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  Reporting Your Injury - Initial Steps

  If you are injured at work, immediately report the accident, regardless of how minor the injury. This ensures that you get the care you need, that you are paid properly if you need to be absent from work, and that any potentially unsafe conditions are addressed promptly.

  Emergencies: Call 911 or Public Safety at (860) 685-2345. If transportation is needed, an ambulance will be called. If you are able to, please contact your supervisor immediately, if not, Public Safety will do so.  You or your supervisor should follow up with Human Resources at 860-685-2100 or benefits@wesleyan.edu as soon as possible.
  
  Non-Emergencies: Notify your supervisor immediately and then contact Human Resources at (860) 685-2100 or benefits@wesleyan.edu within 24 hours to complete a First Report of Injury (FRI) and claim report. If you are unable to do so because of your injury, your supervisor is responsible for the notification. When an incident does not require medical attention, the First Report of Injury is for “Report Only”. This records the incident and would allow you to have future medical treatment at a later date if needed.

   

  Report Safety Concerns on Campus

  Have you noticed a safety issue you want to report?  Have you noticed something that needs to be fixed that is a safety issue?  Do you have a suggestion for the Wesleyan University Safety Committee to consider?

  This form is available for you to submit your sightings and suggestions!   After you submit an idea, it will be sent to the Safety Committee for immediate action.  You are not required to input your name and contact information, but it may be helpful if the committee members want to follow up with questions.
  Submit your Safety Suggestions or Safety Violations.

• Ongoing

  • On an ongoing basis, Human Resources will keep your supervisor informed about your status and provide guidance for work accommodations if needed.
  • A representative from PMA (Wesleyan's workers' compensation administrator) will contact you to obtain further information regarding your workplace incident. Contact information for PMA is included at the end of this packet.
  • A member of the Wesleyan University Environmental Health and Safety team will also contact you to discuss your incident. Although an incident may not cause a physical injury, there may be actions the University may need to address to ensure safe working conditions.
  • Human Resources collaborates with PMA as they manage your claim, assists with questions, and keep your supervisor informed.

  Wesleyan Safety Committee

  Wesleyan University is committed to promoting a safe and environmentally responsible campus.

  Wesleyan Safety Committee

  The Wesleyan Safety Committee is comprised of employees representing various parts of campus – facilities, student life, the sciences, the Wesleyan Advancement team, Public Safety and administration. The Committee encourages continuous discussion and feedback creating new thinking around safety, offering new alternatives, and ensuring Wesleyan is not only safety conscious but also engaged, productive, and working in the University’s best interests.

  If you are interested in learning more about the Wesleyan Safety Committee or would like to become a member of the safety team, please email safety@wesleyan.edu.

Incidents That Require Medical Attention

Once a First Report of Injury is filed, your first medical evaluation is scheduled with a workers' compensation preferred provider under the Wesleyan Managed Care Plan. If you receive emergency care, that will be considered your initial medical evaluation. After your initial evaluation, you must choose a provider(s) from the Wesleyan Workers Compensation Managed Care Plan Network at Workers Compensation Managed Care Plan. If you decline to be treated through the Managed Care Network, your claim will not be paid through Workers' Compensation and will be covered through your medical insurance if the claim is eligible for payment through that plan.

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  What to Expect When Medical Care is Needed

  • Claim Management - PMA, Wesleyan’s Workers’ Compensation administrator, will manage your claim by providing authorization for all appointments, treatments, and procedures and payment of all claims.
  • Nurse Case Management - For more complex cases, you will be referred to a nurse case manager who will help provide authorizations, coordinate treatments, and attend appointments to ensure you are receiving the care you need.
  • Medical Appointments - Whenever possible, medical appointments should be scheduled during your regular work hours as this is considered paid time under Worker' Compensation law. If you are unable to schedule an appointment during your regular work hours, hourly employees should record this time on their time sheet. Exempt staff may adjust their schedule as needed to account for appointments outside of their regular working hours.
  • Out-of-Pocket Expenses - All injury-related out-of-pocket expenses incurred (prescriptions, mileage, parking, etc.) will be reimbursed to you directly by PMA. Please contact your assigned claim administrator to submit reimbursements.
  • Prescriptions - PMA utilizes the Express Scripts Retail Pharmacy network for prescriptions related to your Workers’ Compensation injury. You will receive a card to use at the pharmacy, so they do not pay your health insurance. This card will allow you to obtain a prescription at a retail pharmacy for up to a 14-day supply and $150 maximum. If there are issues processing your prescriptions, please have the pharmacist contact the Express Scripts Patient Care Center at 800-945-5951.

