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Process
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Audience
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Description
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1) Employee has a Work Related Injury or Illness
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Employee
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As soon as you sustain a work related injury or illness tell your manager.
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Manager
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As soon as you are aware an employee sustained a work related injury or illness, contact the employee to ask if he/she needs medical treatment.
If treatment is needed, select a medical provider from the University's Approved Medical Providers List.
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2) Report Your Injury or Illness in Workday
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Employee
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Work related injuries must be reported in Workday within 24 hours of your injury or illness.
Desktop Computer:
I. Log into Workday and type the words "Create Request" in the search bar
II. Select "All"
III. Select "Work Injury/Illness Report"
IV. Fill in every field and select the appropriate dropdown
V. Upon completion, click on Submit
UMiami Mobile App:
I. Tap on the Workday icon and sign in
II. Under Applications tap on the Benefits icon
III. Under External Links tap on Work Injury/Illness Report
IV. Select "All"
V. Select "OK"
VI. Fill in every field and select the appropriate dropdown
VII. Upon completion, tap on Submit
Note: the paper and PDF University of Miami Incident/Accident Form are no longer accepted, you must report your work injury/illness in Workday
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Manager
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You will receive a Managers Notification in Workday advising of the employees work injury or illness. You must respond to the Manager questions within 24 hours. Upon completion click on Submit.
If the employee is incapacitated, hospitalized, or otherwise unable to complete the Work Injury/Illness Report in Workday, you must report the incident to University’s Workers’ Compensation Administrator Gallagher Bassett. The dedicated Call-In Injury/Illness reporting number is 833-203-8306.
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3) RL6 and Workday Injury Reporting
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Employee
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Employees who are required to report their work injury or illness in RL6 must also report their work injury or illness in Workday.
The only way to initiate a workers' compensation claim is in Workday.
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4) Employee Needs Medical Treatment
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Employee
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If you need medical treatment for your injury or illness, you must select a medical provider from the University's Approved Medical Providers List.
Treatment from any other provider is not authorized and payment of the bill will be denied by the University’s Workers’ Compensation Administrator Gallagher Bassett.
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5) Medical Treatment has been Received
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Employee
Manager
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It is your responsibility to keep your supervisor, HR Partner, and Leave and Accommodations Coordinator informed of your work status by providing these individuals with a copy of your Florida Workers' Compensation Uniform Medical Treatment/Status Report Form referred to as the DWC25.
When treatment is received from one of the clinics on the University’s Approved Medical Provider List, you will be given a DWC25 prior to leaving the clinic. If the DWC25 is not given to you, you must ask for it.
a) The DWC25 Form provides information regarding your injury, restrictions, and your next appointment.
b) It is your responsibility to provide your manager, HR Partner, and Leave and Accommodations Coordinator with a copy of your DWC25 form, within 24 hours after every medical appointment.
To assist you in determining who your designated HR Partner and Leave and Accommodations Coordinator is, click on the following links:
Note: if this documentation is not provided to the above within 48 hours of receiving medical treatment, your continued absence from work may be considered unauthorized.
Risk Management does not need a copy of your DWC25 Form.
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6) Additional Information Regarding Medical Treatment
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Employee
Manager
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a) There are urgent care clinics on the Approved Medical Provider List that are open 7 days a week.
b) When you arrive at the clinic, present your University of Miami ID/badge.
c) DO NOT PROVIDE ANY MEDICAL FACILITY OR PHYSICIAN WITH YOUR PERSONAL HEALTH CARE INSURANCE INFORMATION. Medical treatment for authorized work related injuries or illnesses must be billed to University’s Workers' Compensation Administrator Gallagher Bassett.
