Injured Employee’s Responsibilities
All employees are responsible to report work-related injuries, accidents or illnesses to their supervisor. It is mandatory that this be done at the time of injury or, if an illness, immediately when that illness is identified as being work-related.
The employee should assure that the Supervisor’s Report of Injury or Occupational Injury form is completed by reporting the accident/illness to his/her supervisor and participating in the completion of the form that is then faxed by the supervisor to the Office of Risk Management at (202) 687-5680.
All employees are advised that if these instructions are not followed, workers’ compensation claims cannot be reviewed. Employees will not be entitled to workers’ compensation benefits and can be held responsible for any expenses incurred.
All claims are subject to investigation and approval.
- Medical Treatment Following a Work Related Injury or Occupational Illness
- When You Receive Medical Treatment
- If You Have an Authorized Work Absence
- When You Return To Work
- Medical Benefits
- Wage Replacement Benefits
- Wage Replacement Restrictions
- University Payroll Deductions
- Family and Medical Leave
- Short-Term and Long-Term Disability
- If Your Claim is Denied
- Injured Employee’s Guide to Workers’ Compenation
- Urgent: Get treatment at the nearest emergency room or urgent care facility. Ask for someone to accompany you if you are seriously injured.
- Non-Urgent: Get treatment from a healthcare provider of your choice as soon as possible but no later than one week after the incident.
Notify the healthcare provider that you are being treated for a workers’ compensation incident. The office may contact the workers’ compensation claims administrator in Risk Management at (202) 687-6622 for billing instructions.
Do not use your personal medical insurance ID card. Your medical expenses should be billed directly to Travelers Indemnity Company. Also, do not pay any co-payments or co-insurance for the treatment—the University pays for workers’ compensation medical claims. NOTE: Some physicians do not process insurance and require a payment at the time of the visit. In this instance you must pay the bill and forward your medical receipts to Travelers.
If you do pay for medical services or prescriptions, save your receipts and forward them to your Travelers claims adjuster.
If you are unable to return to work after an injury or illness you must provide written documentation from a healthcare provider explaining the reason for the absence, the period the absence is to cover and, if possible, a projected date for return to work. Failure to do so may result in denial of your claim. You are obligated to:
- Notify your supervisor as soon as possible of your indecent status.
- Provide your supervisor with your healthcare provider’s written authorization.
- Keep your supervisor advised of your status and, if possible, your expected return to work date.
- Promptly complete and submit all letter and forms sent to you.
- Cooperate and communicate with the Travelers adjuster assigned to your claim.
- Keep appointments with your healthcare provider.
- Follow your healthcare provider’s treatment plan.
- If you relocate, notifiy Risk Management and Travelers of your new address and phone number.
When you return to work you must provide your supervisor with a healthcare provider’s clearance authorizing you to work with or without restrictions. If you have a clearance with restrictions discuss possible accommodations with your supervisor. The University may not allow employees to return to work without medical clearance.
Once your claim is approved by Traveler, your authorized, medically necessary care and treatment related to your injury is a covered workers’ compensation benefit. Medical treatment may include and are not limited to: physician’s visits, hospitalization, physical therapy, medical tests and prescription drugs.
Once your workers’ compensation claim is approved, you will receive a percentage of wage replacement benefits for lost time supported by medical documentation.
Wage benefits are subject to a three-day waiting period. During this time you must use sick leave, paid leave, or leave without pay*.
Wage-replacement benefits will equal 66 2/3% of your pre-injury regular weekly wage, the benefit will not be higher than your average weekly wage. Deductions are not taken for federal and state income tax and are not reported as income.
*Leave for Union-represented employees is governed by the terms of the applicable collective bargain agreement. Contact your Human Resources Generalist about how leave is handled during the 3-day waiting period.
Employees may not use paid leave or sick leave in lieu of worker’s compensation wage replacement benefits. Except for the mandated three-day waiting period, there are no exceptions.
Employees may not receive workers’ compensation pay and their regular University pay (including holiday pay) for the same period of time. An employee who receives both will be required to reimburse the University the amount of the regular pay.
Your workers’ compensation payment checks are issued by a third-party administrator and are not subject to University payroll deductions. While you are receiving workers’ compensation pay you continue to be responsible for your health and life insurance premiums and any other benefit programs you are enrolled in, as well as payments for University services such as parking, fitness memberships, etc. If your paychecks are garnished for any reason it is your responsibility to immediately report this information to Risk Management. Employees are held responsible for all payments in arrears for all of the above.
When you are absent from work and receiving workers’ compensation wage benefits you may be eligible for Family and Medical Leave. To apply complete the Georgetown University Leave Request Form and submit it to Human Resources for processing. For information and assistance contact your human resources generalist at (202) 687-2500.
You may not receive workers’ compensation wage replacement benefits and Short-Term or Long-Term disability at the same time. For information or assistance regarding these benefits, contact the Faculty and Staff Benefits Office at (202) 687-2500.
If your claim is denied you may be eligible for Short-Term or Long-Term Disability. Contact the Faculty and Staff Benefits Office to process an application.
You may also contact the Office of Risk Management or your human resources generalist to discuss your claim status and options.
The Injured Employee’s Guide to Workers’ Compensation is intended to give you an overview of your responsibilities regarding the program and contact information.
If you have questions regarding your claim, medical treatment, reimbursements, wage benefits or any other issues that you may need assistance with, you should contact your claims adjuster at Travelers.
You may also contact the Office of Risk Management at (202) 687-6622.