the findings with the employee. The physician provides the employee

14 Page 14 of 22 with a copy of the completed DWC-25 form after each visit. f. Division of Risk Management Adjuster. The Division of Risk Management Adjuster is responsible for: 7. Loss Control (1) Handling Workers Compensation claims reported by employees. (2) Coordinating with the Workers Compensation Coordinator to determine the compensability and lost-time benefits when the injured person is unable to work. (3) Serving as an employer resource for questions and issue resolution. a. DEP Safety Officer. The Safety Officer is responsible for developing, implementing and administering the Department s Safety and Loss Control Management Program. As it relates to Workers Compensation specifically, the Safety Officer s responsibilities include: (1) Ensuring that each on-the-job injury or illness is documented on an incident report and related backup documentation is uploaded to the Division of Administrative Services safety drive by the Safety Program Manager for the district/division/office and maintained for three calendar years. (2) Meeting with members of the Loss Control Committee weekly to determine if employees are able to return-to-work and perform the regular, modified or alternate duty assignments that accommodate the functional restrictions and limitations as determined by the authorized treating physician in order to bring the employee back to work as quickly as medically possible. (3) Scheduling quarterly Safety Advisory Board meetings to review injury and incident reports whether or not it results in an injury, to determine the cause of the accident and formulate corrective measures to prevent recurrence. (4) Reviewing claims data monthly and on-going during the fiscal year to determine any trends and make recommendations to management to address these trends.

15 Page 15 of 22 (5) Promoting the employee Return-to-Work Program with managers and supervisors to reduce lost time cases. b. Loss Control Committee. The Department s Loss Control Committee will consist of at least one representative from the Bureau of Personnel Services including the Workers Compensation Coordinator and at least one representative from the Safety Office and the Program Administrator - Agency-wide Programs. The committee will meet weekly. The Loss Control Committee is responsible for: (1) Meeting weekly to determine if employees are able to return-to-work and perform the regular, modified or alternate duty assignments that accommodate the functional restrictions and limitations as determined by the authorized treating physician in order to bring the employee back to work as quickly as medically possible. (2) Evaluating employee injury and incident records identifying trends and patterns, and formulating corrective measures to prevent recurrence. (3) Reviewing and updating workplace safety rules based on incident review findings, inspection findings, employee reports of unsafe conditions or work practices, and addressing suggestions and concerns. (4) Promoting the employee Return-to-Work Program with managers and supervisors to reduce lost time cases. c. Safety Advisory Board. The Department s Safety Advisory Board meets quarterly and is comprised of the Safety Officer, Safety Program Managers from each division/district/office and the Workers Compensation Coordinator. Within each division/district/office there is also a Safety Committee that meets regularly with the Safety Program Manager. The Safety Advisory Board is responsible for: (1) Evaluating circumstances related to reported incidents/accidents to address safety concerns. The Board makes written recommendations to Department management regarding policy changes necessary to promote a safer work environment and reduce lost time cases.

16 Page 16 of 22 (2) Establishing and communicating procedures for evaluating the effectiveness of control measures used to protect employees from health and safety hazards in the workplace. (3) Evaluating employee injury and incident records identifying trends and patterns, and formulating corrective measures to prevent recurrence. (4) Reviewing and updating workplace safety rules based on incident review findings, inspection findings, employee reports of unsafe conditions or work practices, and addressing suggestions and concerns. (5) Promoting the employee Return-to-Work Program with managers and supervisors to reduce lost time cases. d. Safety Committees. The division/district/office Safety Committees primary responsibilities related to Workers Compensation and the Return-to-Work Program include: (1) Investigating and analyzing factors related to workplace close call incidents, safety-related incidents, injuries, illnesses, diseases and fatalities in order to eliminate hazards or reduce their potential recurrence. (2) Evaluating the effectiveness of and recommending improvements to the Department s safety rules, policies and procedures for incident prevention and wellness programs in the workplace. (3) Establishing and communicating guidelines for the safety training of all employees on a continuing basis. (4) Promoting the Return-to-Work Program and reducing Workers Compensation related costs. e. Safety Program Manager. The Safety Program Manager is responsible for the following as it relates to Workers Compensation and the Return-to- Work Program: (1) Reviewing statistical analyses from Risk Management, First Notice of