• Your Responsibilities

  Communication with Human Resources: Please keep Human Resources updated regarding your time out of work and information about your medical appointments, physical therapy, and procedures related to your injury.

  Communication with your Supervisor: Please keep your supervisor informed of your need for time off, however, please submit all medical and time off notes to Human Resources directly. Human Resources will confirm work status and accommodation needs with your supervisor.

  Communication with Your Nurse Case Manager: If you are referred to the nurse case manager, it is critical to keep them informed about your treatment and progress. The nurse case manager is someone who works with PMA to help you with the coordination of appointments, procedures, therapy, and medications. As part of their role, they will also attend appointments with you to be your advocate with the medical providers, ensuring you receive the best care while treating for your injury and ensuring timely authorization of treatments. You will be responsible for contacting the nurse case manager with any appointments you make, especially when rescheduling is needed.

  Working with your Provider: Please follow your provider's treatment plan and attend all appointments.  If you have a conflict, please provide ample time to reschedule. Please keep PMA and your nurse case manager (if applicable) updated on any appointment changes. Continue working with your provider until you have reached Maximum Medical Improvement (i.e. completely recovered or the best your condition will be). Please make your medical appointments during your regular work hours whenever possible.

• If you are placed on modified restricted duty

  • Human Resources will work with your supervisor to determine if a temporary modified duty position exists to meet your doctor's specified restrictions.
  • Once the modified duties are determined and reviewed by your treating provider, you will be notified in writing to clearly communicate the modified duties. A refusal of modified work may impact your Workers' Compensation benefits.
  • If accommodation is needed while on modified restricted duty, it will be reviewed and coordinated by Human Resources and PMA. Examples of accommodation include providing a stool to elevate an injured leg while sitting at a desk or voice text software if an employee is unable to type due to an arm injury. If accommodation cannot be provided, you will receive written notification.
  • If modified duty is not available to meet your restrictions, you will be notified in writing and you will continue on Temporary Total Disability leave.

• What to expect if you are out of work due to your workplace injury

  • If your provider takes you out of work for more than three days, you will be placed on Temporary Total Disability (TTD) certified medical leave or Temporary Partial Disability (TPD).
  • Temporary Total Disability (TTD) is the wage replacement benefit for which an employee may be eligible if they are totally disabled from a work-related injury or illness. The benefit rate is 75% of the employee’s after-tax and social security average weekly wage based upon the wages earned by an employee prior to the injury (up to 52 weeks). You are not taxed on the TTD portion of your paycheck (subject to the state maximum).
  • Temporary Partial Disability (TPD) will be paid when an employee is able to perform some type of work, but not their regular duties or for the same number of hours. TPD benefits are 75% of the after-tax difference between the wages earned post-injury and the wages paid before the injury (subject to the state maximum).
  • If you are unable to work for more than seven days, the three-day waiting period is eliminated, and benefits are paid retroactively to the beginning of your incapacity.
  • While you are out, you will be paid by Wesleyan on your regular pay cycle. You will receive your benefit rate under Temporary Total Disability (TTD) or Temporary Partial Disability (TPD). Wesleyan will supplement the TTD or TPD payment for a period of time-based on your years of service and/or job classification.

  
       Administrative Staff with < 2 years of service - 1 month of supplemental benefit to 100% pay.
       Administrative Staff with 2 - < 3 years of service - 2 months of supplemental benefit to 100% pay.
       Administrative Staff with 3 - < 4 years of service - 3 months of supplemental benefit to 100% pay.
       Administrative Staff with 4 - < 5 years of service - 4 months of supplemental benefit to 100% pay.
       Administrative Staff with 5 - < 6 years of service - 5 months of supplemental benefit to 100% pay.
       Administrative Staff employees with 6 or more years of service or faculty members - 6 months of            supplemental benefit to 100% pay.
  
  Collective bargaining employees should reference their contracts for information regarding the
  supplementation of Workers Compensation payments.
  

  • All University benefits will continue while treating for a workplace injury. Premiums will be collected from your paychecks as usual. Retirement contributions (employee and employer) are not made on the non-taxable portion of your benefits but will be made on the taxable supplemental pay from Wesleyan.
  • All absences related to your injury count toward CT Family Medical and Leave (CT FML) provided you have been employed three months prior to the injury. Information regarding FML is located at https://www.wesleyan.edu/hr/employee-resources/fmla.html If you have questions regarding FML, please email benefits@wesleyan.edu.
  • A medical release from your treating physician is required to return to work either in full duty capacity or modified restricted duty capacity.

