Workers Compensation Information Sheet

EFFECTIVE JULY 1, 2006, EMPLOYEES WHO ARE INJURED ON THE JOB AND ARE SEEKING MEDICAL TREATMENT MAY SEE THE PHYSICIAN OR PROVIDER OF THEIR CHOICE.

IF THE EMPLOYEE NEEDS IMMEDIATE MEDICAL ATTENTION, THEY MAY GO TO ANY EMERGENCY FACILITY.

Claims should be reported to Risk Management as quickly as possible.

Please note:  If the accident or injury involved an overt exposure to recombinant DNA molecules, the Department of Environmental Health & Safety (DEHS) must be notified immediately by phone at 852-6770.  After work hours contact the Department of Public Safety (DPS) at (502) 852-6111.  University of Louisville is required to notify NIH/OBA of the incident immediately as directed by the NIH Guidelines.

 

EMPLOYEE Responsibilities:

 

  • It is the employee's responsibility to immediately report their injury or illness to their supervisor.
  • It is the employee's responsibility to make any appointments for treatment and make sure the provider is clear that your visit is a Workers' Compensation claim.  If the employee needs their Workers' Compensation claim number, they need to contact Risk Management at 852-6925.
  • It is the injured employee's responsibility to notify their supervisor/department each time their treating physician takes them off work (due to their work-related injury or illness).  The injured or ill employee must keep their supervisor/department informed of their work status by providing updated off work statements from their treating physician(s).
  • The UofL Workers' Compensation carrier will mail to the injured/ill employee a Designated Physician Form (Form 113) and the Medical Waiver and Consent Form.  The two forms should be completed and returned to the Workers' Compensation carrier within 10 days of receiving the forms.

 

SUPERVISOR Responsibilities:

 

  • It is the supervisor's responsibility to immediately complete, sign, and forward forms to Risk Management.  If possible, please fax forms to 852-0740. Note:  Employees should not complete or sign their own First Report of Injury IA-1 Form.
  • It is the supervisor's responsibility to keep Risk Management informed of the work status of their injured employee(s) by using the WCF-1 Form.

IA-1 Form (First Report of Injury)

IA-1 Supplemental Form

IA-1 Form "Example"

Lost Time and Return to Work Form

  • It is the supervisor's responsibility to contact Risk Management (as soon as possible) for additional information on how to report employee (off work) lost time.

If Shared Leave is going to be used during the same time as the employee's workers compensation claim, please contact Risk Management immediately.

WORKERS' COMPENSATION LOST TIME BENEFIT


Workers' Compensation will begin paying compensation after the employee has been off work due to a work-related injury or illness for at least seven (7) consecutive calendar days.  If the employee is off work for more than fourteen (14) consecutive calendar days, compensation is also payable for the first seven (7) calendar days of the injury.  Workers' Compensation only pays lost time benefits for full days off work, at the direction (in writing) of the treating physician.  The amount of pay from Workers' Compensation is two-thirds (2/3) of the employee's weekly pay.  An employee may use their sick and/or vacation leave to bring the total compensation from all sources (UofL and Workers' Compensation) up to the employee's full regular pay.

Workers' Compensation does not pay for time off work for a doctors visit, physical therapy, or medical testing.

Please make sure that all claims are reported in a timely manner.  Late or delayed reporting of a claim could jeopardize the compensability of the claim.

If the claim is denied by Workers' Compensation, the employee, or their health insurance is responsible for any payments, including doctor bills, emergency room charges, prescriptions, etc.

If the employee will be off work for seven (7) or more consecutive days, the employee is required to apply for Family and Medical Leave.  If the employee anticipates missing six (6) months or more of work, they may want to file a claim for Long-Term Disability benefits, please contact University Human Resources.

 

Workers' Compensation Information for Needle Sticks and Tuberculosis Exposures

You may be seen at the following locations for needle sticks and tuberculosis exposures that are work-related:

 

If you would like more information regarding workers' compensation, please visit the Kentucky Workers Compensation website.

If you have any questions on how to file a claim, please call 852-6925.