Billing Address:
PO Box 2831,
Clinton, IA 52733-2831
Telephone:
800-889-6764 Ext. 2911
or 800-889-6764 Ext. 2925
Fax: 866-509-8358
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7) Life Threatening Injuries
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Employee
Manager
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Examples of Life Threatening Injuries are (but not limited to) injuries that result in loss of consciousness, a deep laceration, a head injury, a fall from a ladder or down a staircase, possible loss of life or limb; call 911 or go to the nearest hospital emergency department.
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8) Claim Number
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Employee
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The hospital emergency department or any medical provider may ask you for a claim number at the time of treatment.
The Risk Management Department will not have a claim number on the day you are injured.
The University's Workers' Compensation Administrator Gallagher Bassett will have your claim number within 24 to 48 hours after your injury or illness has been reported in Workday. Your social security number can be used as a temporary claim number.
Upon your receipt of your Claim Number It is your responsibility to contact the medical provider and provide same with your claim number, Gallagher Bassett’s mailing address, telephone, and fax numbers.
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9) The Work Injury/Illness Request is Submitted
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Employee
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After completing your Work Injury/Illness Report in Workday and clicking on Submit, your injury information is transmitted electronically to the University’s Workers’ Compensation Administrator Gallagher Bassett.
a. Within 24 to 48 hours, a Gallagher Bassett Resolution Manager will be assigned to your claim.
b. The Resolution Manager will contact you to obtain more information about your injury or illness.
c. The Resolution Manager can answer any questions you have regarding workers’ compensation.
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Manager
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The Gallagher Bassett Resolution Manager will contact you within 24 to 48 hours of their receipt of the employee’s Injury Request to:
a. Obtain information about the accident/injury.
b. The employee’s return to work.
c. Accommodation of restrictions.
d. Request the employees job description.
Note: as the Manager, it is your responsibility to speak with and provide requested information to the Resolution Manager.
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10) Ongoing Medical Treatment and Follow Up Appointments
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Employee
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It is your responsibility to:
a) Go to every scheduled physician and physical therapy appointment. Cancelling and rescheduling physician and physical therapy appointments will result in suspension of your workers’ compensation benefits.
b) Know the date and time of all follow up physician and physical therapy appointments. Obtain this information before leaving the physician or therapist office.
c) Clarify your work status with the treating physician during the appointment.
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11) Absence from Work and Lost Wages
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Employee
Manager
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If your claim is deemed compensable by Gallagher Bassett, and the authorized physician has indicated that you cannot work (or your manager cannot accommodate your work restrictions), Gallagher Bassett will pay you a Lost Wage benefit which is less than your net salary. You may be allowed to supplement the difference by utilizing your accrued sick or vacation time to bring you up to your net salary.
a) The option to utilize accrued sick or vacation time is determined by HR. Contact your HR Partner to determine if you are eligible for this option.
b) If you are eligible to utilize accrued sick or vacation time it is your responsibility to provide your HR Partner with a copy of the check you receive from Gallagher Bassett.
c) Note: Per Florida’s workers’ compensation statute, the lost wage benefit is not paid for the first seven (7) calendar days preceding the injury/illness, however, you may be entitled to Administrative Leave per the University’s Administrative Leave policy. Contact your HR Partner and/or your Leave and Accommodations Coordinator to see if you are eligible for Administrative Leave.
i. Human Resources: Contact Your HR Partner
ii. Leave Management: Leave Management
The Leave Management Team can be contacted via email: umloa@miami.edu
For more information regarding the Lost Wage Benefit, contact your Gallagher Bassett Resolution Manager.
You are not entitled to receive your full salary and lost wage benefits.
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12) Administrative Leave
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Manager
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ABSENCE DUE TO WORK-RELATED INJURY:
The University provides administrative leave to cover an employee’s absence due to a work-related injury suffered by the employee that same day. Thereafter, the University provides administrative leave for the first seven (7) calendar days immediately following the occurrence of a work-related injury, provided the employee’s absence from work is supported in writing by a health care provider.
Administrative Leave due to a work related injury or illness is not extended to UMH employees.