• Recording time off

  • Time out of work must be medically certified by the nurse case manager, your provider, or by PMA.
  • Medically certified time is any time authorized in writing by your treating physician, clinician, nurse case manager, or physical therapist. If your absence is not medically certified, you must use accrued, unused sick time in place of workers' compensation. If you are out of work for an extended period, Human Resources will coordinate the reporting of your time with your supervisor.
  • Please keep your supervisor and Human Resources informed of any appointments or days away from work and any rescheduled appointments.
  • All Workers' Compensation time will be recorded in Workforce Time by Human Resources.

• Who to Contact

  Workers' Compensation Wesleyan University Human Resources Denise White-Patterson, Associate Director, Benefits Phone: 860-685-2100 Email: benefits@wesleyan.edu	PMA, Workers' Compensation Insurance Company Manage Claim Administration Medical/Lost Time Claims Ashley Jackson, Claims Adjuster PMA Management Corp. of New England Phone: 203-679-3813  Fax: 203-679-3894 Email: Ashley_Jackson@pmagroup.com
  Nurse Case Manager, Windham Group Managers & Coordinates Medical Care Mayra Diaz-Crespo, RN, Claims Adjuster Phone: 800-898-0386 x4351 Cell: 860-216-4317  eFax: 866-579-6417 Email: mcrespo@windhamgroup.com

• Resources

  Wesleyan Workers Compensation Managed Care Plan Network
  https://www.wesleyan.edu/hr/pdfs/Wesleyan%20University%20MCP%20-%20eff.%209.1.19.pdf
  
  Wesleyan Human Resources FMLA Website
  https://www.wesleyan.edu/hr/employee-resources/fmla.html
  
  State of Connecticut Workers Compensation Employee Website
  If You're Hurt At Work (ct.gov)

  Payor and Medical Provider Guidelines to Improve the Coordination of Medical Services, State of CT Workers’ Compensation Commission 

  Definitions

  Medical Only Claims - An incident that is reported by an employee to the supervisor with corresponding medical treatment, but the injured employee loses no time from work.
  
  Lost Time Claims - Claims in which the severity of an injury warrants a healthcare provider to restrict the employee from their regular job duties for a specified period of time.
  
  Report Only Claims - An incident that is reported by an employee to the supervisor, but no medical attention is being sought.
  
  Wesleyan Managed Care Plan - A Managed Care Plan (MCP) provides injured employees with a designated network of medical professionals. This network delivers quality medical care at a reasonable cost and helps facilitate a medically appropriate return to work for the employee.
  
  Temporary Total Disability Leave (TTD) - TTD is the wage replacement benefit for which an employee may be eligible if they are totally disabled from a work-related injury or illness. The benefit rate is 75% of the employee’s after-tax and social security average weekly wage based upon the wages earned by an employee prior to the injury (up to 52 weeks). You are not taxed on the TTD portion of your paycheck.
  
  Temporary Partial Disability (TPD) – TPD will be paid when an employee is able to perform some type of work, but not the same kind or number of hours. Temporary partial disability benefits are 75% of the after-tax difference between the wages earned post-injury and the wages paid before the injury (subject to the state maximum). You are not taxed on the TPD portion of your paycheck.
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  Ergonomics in the Workplace

  Wesleyan is committed to providing the resources and support needed to create a safe and efficient work environment through the Wesleyan Ergonomics Program.
  
  The goal of the Wesleyan Ergonomics program is to provide education, assessment, and work site modification to prevent work-related injuries. We outline practical strategies for identifying and correcting ergonomic deficiencies in a variety of workplace settings.
  
  To request an assessment of your Wesleyan workstation please email ergonomics@wesleyan.edu.

   

  Assessment Follow-up

  Assessment Follow-up

  A member of the Ergonomics team will follow up with recommendations after assessing the employee’s workstation. Education will be provided and any applicable workstation changes will be coordinated and installed. The employee’s department will be charged 50% of each approved ergonomics furniture/supply purchase up to a maximum of $500. The balance of the expense will be paid through the Wesleyan Ergonomics Program.
  
  Monitors, Dragon software, and general software are not covered under this program.

  Education Materials

  Good Working Positions handout