System-Wide Workers' Compensation HR Policy No: 6.08 Page 1 of 6

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1 System-Wide Workers' Compensation HR Policy No: 6.08 Page 1 of 6 Policy No: 6.08 Subject: Supercedes: Effective: January 1, 1999 Reviewed: July 1, 2009 Workers' Compensation All existing corporate and business unit policies relating to workers' compensation Page: 1 of 6 Approved by: Human Resources Executive Team (HRET) 1.0 Philosophy/Purpose Henry Ford Health System acknowledges its duty to comply with the Michigan Workers' Disability Compensation Act of It is also the philosophy and practice of HFHS to provide our employees who are injured on the job with the best medical and rehabilitation service possible, which will afford employees the quickest recovery and return to work. This policy will set out the pertinent provisions of HFHS workers' compensation program and the procedure for the proper handling of workers' compensation claims. 2.0 Scope This policy applies to all employees and volunteers at all business units and corporate offices of Henry Ford Health System. The policy and procedures enumerated below shall apply unless such policy or procedures are otherwise specified in a contract to which Henry Ford Health System, or a covered business unit, is a signatory. In such cases, the terms of the contract shall govern for employees covered by that contract, and such terms will take precedence over this policy. 3.0 Responsibility The interpretation, administration and monitoring for compliance of this policy shall be the responsibility of HFHS Human Resources and operational leadership. 4.0 Policy Henry Ford Health System endeavors to provide all employees with a safe and healthful working environment. Regardless of how cautious HFHS and its employees are, it is recognized that work-related accidents which cause injuries and illnesses inevitably occur. It is the policy of HFHS to provide for the payment of an employee s medical expenses in the event of a job-related injury or illness. Additionally, HFHS will provide for the partial payment of lost wages in the event that lost work time exceeds a certain number of days as defined by state law. The amount and duration of benefits provided

2 System-Wide Workers' Compensation HR Policy No: 6.08 Page 2 of 6 under this policy depends upon the nature of the injury or illness and the provisions of applicable state law. This policy covers only work-related injury or illness. This policy does not cover nonwork related injury or illness merely because the condition becomes symptomatic while the employee is at work. 5.0 Procedure 5.1 REPORTING Any occupational illness or injury suffered by or otherwise identified by an HFHS employee, including injuries or illness that have been aggravated on the job, should be reported immediately to the employee s supervisor. Immediately is defined as prior to the end of the shift in which the injury occurred or was identified. Delays in reporting or the failure to report an on-the-job illness or injury may result in the subsequent delay or possible loss of workers' compensation benefits. Knowledgeable failure to report employee injury/illness or efforts to cover up information relating to an injury incident may be grounds for corrective action, up to and including termination and/or jeopardizing workers' compensation benefits. See Corrective Action Program Policy After the supervisor has obtained the proper medical attention for the injured/ill employee, the employee and/or supervisor should complete a on-line Incident Report (Red form). The supervisor shall be responsible for correcting any conditions and/or eliminating any workplace hazards that may have contributed to the accident, or contacting appropriate personnel to discuss the need to address the cause of the injury. The supervisor shall also conduct an investigation of the incident, which should involve interviewing the injured/ill employee and any other employees who may have witnessed the incident. Human Resources (via Employee Health) is responsible for the administration and completion of all appropriate forms as required by HFHS workers' compensation insurance carrier or Third Party Administrator (TPA). Employee Health shall record the injury/illness information on applicable MIOSHA logs and on any other forms that may be required by any other state safety and/or health departments or agencies.

3 System-Wide Workers' Compensation HR Policy No: 6.08 Page 3 of INJURIES/ILLNESS REQUIRING MEDICAL ATTENTION Immediately after being notified of an on-site injury or illness, the supervisor shall determine whether or not the injured employee requires the attention of a physician and shall notify the Human Resources Department if medical care is necessary. The supervisor or Human Resources will arrange for transportation of the injured/ill employee to the nearest HFHS facility for treatment. In most cases, the supervisor should arrange for the injured employee to be transported to the local Occupational Health clinic for medical treatment. In the case of needle sticks, employees should be directed to the local Employee Health clinic. Either the supervisor or HFHS professional drivers are permitted to provide transportation for the injured/ill employee, as determined by the supervisor or Human Resources. All work-related injuries are to be triaged by the Employee Health clinic physician as soon as an appointment is reasonably available. If it is determined that emergency medical attention is necessary, under no circumstances should the injured employee be sent to drive to the occupational clinic or hospital on his or her own. Emergency cases should be transported by ambulance to the nearest adequate health care provider. 5.3 MEDICAL TREATMENT An HFHS facility that renders treatment to an employee injured or becoming ill on the job shall follow their normal documentation (medical record) and reporting procedures for such work-related incidents. Any non-hfhs facility rendering treatment to an employee injured or becoming ill on the job should be informed that the employee sustained a work-related accident or illness. The injured employee should give the treating facility HFHS address and his or her supervisor s name and phone number and sign a Medical Authorization release to allow for HFHS to follow up on the medical care of the injury.. All medical bills and records submitted to HFHS by the employee which are incurred as a result of the on-the-job accident must be forwarded to the HFHS workers' compensation insurance carrier or TPA for claims management, processing and reimbursement. 5.4 LOST TIME OBTAINING TREATMENT Employees who are sent home by the treating physician will be paid for the duration of the scheduled shift day, including the time spent undergoing treatment. The employee s time summary should include a

