Workers' Compensation

Welcome to Risk Management’s workers’ compensation information page.  Worker’s compensation (WC) insurance is a benefit afforded to all University of Miami employees beginning immediately upon hire.  This type of insurance is purchased by UM through its insurance brokerage company to provide employees with the indemnity and medical benefits required by the laws or acts of the State of Florida Department of Financial Services.  The University’s WC insurance program is administered by the Department of Risk Management on the Coral Gables campus.  For any questions regarding policies and procedures, please contact Norma Lango, Workers’ Compensation Manager at (305) 284-2054 or (305) 284-3163 for general information and forms.

For information on the Department of Financial Services and a thorough history of WC, please visit their site: http://www.myfloridacfo.com/division/wc/InfoFaqs/history.htm. For further assistance, you may contact your Human Resources representative.


 

Downloadable Forms:


Anti-Fraud Reward Program:

Rewards of up to $25,000 may be paid to persons providing information to the Department of Insurance leading to the arrest and conviction of persons committing insurance fraud, including employers who illegally fail to obtain workers’ compensation.  Persons may report suspected fraud to the department at 1-800-378-0445.  A person is not subject to civil liability for furnishing such information, if such person acts without malice, fraud or bad faith.


Approved Medical Providers:

Guidelines to Authorized Medical Providers for Workers Compensation Injuries.

The University of Miami consists of various campuses which are located throughout the greater Miami and surrounding areas. The University of Miami Hospital (UMH) Occupational clinic has been designed to assist employees in obtaining medical care as soon as possible in order to minimize the inconvenience caused to all parties involved.  The UMH Occupational Clinic is located at:


UMH Occupational Health Clinic
1321 NW 14 Street, Suite 502
West building, 5th floor
Miami, FL 33136

Phone:  (305) 689-5891
Open 7:00 am - 5:00 pm Monday - Friday

After hours:  If you have an emergency please go to the nearest emergency room.  UMH ER is set up to provide emergency and non-emergency care to employees after hours.


Although a University of Miami employee injured on-the-job may go to any authorized medical providers please keep the following in mind:

Seek treatment at an authorized facility. Emergency rooms treat patients by the severity of the injury they have sustained. An employee, who is sent to an emergency facility for an injury which is not an emergency, may wait hours before they are treated. If an employee can easily ambulate and has not suffered a severe head injury, they should be sent to the University of Miami Occupational Clinic which is a fully equipped walk-in facility.

Use your judgment. Injured employees should be sent to the nearest facility capable of providing medical attention as quickly as possible given the severity of their injury.  Sending non-emergency situations to an ER will result in delaying treatment to the employee and prevent them from returning to work. If there is a true life threatening emergency situation involving an injured employee, then Fire Rescue 911 (City of Miami, City of Coral Gables, or Metro Dade County) should be called. Fire Rescue will transport the injured employee to the nearest available treatment facility.

Employees who are treated in an emergency room facility should contact the Department of Risk Management immediately afterward. Employees needing follow-up care by a specialist such as an orthopedic surgeon or physical therapist must contact Risk Management for authorization before they make an appointment to see anyone they have been referred to by the physician at the emergency facility.

If an injured employee requires treatment at an emergency facility please note that the facility should be told to send all bills and inquiries to:

Department of Risk Management
P.O. Box 248106
Coral Gables, FL 33124-1437
PHONE: (305) 284-2054
FAX:  (305) 284-3405

The following providers are ONLY to be used after UMH Occupational Health hours or on weekends:

Physicians Health Center (Kendall)
7887 N. Kendall Drive
Suite 102
Miami, FL 33156
(305) 279-7722
Open 8:30 am - 5:30 pm Monday - Friday

Physicians Health Center (North Dade)
20535 NW 2nd Ave (441), #150
Miami, Fl 33169
Phone:  (305) 653-7720
Fax: (305) 653-2099
Open 8:30 am - 6:00 pm Monday - Friday
8:30 am - 12:30 pm Saturday

Physicians Health Center (Airport)
6221 NW 36th St, Suite 120
Miami, Fl 33166
Phone:  (305) 871-3627
Fax: (305) 871-7569
Open 7:30 am - 6:00 pm Monday - Friday
8:30 am - 12:30 pm Saturday

Concentra (Pinecrest)
10205 South Dixie Highway, Suite 102
Pinecrest, Fl 33156
Phone:  (305) 666-5971
Fax: (305) 666-0496
Open 8:00 am - 8:00 pm Monday - Friday
10:00 am - 4:00 pm Saturday - Sunday

Concentra (Miami)
7800 NW 25th St, Suite 4
Miami, Fl 33122
Phone:  (305) 593-2174
Fax: (305) 653-1417
Open 7:00 am - 8:00 pm Monday - Friday
10:00 am - 4:00 pm Saturday - Sunday

Concentra (Ft. Lauderdale)
1347 South Andrews Ave.
Ft Lauderdale, FL 33316
Phone:  (954) 767-9999
Fax: (954) 763-9828
Open 8:00 am - 8:00 pm Monday - Friday
10:00 am - 4:00 pm Saturday - Sunday


DO NOT PROVIDE ANY MEDICAL FACILITY OR PHYSICIAN WITH YOUR PERSONAL HEALTH CARE INSURANCE INFORMATION!


FAQs

Q. How long do I have to report the accident to my employer?

A. You should report the accident immediately to your supervisor in order not to cause a delay in receiving any workers compensation benefits.

Q. Do I have to pay for any of the medical costs?

A. No, the University or its insurance company must pay for all authorized and medically necessary care in accordance with a schedule of reimbursement allowances as authorized by the Division of Workers Compensation.

Q. How are the doctors and other health care providers paid?

A. All authorized health care providers must bill your employer s workers compensation insurance carrier directly. If you receive a bill, mail it to Risk Management. Do not pay it yourself. If you know the claim number the carrier has assigned to your case, write it on all bills and correspondence.

Q. Can I choose my own doctor?

A. No, the University or its insurance carrier has the right to choose the doctor who will treat the injured employee. Injured employees should not seek medical attention from their UM Care physician or primary care provider.

Q. If I am unable to work because of my job-related injury or illness can the University fire me?

A. The University is not obligated to hold an employees job. However, the law states that the employer can not “discharge, threaten to discharge or intimidate or coerce an employee because of the employees valid claim for compensation or attempt to claim compensation.”

Q. Can benefits be reduced for failure to use safety appliance or follow safety rules?

A. Where injury is caused by the refusal of the employee to use a safety appliance or to observe a safety rule required by statute or lawfully promulgated by the Division, which was brought prior to the accident to his/her knowledge, or where injury is caused by the knowing refusal of the employee to use a safety appliance provided by the employer, compensation may be reduced by 25%.

Q. If my employer has a Drug Free Workplace Program, can I still get workers compensation benefits?

A. It depends, if you test positive for drugs or alcohol at the time of the accident, you may lose your workers compensation benefits.

Q. Should I hire an attorney?

A. You are not required to have an attorney. Free assistance is available. Disputes between you and your employers workers compensation insurance carrier can usually be handled quickly by calling the Employee Assistance Office of the Division of Workers Compensation at 1-800-342-1741 or the Employee Assistance Office near you.

You cannot have a dispute heard by a Judge of Compensation Claims until you have participated in good faith in the Employee Assistance Office dispute resolution program.

You may hire an attorney to help you if you choose. If you do hire an attorney, you may be responsible for paying the attorneys fees.

* The above questions and answers were taken from the “Employees Rights and Responsibilities Under the Workers Compensation Law,” published by the Florida Department of Labor and Employment Security.