File:  GBGD-R - Worker's Compensation Claims Procedures

An employee who sustains a work related injury or disease which is directly attributable to the employee's job, trade, occupation, or position may qualify for medical and/or wage loss benefits under the Colorado Workers' Compensation Act.  Workers' Compensation claims are administered and adjusted by a third party administrator.

The purpose of the procedures is to establish the required reporting, time lines, and forms to be used for the reporting and handling of Workers' Compensation accidents.  The employee will take the following action:

Employee Medical Treatment

The Colorado Workers' Compensation Act allows the employer to select the physician(s) who treat injured employees.

  The injured employee may be examined by the nearest district nurse, providing a nurse is available.

  If further medical treatment is required, the district nurse or supervisor will issue the injured employee an Authorization Form for medical treatment at the designated medical provider: Summit Medical Center, Highway 9 at School Road in Frisco (970-668-3300).

  The employee, after treatment, will return the Medical Status Report issued by the designated provider to their supervisor and assist in the completion of the First Report of Injury form.

  In the event of a serious medical emergency, treatment should be sought from the nearest medical facility.  However, the designated provider must be contacted and follow-up care must be directed by the designated physician.

  In the event medical treatment is required for a work related injury after the office hours of the designated clinics or on a weekend, the employee should go to the Emergency Room at the Summit Medical Center, Highway 9 at School Road in Frisco (970-668-3300) or to the nearest medical facility.

  If an employee wishes to be treated by a physician other than one approved, they do so at their own expense.

Employee Reporting Requirements

  Injured employees should notify their supervisor within 24 hours after a work related injury.

  The injured employee must give written notice to the Human Resources Coordinator within four working days after the accident.

  The injured employee will assist the supervisor in completion of the First Report of Injury form.

Lost Time

  Any time off from work due to a work related injury must be authorized by a designated physician.

  In accordance with the Colorado Workers' Compensation Statute, an injured employee must be absent from work for three full working days before Workers' Compensation Wage Benefits begin.  Employees may use up to three days of their accumulated sick leave for the first three days of absence due to a work related injury, and thereafter, receive Statutory Workers' Compensation Benefits which is 2/3 of the employee's average weekly wage at the time the injury occurred.

  The injured employee must return a copy of the doctor's report to their supervisor after each doctor's visit.  This report will give the prognosis and the date the employee must return for follow-up visits.  The supervisor will send the report to the Human Resources office.

  It is the duty and responsibility of the injured employee to keep his/her supervisor advised of their return to work status.

The supervisor/administrator/nurse will take the following actions:

Medical treatment

If appropriate, seek medical or emergency care for the injured worker at the nearest medical facility.

If medical treatment is required beyond the first aid rendered by the school nurse, the building administrator, supervisor or nurse should complete the Designated Physician's Authorization Form for the employee.  Direct or take the injured employee to the nearest designated provider facility.

Supervisor Reporting Requirements

  Give the injured employee the Summit School's Information Document on the District's Workers' Compensation Program

  Forward the following to the Human Resource Office along with the physician's report on the injured employee:

1.  The Employer's First Report of Injury Form

2.  Completed Workers' Compensation Employee Status Report

These items must be forwarded to the Human Resource Office within four working days of the occurrence.

Note: The injured employee should not complete the Employer's First Report of Injury, but should assist in completion of the form.

  Advise the injured worker that written notice must be delivered to the Human Resource Office within four working days of the accident.

  Investigate the claim and complete a Supervisor's Workers Compensation Claim Follow-up Report and forward to the Human Resource Office.

  If the supervisor feels the claim is not valid, Human Resource should be notified of the fact and the supervisor will submit a written statement verifying why he/she feels the claim should not be honored.

  Note: All fatalities and any accident involving two (2) or more employees must be reported immediately by telephone to the Human Resource Coordinator and the Superintendent.

The supervisor will work closely with the Human Resource Coordinator on the following:

1.  The exact amount of time lost due to the injury

2.  The exact date employee returns to work

3.  Determine whether sick leave is being used for the first three days of absence

4.  Provide completed employee status reports after each follow-up visit by the injured employee to the designated provider

5.  Provide restricted light duty for the return to work of employees that have been released by the designated physician with restrictions

Hearings

The supervisor will attend hearings and cooperate with the District's Workers' Compensation insurer on the handling and adjudication of Workers' Compensation Claims.

Reporting

Written notice of accidents received from injured employees will be date stamped.  Copies of the written notice will be made available to the injured employee within two working days following receipt of the notice.  The Human Resource Coordinator will forward the First Report of Injury Form, medical reports, and supervisor follow-up reports to the District's Workers' Compensation Insurer within eight days of injury.

Claims

The Human Resource Office will coordinate the claims with the insurer, injured employee, designated provider and the supervisor.  Workers' Compensation master files and records will be maintained in the Human Resource Office.

Compensation

An employee is eligible for workers' compensation leave from the district during the period of time the employee is temporarily disabled as the result of any injury arising out of and in the course of employment which qualifies for an indemnity payment from the workers' compensation division of the Colorado Department of Labor and Employment.

Workers' compensation leave shall be available only to those persons who sustain a temporary total disability and are unable to perform services for the district while disabled.

It is the intent of the Board that temporarily disabled employees receive a payment from the school district in addition to any temporary disability indemnity payment for which the employee is eligible under the Workers' Compensation Act so that the employee does not suffer a financial hardship while disabled.

While an employee is on workers' compensation leave, the employee shall receive a payment from the district equal to 33 percent of the weekly wage.  This is an amount that exceeds the temporary total disability benefits available under workers' compensation.  Such payments by the district shall continue until the employee is no longer eligible for temporary total disability benefits, but in no event shall workers' compensation leave exceed three months from the date of the application for benefits.

In the event that an employee receives benefits and pay in excess of 100% of his normal pay, the amount in excess of 100% will be assigned to the school district.  To assist in the collection of such funds, the district may seek authorization from the workers' compensation division to allow reimbursement by the division or insurance carrier directly to the district for any benefit payments for which a district employee applies and for which the employee is eligible.  The indemnity payment may be assigned to the district while it is making workers' compensation payment to the employee in accordance with this policy.

During the period of workers' compensation leave, the district shall not charge any earned vacation leave, accrued sick leave or other similar benefits to the employee, nor shall such benefits be available to the employee while eligible for workers' compensation leave.  The sole compensation to the employee during the period of disability shall be the district's workers' compensation leave payment provided for by this policy.

In the event temporary disability exceeds the three months for which workers' compensation leave payments are available from the district and the employee is still eligible for indemnity payments, those payments shall be made directly to the employee from the workers' compensation division or insurance carrier.

An employee shall be entitled to supplement the indemnity payment by using earned sick leave and vacation time computed so that the combination of indemnity payment and district-paid benefits equals 100 percent of the employee's weekly wage or equivalent.

Employees shall continue to have school district health insurance coverage, while on workers' compensation leave, to the same extent the employee had such coverage prior to taking workers' compensation leave.

Approved: January 8, 2003

LEGAL REF. :  C.R.S. 8-42-124

CROSS REFS.:  GCD, Professional Staff Vacations and Holidays

GDCA, Support Staff Sick Leave

GDD, Support Staff Vacations and Holidays

GDCB, Support Staff Personal/Emergency/Legal/Religious Leave