4 System-Wide Workers' Compensation HR Policy No: 6.08 Page 4 of 6 notation that the employee was injured at work. If an employee does not keep a time summary, then the time should be noted on an incident report and forwarded to Corporate Payroll accordingly. Treatment is defined as initial time spent in the emergency room, including examination, x- rays, waiting time, etc. The employee who is designated by HFHS to transport or escort the injured/ill employee will also receive his or her regular rate of pay for time away from the work site spent in obtaining medical attention for the injured/ill employee. As a guideline, supervisors should maintain ongoing communication with their employee to facilitate a positive morale and an early return to work. 5.5 MEDICAL LEAVE PROVISIONS Employees who are absent from work for more than three (3) days due to an on-the-job injury or illness must apply for a medical leave of absence under the HFHS Family Medical and Leave Policy and will be treated in accordance with the terms of that policy. See also Family Medical & Leave Policy 7.02, Medical (Non-FMLA) Leaves of Absence Policy 7.03 and the Return to Work Program Policy. 5.6 BENEFITS Benefit Continuation Benefits for employees who are on a medical leave of absence for an on-the-job injury/illness will continue as provided in the Family Medical and Leave Act policy (the employee s contribution will be put in abeyance until they resume receiving a paycheck). See Family Medical & Leave Act Policy Non-Duplication of Coverage No employee may receive duplicative payment under workers' compensation and also under any disability or CTO or other paid time off plan provided by HFHS. Any STD, CTO or other paid time off paid to an employee for time off that is also later paid for by workers' compensation must be repaid to HFHS via payroll deduction. Any CTO time or other paid time off used by an employee which is later paid by workers' compensation will be credited back into the employee s CTO or other paid time off bank upon the employee s full return to work.

5 System-Wide Workers' Compensation HR Policy No: 6.08 Page 5 of PETITION FOR HEARING As internal customers of HFHS, employees who have incurred a workrelated injury should receive prompt medical care and service. Soon after sustaining the injury, a representative of HFHS TPA should be in contact with the employee. The employee should be apprised of the rehabilitative plan, wage loss concerns, legal rights and responsibilities and a good faith offer of continued open communication. If an employee were to become dissatisfied with the service, or with information received, he or she should contact their Human Resources representative in an effort to resolve the situation. If a workers' compensation claim is denied because: an illness, injury, or accident is found not to be work related, or HFHS and the injured/ill employee do not reach a successful resolution of the claim, the employee has the right to appeal to the state Workers' Compensation Bureau to resolve the matter. By law, such an appeal must be submitted within two (2) years from the date of the illness, injury or accident. Upon receipt of such appeal, the name of the individual who submitted the appeal, as well as the date and time of receipt should be noted on the document before the petition is forwarded to Human Resources. 5.8 RETURN TO WORK If the injury/illness is one that involved lost work time, the injured employee s supervisor shall notify Human Resources of the employee s return to work so that the appropriate forms can be forwarded to the TPA. Following a work-related injury or illness, employees are obligated to accept a bona fide offer of work. It is the goal and policy of HFHS to accommodate employees return to work restrictions, and thus continue each employee s wage earning capacity. (see Transitional Work Program policy #6.21) For work-related injury or illness absences requiring an absence from work up to a period of three (3) weeks, the employee shall be required to submit a return to work clearance from his or her physician. If the absence extends for a period of three (3) weeks or longer, the employee must receive return to work clearance from a physician to be designated by HFHS. Upon receiving a release to work (with or without restrictions), the employee, supervisor or manager, Return to Work Coordinator and TPA

6 System-Wide Workers' Compensation HR Policy No: 6.08 Page 6 of 6 representative will attempt to place the employee in a job which will foster both the rehabilitative process and continued employment. 5.9 RECORDKEEPING After processing the claim with the workers' compensation insurance carrier or third party administrator, a copy of the claim should be filed with Human Resources. The incident report and any other documentation generated as the result of an injury/illness investigation should also be filed in Human Resources, along with any other documentation relating to the workers' compensation incident. Under no circumstances should any documentation relating to medical information or workers' compensation claims be filed in the employee s personnel file. See Employee Records Retention Program Policy Attachments to HR Policy 6.08 HFHS Incident Report See also: Americans with Disabilities Act Policy 4.11 Corrective Action Program Policy 5.17 Employee Records Retention Program Policy 4.13 Family and Medical Leave Act Policy 7.02 Medical (Non-FMLA) Leave of Absence Policy 7.03