MSU Human Resources

When an Employee Sustains an Injury . . .

It’s important to take

all the right steps!

MSU Human Resources

What type of treatment is needed? Contact 911 for emergencies

For non-emergencies - Olin Health Center is the primary facility

Secondary facility for after hours and weekends – Sparrow Urgent Care

Complete an “Authorization to Invoice MSU” form for the employee to take with them

MSU Human Resources

Authorization to Invoice MSU Form Find this on www.hr.msu.edu under the forms directory

Fill form out completely

Please write legibly

Time of day determines facility used

MSU Human Resources

Reporting the Injury or Illness

Complete a “Report of Claimed Occupational Injury or Illness” form

Forward completed form to the Workers’ Compensation office in Human Resources within 24 hours

Tony Lemke (A-K) 884-0163

Kendra Sokol (L-Z) 884-0208

MSU Human Resources

Report of claimed occupational injury or illness form

Find this on www.hr.msu.edu under the forms directory

Employee completes and signs first section

Supervisor completes and signs remaining sections

Do NOT send this form to the medical facility, it goes to MSU Human Resources

MSU Human Resources

What is the Employee’s responsibility?

Report injury to supervisor

Seek medical treatment if necessary (release time)

Complete claimed occupational injury or illness report

What is the Supervisor’s responsibility?

Complete authorization form

Send employee for medical treatment if necessary

Complete claimed occupational injury or illness report

MSU Human Resources

Who should receive this report? Worker’s Compensation Office at MSU HR (original)

Fax form over immediately once employee and supervisor have signed. Continue circulating original for other necessary signatures

The employee

The department where the employee works

MSU Human Resources

Medical Treatment

An injured worker must treat with the MSU designated provider(s) for the first 28 days

After 28 days they can choose their own physician by submitting an “Intent to Treat” form

MSU Human Resources

Intent to Treat Form

Find this on www.hr.msu.edu under the forms directory

This form is the employee’s responsibility

Must be completed prior to appointment

Coverage is not guaranteed

MSU Human Resources

Work Restrictions

Can the department accommodate the restriction(s)?Own jobLight dutyReduced hoursDifferent job

Options if the department is not able to accommodate restriction(s)Help in another unitOff work until next re-check

MSU Human Resources

Total Disability FMLA is applicable after 3 days off, or if seeking on-

going treatment.

Runs concurrently

FMLA forms need to be completed

Time is recorded FMLA on attendance system by

department for the first 10 days of leave; then FMLA

team member

FMLA questions: Beth Tominski 884-0188 (A-L) or

Sheila Chorey 884-3652 (M-Z)

MSU Human Resources

Total Disability ADA is applicable depending on the length of

limitation(s) and/or restriction(s)

Permanent disability

Affecting one or more activities of daily living

Questions regarding ADA go to Resource Center for

Persons with Disabilities at 517-884-7906

When does vocational rehabilitation apply?

MSU Human Resources

Wage Replacement

Accident Time

Criteria for wage replacement

Totally disabled

Anytime the employee does not earn full wages beyond 7 calendar days

MSU Human Resources

Wage Replacement

Workers’ compensation calculates a rate based on previous earnings Rate is state-mandated

Currently 80% of after-tax wages

Highest 39 weeks of previous 52 weeks worked is used to calculate wage replacement amount

Marital status, dependents and tax filing status affect rates

There is a cap or weekly maximum on wages replaced

MSU Human Resources

Impact on Time Off Accruals

MSU HR will use available sick time to off-set workers’ compensation earnings

WC staff will enter this time into the SAP attendance system

MSU Human Resources

Medical Travel Reimbursement Request Form

Reimbursement of travel expenses to and from medical appointments

Find this on www.hr.msu.edu under the forms directory The rate of reimbursement

changes each year

MSU Human Resources

Other entitlements Cab service is available through Spartan Cab at

517- 485-4400

Reimbursement of any related out-of-pocket expenses

Co-pays

Bandages

OTC expenses

Original receipts to MSU HR

Glasses may be covered

MSU Human Resources

Impact on Benefits Accrued time

Sick time must be used per contract

Vacation and personal time use must be authorized by employee

Once accruals are exhausted, the employee will not continue to accrue until he or she returns to work

Health insurance, dental insurance and other fringe benefits

If going on workers’ compensation, may need to pay benefits premiums to continue coverage

MSU Human Resources

QUESTIONS

MSU Human Resources

Long Term Disability Benefits

MSU Human Resources

Long Term Disability Benefits

Must be full-time employee

Must have required number of service months

Must be off 180 days with LTD payable on 181st day

May be eligible for Extended Disability Leave (EDL)

60 percent of base wages at time of disability

MSU Human Resources

Long Term Disability Benefits

15 percent into retirement contracts

Health and dental benefits continue

University pays life insurance premiums (if previously enrolled)

Placed on leave of absence for up to two years

Payable until age 65 if under 60 when disability occurs