Policies and Responsibilities

10.2.9 WORKER'S COMPENSATION CLAIMS ADMINISTRATION

10.2.9.A Occupational Injury and Illness

Policy

All University employees are covered by the Michigan Workers Disability Compensation Act, which provides for medical and wage loss payments when an injury or illness arises out of and in the course of employment. Failure to follow the procedures outlined below may jeopardize an employee's entitlement to benefits under the law, or cause a delay in benefits. The University reserves the right to determine liability for alleged occupational injuries and illnesses. Liability is determined following completion of a Report of Injury, an evaluation by a WSU authorized occupational clinic, and receipt of associated medical reports.

An evaluation by a WSU authorized occupational clinic is required in all instances of occupational injury or illness even if no treatment is necessary. The designated-authorized occupational clinics and ER facilities are:

Non-emergency issues:

University Health Center (UHC)-4K
Henry Ford Medical Center - Harbortown

Emergency issues:

Detroit Receiving Hospital ER
Henry Ford Hospital-Detroit-ER

Procedure

Responsibility		Action

Employee	1.	Report the injury/illness to supervisor and/or director IMMEDIATELY after incident. Obtain authorization form from supervisor/director, unless emergency services required.
	2.	Seek IMMEDIATE medical attention at a WSU authorized occupational clinic (no appointment necessary) during business hours, or designated authorized hospital-ER for emergency or after-hours care. If an ER visit is sought, report to the associated occupational clinic the next business morning (no appointment necessary). (i.e., DRH-ER = UHC 4K; HF Hospital-ER = HF Clinic)
	3.	Complete Report of Injury form with supervisor or director immediately after initial medical visit. Employees report immediately to their department after each medical visit to keep their supervisor and/or director abreast of their injury/work status and to receive work instruction. Present Work Status/Discharge form to department for review.
	4.	Verify with supervisor/director that the Report of Injury form was submitted to the Office of Risk Mangement.
	5.	Forward invoices directly related to the work injury to the Enterprise Risk Management & Insurance Programs for review.

	6.	Ensure compliance with all medical treatment and future appointments related to the injury as deemed necessary by occupational physician and authorized specialists.


Supervisor/Director	1.	For off-campus emergency situations: Follow the local community emergency procedures (i.e., call 911, etc.)
	2.	On Campus emergency situations: Contact WSU Police Department (7-2222) to report the incident. If immediate treatment is necessary or the employee is not ambulatory to receive transportation, WSU Police Department will determine the type of transportation required, if necessary.
	3.	Instruct employee to report to a WSU authorized occupational clinic (or ER) immediately after the injury, regardless of how insignificant the injury appears at the time. Provide employee with signed Authorization form that permits employee to visit clinic.
	4.	Assist employee with completion of the Report of Injury after initial medical treatment has been rendered. Supervisor or director shall sign and date the Report of Injury form at that time and ensure the Report of Injury form is presented to Risk Management immediately upon completion.
	5.	Review restrictions and determine if the department can work the employee within the restrictions provided by the occupational clinic. Advise employee and the Enterprise Risk Management of work status. Continue to keep Enterprise Risk Management & Insurance Programs aware of employee's work status throughout the claim (i.e., off duty, working with restrictions, return to work, etc.)

	6.	Complete a Supervisor's Injury Investigation Interview and forward to the Enterprise Risk Management & Insurance Programs within 48 hours of the injury.


Enterprise Risk Management & Insurance Programs		Review Report of Injury and medical documents to determine compensability under Worker's Compensation.
	2.	Review and remit payment of properly submitted invoices for authorized medical services per Healthcare Rules.