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Hillsborough Community College is self-insured for Workers’ Compensation insurance coverage through the Florida College System Risk Management Consortium (FCSRMC). This program is administered by Gallagher Bassett Services, Inc. and coordinated by the College’s Employee Relations Office in Human Resources. Gallagher Bassett is the insurance carrier that pays medical and indemnity benefits under the provisions of Florida Statutes to employees with a work-related illness or injury.
The law requires that the College be responsible for all accidental injuries and occupational diseases arising out of, and in the course of, employment. Generally, no compensation is payable if the injury was caused primarily by the employee’s intoxication, by the influence of non-prescribed drugs, or willful intention to injure himself/herself or another person. The law also provides that where the injury is caused by the knowing refusal of the employee to use a safety device or observe a safety rule, compensation may be reduced by 25%.
Claims may be investigated where it is not obvious that the injury is job-related. An injury or illness may or may not be covered by Workers' Compensation. These incidents are compensable only if the injury arose out of, and in the course of, employment while the employee is actively engaged in the duties of the job. Gallagher Bassett will make this determination based on knowledge of the Workers' Compensation law and investigation of the facts surrounding the injury.
If the injury is covered, payment of all reasonable and necessary medical care, including surgical, hospital, and dental (within limits of various fee schedules) will be authorized and paid by Gallagher Bassett. Items such as medication, braces, crutches or other medical supplies, when ordered by an authorized medical provider treating the injured employee, are also covered. Rehabilitation services for injured workers who need help to returnto employment may be available, if prescribed by the assigned physician.
The program also provides indemnity payment to the employee for 66-2/3% of the wages he/she might lose, if the injury disables the employee for more than the 45 hours of illness-in-line of duty leave the College awards. The remaining 33-1/3% of wages is deducted from the emplyee's accrued compensatory, sick, and vacation leave.
Employees sustaining work-related injuries that require an absence of three or more days from the workplace, or that otherwise qualifies under the Family Medical Leave Act (Administrative Procedure 3.31) will have the absence counted towards the entitlement of FMLA.
WHAT DO TO WHEN INJURED
An injured employee must immediately notify their supervisor and the Public Safety Office (x-7911) of the incident even if medical attention is not thought to be necessary at that time. A Public Safety Officer will notify the Office of Employee Relations in Human Resources, and will complate appropriate forms and reports to begin coordination of the claim. The injured worker must provide signature on the reports. If there are witnesses to the incident, Public Safety will record those observations as well.
BENEFITS
Immediate medical attention, remedial treatment, and medical benefits are available to all injured employees. In addition, specific expenses incurred as a result of a Workers' Compansation injury/illness may be reimbursed.
At the time of injury, HCC will refer an employee to an authorized medical provider for treatment. Treatment received outside of the authorized Workers' Compensation medical provider may not be paid unless authorized by Gallagher Bassett prior to the treatment date. The exception fo this may include emergency treatment.
HCC's Public Safety Officer will provide an Identification Form for the employee to present to the medical facility at the time of initial treatment. The employee will also be provided with contact information for Gallagher Bassett Services.
The Public Safety Officer or personnel in the Employee Relations Office are the only persons who can authorize initial medical treatment for an injured employee. In the case of an emergency, the injured employee may be transported by local emergency personnel to the nearest hospital emergency room/trauma center.
Referrals must be made to a participating network provider unless the referral is for emergency treatment not available within the network. The claims adjuster with the insurance carrier will authorize, if appropriate, additional health care services following the initial treatment and/or referrals to medical specialists.
Under the provisions of the Workers' Compensation law, an injured employee will be allowed to change to another medical provider within the network one time only. To do so, the employee must call or write to the claims adjuster to request a change. Rationale should be provided for consideration, such as a provider is closer to home, or to work, etc. The adjuster will review the employee's request and will identify another provider within the network and of the same specialty.
If the injured employee is unable to perform the duties of their regular job, the employee must notify his/her immediate supervisor AND Employee Relations (x-7187). The employee is expected to keep Employee Relations informed of his/her progress and must provide notification the day he/she returns to work. It is the employee's responsibility to request and obtain an ability to work report from the treating physician upon each treatment visit. All forms given to the employee by doctors, therapist, etc., MUST be reviewed with the supervisor then forwarded to the Office of Employee Relations.
If the employee returns to work with limitations or restrictions, it is the responsibility of the employee to comply with the restrictions designated by the medical provider. It is also important that the employee's supervisor is aware of the restrictions and makes certain the employee does not perform beyond those limitations until fully released to do so by the medical provider.
The Payroll Office (x-7098) is the custodian of leave records and is responsible for maintaining the official absence records for an injured employee. The employee's administrative supervisor, in conjunction with the Payroll Office and Employee Relations will ensure that the employee's absences are properly recorded.
If an employee qualifies for disability payments, the employee, the Employee Relations Office and Payroll Office will coordinate indemnity payments from Gallagher Bassett to make certain that the amount received complies with the law.
Please feel free to contact the Employee Relations Office in Human Resources at x-7187 with any questions you may have. Additional information is provided in the Administrative Procedure (3.20) for Workers' Compensation on HCC's website at www.hccfl.edu.
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