17 Page 17 of Reporting Leave Injury or Illness, incident investigations, property damage and vehicle incident reports. (2) Assisting management in establishing and maintaining a healthy and safe working environment and providing management with the information, advice, and assistance needed to formulate the Division/District/Office Health and Safety policies, directives, procedures and standards. (3) Ensuring that each on-the-job injury or illness is documented on an incident report and related backup documentation is uploaded to the Division of Administrative Services safety drive for the district/division/office and maintained for three calendar years. (4) Assisting supervisors in providing training and technical assistance, determining needs for personal protective equipment, and assessing job-related health and safety issues as required. (5) Maintaining a library containing copies of codes, standards, safety manuals, and reports that regulate the Health and Safety Program and copies of records and reports regarding health and safety issues. (6) Promoting the Return-to-Work Program and reducing Workers Compensation related costs. a. Disability Leave. A Career Service, Selected Exempt Service or Senior Management Service employee injured in the course of their employment and unable to work because of that injury or illness, (as determined by an authorized Workers Compensation physician), shall be carried in full pay status for a maximum period of seven calendar days, not to exceed 40 work hours. If an employee receives medical treatment the day of their injury, it is counted as a full day worked and the employee does not use leave. Such full pay status on the day of the injury only should be entered on the employee s People First timesheet as work hours. An employee may use disability leave beginning on the day after the injury for follow-up appointments or when the authorized physician has placed the employee on non-work status providing the total disability period does not exceed 40 work hours.

18 Page 18 of 22 b. Additional Disability Leave Allowance. Upon written confirmation from the authorized physician, employees, except OPS, who are in a work status will be granted up to 48 hours of additional disability leave to be used intermittently to cover appointments to health care providers, physical therapy and similar activities provided that these activities are directly related to the employee s Workers Compensation injury. If the injured worker has not exhausted the initial 40 hours of disability leave, then all or any remaining hours may also be used, if needed, for follow-up medical appointments or treatment required by the authorized physician for a particular injury. c. Effect of Holidays. If any holidays provided for in s , F.S., occur while an employee is being carried in full pay status during the first seven days following the job-connected disability, the holiday shall count towards the initial 40 hours. When the holiday occurs during subsequent disability, the employee will receive holiday pay in lieu of using leave credits. d. Sick, Annual or Compensatory Hours. If the employee is unable to resume work at the end of the seven calendar-day period (40 work hours), the supervisor shall advise the Workers Compensation Coordinator by telephone and confirm in writing which of the following methods of payment the employee elects. The employee may elect to use accrued sick, annual or compensatory leave only. After exhaustion of all leave credits, an employee will be on approved leave without pay. (1) Leave Without Pay. If an employee has no accrued leave, has exhausted all leave or wishes to be placed on leave without pay, the employee will be entitled to receive Workers Compensation benefit payments at the rate of 66 2/3 percent of pre-injury average weekly wage, not to exceed the maximum weekly compensation rate and will be placed in leave-without-pay status for the period of time actually missed from work that is not covered by Workers Compensation. Employees receiving benefit payments are considered to be in "pay status" even though the People First timesheet reflects leave-without-pay. The employee will continue to earn leave credits as long as the employee is carried in a payroll leave-without-pay status due to an on-the-job injury or illness. (2) The employee is responsible for payment of the employee's portion of personal health and life insurance and miscellaneous insurance deductions to the People First Service Center when their regular pay