Contact your HR Partner if you have questions regarding Administrative Leave, e.g. who’s eligible, how to enter it in Workday, etc..
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13) Returning to Work
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Employee
Manager
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When released to return to work by the treating physician you must notify your supervisor, HR Partner, and Leave and Accommodations Coordinator immediately because written clearance to return to work may be required.
a) Failure to return to work after receiving clearance from your Leave and Accommodations Coordinator, HR Partner, or supervisor, may be considered a violation of University policy and result in disciplinary action.
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14) Gallagher Bassett Handles Your Workers’ Compensation Claim
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Employee
Manager
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The University's Workers' Compensation Administrator is Gallagher Bassett.
A Gallagher Bassett Resolution Manager will be assigned to your claim to assist you with medical appointments, physical therapy appointments, and obtaining medication relative to your work injury or illness.
Your Resolution Manager will send you a packet containing information and forms explaining the State of Florida Workers' Compensation process.
You must complete and return the forms to your Resolution Manager. This includes (but not limited to) the medical records release form and the Mandatory Fraud Statement. By signing the mandatory fraud statement, you are confirming your understanding of this important information. Your Workers’ Compensation benefits will be suspended if you refuse to sign and return the above-mentioned documents to Gallagher Bassett.
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15) Gallagher Bassett’s Mailing Address, Telephone, and Fax Number
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Employee
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PO Box 2831, Clinton, IA 52733-2831
Telephone:
800-889-6764 Ext. 2911 or
800-889-6764 Ext. 2925
Fax: 866-509-8358
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16) Medical Bills
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Employee
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If you receive a medical bill for authorized medical treatment relative to your work injury, it is your responsibility to email or fax the bill to your assigned Gallagher Bassett Resolution Manager.
It is your responsibility to give the medical provider your claim number, Gallagher Bassett’s mailing address, telephone, and fax numbers.
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17) Time Missed from Work Due to Medical or Physical Therapy Appointments
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Employee
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You may utilize your accrued sick or vacation time for hours missed from work for medical or physical therapy appointments.
Administrative Leave is not applicable.
Loss wage benefits from Gallagher Bassett are not applicable.
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18) Work Restrictions, Limitations
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Manager
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An employee may be released to return to work with restrictions or limitations.
It is a benefit to the employee’s overall wellbeing when accommodations can be made for an employee to return to work in a limited capacity, even if it is for 4 hours a day.
Contact your HR Partner or Leave and Accommodations Coordinator for assistance with determining restricted work options.
If you cannot accommodate the employee’s restrictions/ limitations advise your HR Partner and Leave and Accommodations Coordinator so other time sensitive benefits can be initiated.
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19) FMLA
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Manager
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FMLA runs concurrent with workers’ compensation. When an employee is off work due to the work injury or illness, you must immediately advise your HR Partner and your Leave and Accommodations Coordinator.
i. Human Resources: Contact Your HR Partner
ii. Leave Management: Leave Management
The Leave Management Team can be contacted via email: umloa@miami.edu
Note: all questions regarding FMLA must be directed to HR or Leave Management.
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20) Short-Term Disability (STD)
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Employee
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If your time off work extends beyond two weeks, and you are enrolled in the University’s Short-Term Disability (STD) plan contact your Leave and Accommodations Coordinator to determine if you can/should initiate STD.
i. Leave and Accommodations Team email: umloa@miami.edu
The University's STD Plan Administrator is Cigna.
Cigna's contact telephone number is: 1-800-362-4462.
Note: all questions regarding STD must be directed to your Leave and Accommodations Coordinator or Cigna.
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21) Manager Responsibilities
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Manager
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a. Discuss work injury/illness reporting procedures outlined in this document with your staff.
b. Investigate the accident to determine cause.
c. Identify procedures for the prevention of future accidents, if possible.
d. When medical documentation is received from the employee, email this documentation to your HR Partner and Leave and Accommodations Coordinator.
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