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Policy No: 2099
Responsible Office: Human Resources
Last Review Date: 05/06/2024
Next Required Review: 05/06/2029
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Accidents While at the Workplace
1. Purpose
The 黑料天堂, USA HealthCare Management, LLC, and the USA Healthcare Authority (USA Employer Group) strive to protect its employees from undue financial hardship resulting from qualified job-related injuries, illnesses, or disabilities. The Worker’s Compensation Act of the State of Alabama does not apply to the USA Employer Group. The University’s On-theJob Injury Program will cover employees’ approved medical expenses and lost wages incurred as a result of an on-the-job injury (OJI).
2. Applicability
All of the USA Employer Group employees (both University General Division and USA Health) are eligible for benefits provided by the OJI program, including:
- Full-time and part-time employees;
- Temporary workers employed by the 黑料天堂 General Division and USA Health; and
- Student employees (injury must occur in the course and scope of duties as a University employee).
The OJI program does not provide benefits to volunteers, independent contractors, or workers employed outside of the USA Employer Group.
All OJI claims are investigated for compensability by the University’s Third Party Administrator (TPA). Benefit eligibility is based on employment status and whether the injury, illness, and/or disability results from an incident arising “out of and in the course and scope of employment” with the USA Employer Group.
3. Definitions
N/A
4. Policy Guidelines
N/A
5. Procedures
5.1 Application Process
An Accident/Incident Report must be completed within 72 hours of the worksite incident for you to be considered for OJI benefits. For this reason, a worksite incident should be reported immediately to your supervisor. If the report is not filed within the required 72 hours from the date of the accident/incident, and the claim is deemed compensable, no medical or indemnity benefits will be paid for any costs incurred related to the accident/injury prior to the reporting date.
University General Division employees: the Accident/Incident Report is available online at
Accident/Incident Reporting.
USA Health employees: must complete an accident/incident report via RL6 located within the USA Health employee intranet.
5.2 Medical Treatment
For detailed information please visit: /departments/financialaffairs/hr/accidents.html
5.3 OJI Benefit Duration
The OJI program will provide Wage Replacement benefits for a maximum of 180 calendar days from the date of the incident, regardless of when medical treatment is sought.
The OJI program will provide payment for medical care received to a Maximum Medical Improvement (MMI).
An employee whose employment is terminated (voluntarily or otherwise), after the incident, is not eligible for the Wage Replacement benefits following the employment termination date. Payment for medical care received will continue to a Maximum Medical Improvement (MMI).
5.4 Waiting Period
Any time lost on the day of the injury/incident, will be paid as administrative leave. The first three days following the date of the injury/incident are considered a waiting period, and no lost wage benefit will be paid during this time. An employee may request to use available sick leave, vacation, or PTO, as applicable, during this waiting period. Accrued sick leave, vacation, or PTO used will not be reinstated. Employees may also choose to be unpaid during this time. If the TPA determines that the injury, illness, or disability qualifies for OJI program benefits, the OJI program will compensate for lost wages beginning on day five.
5.5 Wage Replacement Benefit
Beginning with the fifth calendar day following the day of the injury incident, the OJI program will pay a wage benefit at the rate of 66 2/3% of the employee’s regular rate of pay, which shall not exceed the annually adjusted weekly maximum wage established by the Alabama Department of Industrial Relations. Part-time employees will receive prorated wage replacement benefit based on their FTE.
Employees may supplement the 66 2/3% OJI wage replacement benefit with accrued sick leave, vacation, or PTO, as applicable, to achieve 100% of the employee’s regular rate of pay. Employees must notify their supervisor, by submitting a leave of absence request form (see links in Section 7, below), of their desire to supplement the OJI benefit with accrued leave. In no event shall a combination of OJI benefit and supplemental time exceed 100% of an employee’s regular base rate of pay. Sick leave, vacation, or PTO used to supplement an OJI wage replacement benefit will not be reinstated. This payment is issued via the University’s Payroll Office, and normal payroll deductions, such as employee benefits premiums and federal, and state taxes will continue.
5.6 Wage Replacement and Long-Term Disability (LTD)
If you expect that you will be unable to return to work within 90 days, you are required to begin an application for benefits under the University’s LTD insurance program at least 45 days prior to the 90th day on leave. The LTD benefit will pay 60% of the employee’s base pay.
Because this benefit will be paid directly to the employee from the LTD TPA, the employee will be responsible for the direct payment of employee benefit premiums at the employee rate. Premium payments are due no later than the 25th of the month to maintain the next month's coverage. Please make your check or money order payable to the 黑料天堂 and submit your payments to the Payroll Office, TRP Bldg. III, Suite 1300.
Employees may not supplement LTD wage replacement benefits with sick leave, vacation, or PTO, as applicable.
5.7 Reimbursement of Expenses
All OJI claims are investigated for compensability by the University’s Third Party Administrator (TPA). Employees with evidence of payments from their personal funds may be reimbursed for qualifying expenses. Once the employee is released from the care of his/her designated physician, all University payments cease unless approval for follow-up care is given from the claim adjuster.
The OJI program will provide payment for medical care received to a Maximum Medical Improvement (MMI).
