BRANT COMMUNITY HEALTHCARE SYSTEM MANUAL Policy/Procedure CATEGORY: Organizational Health NUMBER: X - 130 ISSUED BY: Board of Directors PAGE: 1 of 6 Date: March 1983 SIGNATURE: Review Date: July 2006 PRESIDENT DISTRIBUTION: All Staff Via Electronic Access Revision Date: July 2006 SUBJECT TITLE: Sick Leave ( Policy ( Procedure POLICY: Illness is defined as a state of incapacity resulting from bodily injury or disease, physical or mental, preventing the employee from performing regular duties in which the employee was engaged immediately prior to the commencement of disability, and for which compensation is not payable under The Workers Compensation Act. Sick leave is the period of time an employee is permitted an absence due to illness. The Hospitals of Ontario Disability Income Plan (HOODIP) sick leave benefits are available solely to protect the employee against loss of income. Qualifying criteria must be met in order to be eligible for sick leave benefits (In accordance with V= 235 HOODIP- Qualifications for Short & Long term Disability Pay Hospitals of Ontario Disability Income Plan). The employee must provide proof of illness by a HOODIP Sick Pay Medical certificate from a duly authorized medical doctor, stating the nature and length of the illness or disability when the employee has been absent for three (3) or more days. The Hospital has the option, however, to request such proof of illness or disability for absences of shorter duration. In the case of illness or surgical procedure covered by OHIP where disability is expected to last more than ten (10) working days, the employee must complete a Leave of Absence Form A187, and have an Attending Physician s Statement completed by a duly authorized medical doctor. The employee must provide proof and notify their manager and Organizational Health of a planned OHIP covered surgical procedure at least one month prior to the start of total disability.
Title of policy: Sick Leave Page 2 of 6 Further proof of total disability may be required at any time by the Hospital to maintain entitlement to Sick Pay Benefit. In order to qualify for sick leave, the employee must notify the immediate Supervisor or designate as soon as possible before the start of the employee s regular shift. Sick leave will not be paid in any of the following circumstances: When the absence is caused by an injury compensable under the Workers Compensation Act, During scheduled vacation, unless illness requires hospitalization or bed rest for more than 3 days and is of a serious nature as confirmed by the Occupational Health Nurse - Ref. V-680 Vacation Non Union - Entitlements. For absence resulting from over exposure to the sun, which does not restrict the employee from performing any work in the department nor does it require the care of a physician. The Manager in granting sick leave and authorizing payment of sick leave, must prevent its misuse and must therefore be certain that the absences are due to bona fide illness or injury. Ref.: V-235 HOODIP - Qualifications for Short & Long Term Disability Pay Hospitals of Ontario Disability Income Plan Reporting Employees who are unable to report for work due to illness (incapacity as a result of bodily injury or disease) must notify their immediate Manager or designate as far in advance as possible. Absences will be recorded on the yellow Absence Notification and Follow up form by the manager or designate when the absence is called in. If the illness is prolonged, employees must keep their Manager informed on a regular basis. Employees who fail to comply with this procedure will be considered absent without pay. Employees who have so notified their Manager and are unable to confirm attendance on their next regularly scheduled shift shall be required to notify the Manager when they are able to return to work, at which time they will be advised of their next scheduled shift.
Title of policy: Sick Leave Page 3 of 6 Employees who become ill while on duty will report to their immediate Supervisor who will arrange for them to see the Occupational Health Nurse, if necessary. If the Occupational Health Nurse is unavailable, the Administrative Manager must be contacted to determine if the employee should be sent to the Emergency Department for treatment. In either case, if the employee is subsequently absent for three or more working days, the Manager, or designate, must complete Form A-92 and submit the form to the Health Office. If the absence will extend to 5 or more working days the Manager or designate is to complete and submit the Absence Notification and Follow up form to Organizational Health, and the employee is instructed to contact Organizational Health. For absences of 5 days or greater, an Attending Physician s Statement must be completed by a duly authorized medical doctor and returned to Organizational Health by the 10th day of absence. Exceptions will be considered under extraordinary circumstances. If the supporting medical is not received, or does not qualify for sick pay benefits, sick pay may be ceased, and the matter will be forwarded to Human Resources. When employees return to work after an absence of three or more days, they must report to the Health Office and submit the required medical clearance certificate. The Occupational Health Nurse will then complete Form A-92 and the employees will return to their Department with the completed form. An employee who reports for work following an illness without prior notice, as above, may be sent home without pay for that shift.