19 Page 19 of 22 is not sufficient to cover the deductions, during the time they are only receiving Workers Compensation benefit payments. e. Timesheet Completion. Supervisors are responsible for coordinating with the Workers Compensation Coordinator to ensure an accurate record of the employee s attendance and absences are recorded in the People First system. 9. Employee Benefits Employees that are placed on out-of-work status for more than 40 hours will automatically be placed on leave as provided in the Family and Medical Leave Act (FMLA) if they meet the FMLA eligibility criteria. The FMLA entitles employees, with at least twelve months of service or who have worked 1,250 hours in the past twelve months, to take up to 12 weeks of leave, within a twelve-month period commencing the first day of leave with or without pay (may use accrued sick leave, annual leave or compensatory leave or be placed on leave without pay) for a serious personal or family illness or continuing treatment. Prior to granting FMLA, the Department will require that medical documentation be provided in accordance with FMLA provisions. Supervisors and employees are encouraged to seek assistance and information from the Bureau of Personnel Services concerning FMLA provisions and requirements. a. Wage and Benefit Payments. (1) Career Service, Selected Exempt Service, and Senior Management Service Employees. At the expiration of the initial 40 hours or seven calendar day disability period, the Division of Risk Management will pay, directly to the employee, approximately 66 2/3 percent of the employee's average weekly wage. Excluding OPS employees, the Department will pay the 33 1/3 percent not paid by the Division of Risk Management charging the employee's leave credits at the rate of approximately 2.75 hours per eight-hour day in order to keep the employee in full pay status as long as the employee has leave credits. Until the employee returns to work, monthly pay warrants will be based on the prorated leave usage. (2) OPS Employees. If an OPS employee is injured in the course of employment and an authorized Workers Compensation physician places them in non-work status, the Division of Risk Management will pay approximately 66 2/3 percent of the employee s salary beginning

20 Page 20 of 22 with the eighth calendar day. After 21 days of disability, the Division of Risk Management will retroactively pay the employee for the first seven days of disability. b. Mileage Reimbursement. Employees may request mileage reimbursement for trips made to an approved medical care provider on the Division of Risk Management Mileage Reimbursement, Form DFS-D0-866, which can be found as part of the OptaComp Orientation Booklet for Injured Workers. Trips to the drug store and medical equipment suppliers (i.e., wheelchairs, walkers, crutches, etc.) are not reimbursable. 10. Awareness and Accountability a. Supervisors will receive training on Workers Compensation and the Returnto-Work Program upon hire, as part of basic supervisory training, and each time the directive is amended. b. Employees will receive training on Workers Compensation and the Returnto-Work Program as part of New Employee Orientation and other pertinent information by and on the Bureau of Personnel Services web site. c. Return-to-Work Program articles will be featured in Department-wide s and the Division of Administrative Services electronic bulletin board. d. The Return-to-Work Program will be evaluated annually using metrics provided by the Division of Risk Management. 11. Penalty a. The supervisor is responsible for complying with the provisions of this directive to ensure the Department s compliance with statutory reporting requirements. It is the supervisor s responsibility to follow set procedures for reporting an on-the-job injury or illness. Failure to timely notify OptaComp, the Medical Case Management Provider, could result in the Department being responsible for the payment of interest and penalties. b. In the event the Department is penalized, the applicable director or designee will be responsible for arranging for payment of such penalties and interest from the organizational unit s appropriated funds.

21 Page 21 of Recordkeeping a. Any confidential information will be securely maintained in a locked cabinet or in a locked room. b. A file will be created and maintained by the Bureau of Personnel Services for employees who are in an out-of-work status and a Return-to-Work Section will be created within the existing file. Once the employee has reached Maximum Medical Improvement and is released to return-to-work or it is determined that they will not be able to return-to-work, these records will be placed in the employee s official Personnel file. Summary of Revised, Deleted or Added Material This directive supersedes DEP 450, dated February 12, 2010 and is being modified to formalize the Department s Return-to-Work Program. This update removes the option for employees to use donated hours for leave due to a Workers Compensation injury. Responsible Office: Division of Administrative Services Bureau of Personnel Services

22 Page 22 of 22 ATTACHMENTS: Attachment I First Report of Injury or Illness Form DFS-F2-DWC-1 Attachment II DEP Location Codes Attachment III OptaComp Orientation Booklet for Injured Worker rkers_engonly.pdf Attachment IV Florida Workers Compensation Uniform Medical Treatment/Status Reporting Form DFS-F5-DWC inter.pdf Attachment V Wage Statement Form DFS-F2-DWC-1a Attachment VI DEP Workers Compensation Procedures for Reporting Onthe-Job Injury/Illness/Death Attachment VII Employee Notification of Alternate/Modified Duties Form DEP Attachment VIII Employee Exit from Alternate/Modified Duties Form DEP