5.8 Leave of Absence
If lost time resulting from an OJI exceeds two calendar weeks, the employee will be placed on Family Medical Leave or a personal leave of absence, if eligible and as applicable, retroactive to the date of the incident. A leave of absence and OJI program leave will run concurrently and will not “stack” one after the other. The employee and the supervisor are responsible for submitting a new leave of absence request form to Human Resources to verify the employees’ eligibility and identify status.
For University General Division employees, the Human Resources Employee Health and Wellness Office will monitor the status of employees who are unable to work as a result of an OJI.
For USA Health employees, the Employee Health Clinic will monitor the status of employees who are unable to work as a result of an OJI.
5.9 Return to Work from an OJI-Related Medical Leave of Absence with Temporary Modified Duty
This section provides information relating to an employee’s ability to return to work after experiencing an injury, illness, or disability as a result of an OJI. Employees who are released to return to work on a regular or reduced schedule basis but with temporary job restrictions, as supported by medical evidence, may be eligible for a modified duty assignment as defined in this section.
The department head or designee, with the concurrence of the Human Resources Department, as supported by medical evidence, may assign the employee to perform certain modified duty assignments on a temporary basis. The goal of this program is to enable employees to continue using skills and abilities temporarily limited by injury, illness, or disability when modified duty assignments are available. This shall apply to any employee who has a temporary injury, illness, or disability as a result of an OJI that prevents him/her from performing his/her full duties or meeting the minimum standards established for his/her position.
In cases where the employee is not able to return to work, the employer may rely on the information contained in the “Certification of Health Care Provider” form, if applicable and available, to determine appropriate next steps. An employee must adhere to any restrictions noted on the fit-for-duty certificate provided by his/her physician.
Modified duty is an assignment, which is for a specified and limited period, that fulfills a necessary job function appropriate to the employee’s skills and level of experience and that the employee can perform without violating any medical restriction imposed on him/her as a result of an OJI. It is the employer’s responsibility to determine whether a modified duty assignment is appropriate for an employee. During a modified duty assignment, the employee is compensated at his/her normal rate of pay and benefits.
Modified duty assignments are not a matter of right. The number, availability, and duration of such assignments are limited by departmental needs as defined by the department head or his/her designee. If restrictions, as noted on the fit-for-duty physician’s note or “Certification of Health Care Provider” form, are determined to be permanent, the employee is not eligible for a modified duty assignment.
A modified duty assignment ends on the earliest of:
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- The date the employee is released to his/her regular schedule with no restrictions as evidenced on the fit-for-duty physician’s note;
- The date the physician determines the employee has permanent restrictions; or
- The date the employee fails to take a required medical examination, without good cause.
Assignment to a modified duty assignment does not in any way create a right for the employee to occupy that or any other position on a regular basis. At the end of the modified duty assignment, if an employee is unable to return to work without restrictions, he/she may be placed on a leave of absence, as applicable.
Employees who are unable to return to full duty with or without a reasonable accommodation or to modified duty, if it cannot be accommodated by his/her department, will be advised of the disability programs available and may be discharged from employment.
5.10 Reasonable Accommodation Request
The University is committed to nondiscrimination and employment of qualified individuals with physical and mental disabilities in accordance with the Rehabilitation Act of 1973 (Section 504), the Americans with Disabilities Act (ADA), as amended by the Americans with Disabilities Act Amendments Act (ADAAA), and state and local laws and ordinances. The University’s attendance policy is subject to requests for reasonable accommodation under the ADA and ADAAA.
It is the employee’s responsibility to request an accommodation. Requests for a workplace accommodation will require the employee to complete the University’s Employee Accommodation Request form (click link for more information) and submit it to Human Resources for review. The University may require written documentation of the employee’s limitations from an appropriate health care provider. If obtaining this information is necessary, the employee will be provided with a Medical Inquiry form for the health care provider to complete. Once the required documentation is reviewed and approved, the University will engage in the interactive process with the employee in seeking the availability of a reasonable accommodation.
If the request for a workplace accommodation is granted, implementation of the accommodation will be handled by the employee’s department with guidance provided by Human Resources. The employee who has been granted a workplace accommodation must report changes in the ongoing need for the accommodation.
5.11 Alabama State Board of Adjustment
If you seek to recover for lost wages, property damages, and/or medical expenses not paid by the On-The-Job Injury Program you must file a claim with the State Board of Adjustment (“BOA”). The BOA will determine if you qualify for additional OJI compensation based upon an investigation of the incident conducted by University officials. BOA procedures and claim forms are available at:
Claims must be filed with the BOA within one year of the incident date, regardless of when you incur expenses related to the incident. If you believe you may incur incident-related expenses after the one-year deadline, you should submit a BOA Claim Form prior to the one-year deadline, noting that the expenses claimed are “to be determined.” It is not the responsibility of the University to remind you of the one-year time limit for filing a claim with the BOA.
6. Enforcement
The University’s Human Resources department is responsible for implementing and enforcing this policy,
including the resolution of reasonable accommodation, safety/direct threat, and undue hardship issues.
7. Related Documents
7.1 USA Accident/Incident Report
7.2 Employee On-the-job Injury Initial Medical Referral form
7.3
7.4 PTO Leave of Absence Request Form (USA Health)
7.5 Leave of Absence Request Form (University General Division)