Title of policy: Sick Leave Page 4 of 6 Absence Notification and Follow Up Employee Name Department Date of Notification Time of Notification Scheduled Shift Expected Return to Work Date Date Unknown If date unknown, employee instructed to notify department as soon as possible to confirm a return to work date Expected return to work date (to be filled out if date was initially unknown) If absence is expected to be 3-4 days, employee instructed that HOODIP Sick Pay Medical Certificate will be required for return to work Reason for Absence Personal Request Referred to Manager/Supervisor for approval Non work-related Illness or Injury If non work-related absence employee instructed to: i) Contact extension 2248, Organizational Health Services if absence expected to be 5 days or greater. Employee instructed that Attending Physician Statement will need to be completed ii) Contact extension 2248 for instructions if absence due to possible communicable disease resulting in vomiting, fever diarrhea, rash, sore throat or flu-like symptoms Work-related Illness or Injury If work related absence employee instructed to: i) Complete an Employee Incident Report ii) Contact extension 2248, Organizational Health Services, Health & Safety Coordinator Recorder s Name Signature Manager/Supervisor Signature Date Copy to Organizational Health if absence expected to be greater than 5 days
Title of policy: Sick Leave Page 5 of 6 HOODIP Sick Pay Medical Certificate Employee s name Position Employee s Signature Date I understand the reason for this form is to enable me to provide proof of illness causing total disability by a medical certificate from a duly authorized medical doctor. The purpose of this information is to allow the Organizational Health department to adjudicate the HOODIP Sick Pay benefits under policy X130 and PolicyV-235 or equivalent [Sun Life]. The information provided on this form will be used for the stated purpose and kept confidential within the employee s health file. 1. *Nature of illness/ injury: 2. Current treatment: 3. Return to regular work: yes no Date: Please return this confidential form to Organizational Health fax [519]751-5892. Physician s signature Date *Illness is defined as a state of incapacity resulting from bodily injury or disease, physical or mental preventing the employee from performing regular duties in which the employee was engaged in immediately prior to the commencement of disability, and for which compensation is not payable under the Workers Compensation Act.
Title of policy: Sick Leave Page 6 of 6 Three Day Absent Report Form: A-92 To: Organizational Health Notice of absence due to illness or other disability has been received from: Name: Department: First day off: Reason given: Date: Signature: To: Department Manager This will certify is fit to return to work on: Doctor s medical certificate received Date: Signature: APPROVAL BY: Occupation H&S APPROVAL BY: Operations Team Date: June 2006 Date: July 2006 APPROVAL BY: APPROVAL BY: Senior Leadership Team Date: Date: July 2006 If applicable: If applicable: TWH Date Originated: BGH Date Originated: Original Policy No: Review Contact Position: VP Resources/Development
BCHS ABSENCE REPORTING PROCEDURES Policy X-130 attachment EMPLOYEE must call manager/designate or if after hours, they must call their unit area Non-work related Work related Less than 5 days Off Work 5 days or greater Call Organizational Health, Health & Safety Coordinator Complete Employee Incident Report Provide medical documentation (Treatment memorandum) Call manager If absence 3-4 days, HOODIP sick pay medical certificate required, however such proof of illness or disability may be requested for absences of shorter duration Manager notifies Organizational Health (absence notification and follow up form delivered) Employee to contact Organizational Health APS/LOA Form to be completed Assess for RTW Modified Work not appropriate Assess for RTW RTW Regular duty Modified work appropriate Modified work not appropriate RTW Regular Duty Modified work appropriate Off work Medical supporting Total Disability required RTW modified duty Remain off work Maintain regular contact with Organizational Health, Manager Ongoing medical documentation required C:\inttemp\OLK103\X130 attachment - Sick policy.doc RTW Modified duty Maintain regular contact with Organizational Health: Health & Safety Coordinator Ongoing Medical documentation required