Purpose of the Policy
The purpose of this policy is to set forth the obligations of University employees and the University under the Workers’ Compensation Law with respect to reporting, filing, and processing claims, as well as returning to work from a Workers’ Compensation leave.
Who Needs to Know This Policy
All University employees need to know this policy and process. Special note of this policy and process should be taken by all employees occupying managerial and human resource positions because of their obligations under this policy.
The University’s Obligations
New York University (“NYU”) pays for and maintains Workers' Compensation Insurance. Employees are not required to contribute to the cost of Workers' Compensation Insurance.
Employers must post a Form Notice of Compliance - Workers' Compensation Law (C-105) that includes the name, address and phone number of their insurer and the policy number of the employer. It must be posted in a conspicuous place in the employer's place of business. Violations of this requirement can result in a fine of up to $250 per violation.
Supervisor/Human Resources Officers’ Obligations
1. Upon notification that an employee has or may have suffered a work-related injury or illness, a supervisor or HRO must complete the Work Related Notice of Incident / Injury Form found online at: http://www.nyu.edu/pages/insurance/insurance_web_site_028.htm within three (3) days from the date of the incident. This form must be completed even if the injured employee did not lose time from work, and even if the employee does not want to file a claim.
2. The Supervisor or HRO must fully investigate the claim to ensure all relevant facts are gathered because the statements made in the Employer’s Report of Work-Related Injury/Illness to the Workers’ Compensation Board are legally binding. Reporting an incident is not an admission that the employer agrees with the facts surrounding the alleged work-related injury or illness, just a report of the occurrence.
3. If an employee is in need of first aid or urgent care as the result of a work-related incident, injury or illness, a supervisor or HRO should immediately escort the employee to an urgent care facility near the worksite. If near Washington Square (New York campus), the University Student Health Center - Urgent Care Reception Desk is located at 726 Broadway, Third Floor. If possible, someone should contact the Urgent Care Reception Desk at (212) 443-1007 in advance to notify them that the employee is coming. If an employee has suffered a medical emergency, including but not limited to difficulty breathing, profuse bleeding, loss of consciousness, severe allergic reaction, or fracture, the supervisor and/or HR Officer must call 911 and have the employee taken to the closest emergency room.
4. In accordance with the New York State Workers’ Compensation Board regulations, prior authorization is required by the University’s Workers’ Compensation insurance carrier for any special service or procedure costing more than $1,000. The employee’s health care provider should seek the authorization.
In accordance with the District of Columbia Office of Workers’ Compensation, “medical care furnished or scheduled to be furnished is subject to utilization review for determinations of necessity, character or sufficiency of care or service.”
5. The Supervisor or HRO must forward a copy of any medical notes, discharge paperwork, or any other paperwork concerning a work-related injury or illness to the Manager of Workers’ Compensation in the Department of Insurance & Risk Management.
1. All work-related incidents, injuries or illnesses must be immediately (within 24 hours of the incident) reported to a supervisor and/or HRO.
2. Employees must obtain medical treatment for work-related injury or illness. If an employee is in need of first aid or urgent care as the result of a work-related incident, injury or illness, the employee may go immediately to a medical provider that accepts workers’ compensation of his or her choice. If the employee has suffered a medical emergency, including but not limited to difficulty breathing, profuse bleeding, loss of consciousness, severe allergic reaction, or fracture, 911 must be called and the employee transported to the nearest emergency room. If near Washington Square (New York campus), the University Student Health Center - Urgent Care Reception Desk is located at 726 Broadway, Third Floor. If possible, someone should contact the Urgent Care Reception Desk at (212) 443-1007 in advance to notify them that the employee is coming.
3. Employees must ensure that their NYU e-mail addresses are active, because claim numbers and instructions will be sent to NYU e-mail addresses.
4. Employees must cooperate with the independent medical examination process, under the Workers’ Compensation Law, or risk the nonpayment of workers’ compensation benefits and the closure of the Workers’ Compensation claim.
5. Employees must follow the absence and leave notification procedures of the School, Division, Department, or Unit in which they work.
6. Employees are required to contact Liberty Mutual, NYU’s administrator for FMLA leave under the Family and Medical Leave Act of 1993 (“FMLA”), at 1-888-339-6830 to determine FMLA eligibility. FMLA runs concurrently with Workers’ Compensation leave.
7. Employees are eligible to apply for reimbursement from the insurance carrier for any “out-of-pocket” medical and medical-related expenses, such medications and mileage or transit costs to and from doctors’ appointments. Therefore, records of expenses should be maintained and submitted by the employee to NYU’s Workers’ Compensation Insurance carrier, Liberty Mutual, for consideration.
8. Statutes provide that a waiting period must elapse during which income benefits are not payable. Employees of varying object codes and members of collective bargaining units may be subject to different sick leave usage rules than employees who are notii. After the waiting period the employee will receive income benefits issued by NYU’s insurance carrier. The waiting period affects only compensation; medical and hospital care are provided immediately. Necessary medical care is provided no matter how short or how long the length of the disability.
9. Follow return to work procedures.
Temporary or Student Employees
Temporary and student employees are not eligible for sick leave or vacation benefits and therefore will not be paid for the waiting period of the disability. However, if their disability exceeds the waiting period they will be eligible for wage replacement benefits. Benefit payments will be made directly by NYU’s Workers’ Compensation carrier at the Workers’ Compensation rate as prescribed under law and will continue until the employee is certified by a doctor to return to work.
Return to Work
The employee or the University’s Workers’ Compensation Insurance carrier will notify the University when the employee is authorized to return to work with or without restrictions. The employee will also be required to present to the Supervisor / HRO written confirmation from the employee’s medical provider of the employee’s ability to resume work. If an employee is out of work 3 or more days as a result of a work related injury /illness their treating physician must complete the “Work Related Injury / Illness – Physician’s Status Report.” An employee will not be allowed to return to work after a work related injury / illness without written authorization.
Returning to Work With Restrictions
If an employee is authorized to return to work with restrictions, the employee’s health care provider must complete the “Work Related Injury / Illness – Physician’s Status Report,” which will be provided by the insurance carrier along with the employee’s job description provided by the HRO. The form should identify the required restrictions, the basis for the restrictions, and the duration of such restrictions. The Department of Insurance & Risk Management will consult with the Office of Equal Opportunity (“OEO”) and the employee’s department to address the prescribed restrictions. Please note that disability law does not require an employer to provide a reasonable accommodation to an employee suffering from an occupational injury if the injury does not qualify as a disability under either federal, state, or local law. Thus, an employee’s request to return to work with restrictions may qualify under the Workers’ Compensation Law, but not necessarily qualify as a reasonable accommodation under disability law.
Record Keeping Requirements
Medical information regarding an employee’s Workers’ Compensation claim must be collected and maintained separately in a confidential manner from the employee’s personnel records. Such information must be kept confidential even after the employee separates from the University. Workers’ Compensation records must be kept for at least eighteen (18) years from the date of the incident or accident report. The NYU Department of Insurance serves as the official repository for Workers’ Compensation records.