Procedures and Responsibilities
When an employee experiences an injury or illness arising out of and in the course of his or her work duties for the University, it is important for University procedures to be strictly followed in order to ensure the employee receives prompt medical attention. Immediate notice of the injury or illness allows for a vigorous investigation of the claim to begin and a timely determination to be made concerning compensability, causation, and prevention.
- Immediately reports accident/incident to supervisor.
- Seeks medical attention as needed and provides a written medical status update to the Office of Workers’ Compensation and Claims Management and supervisor after each office visit.
- Thoroughly completes and signs the First Report of Injury/Illness form within 24 hours and faxes (217-244-5152) or e-mails (WorkComp@uillinois.edu) it to the Office of Workers’ Compensation and Claims Management.
- Cooperates with the accident investigation process.
- Attends all medical appointments and schedules all follow up appointments either before or after work. Costs associated with treatment such as mileage, parking, meals, partial lost work days, etc. are not reimbursable per the Illinois Workers’ Compensation Act, unless the treatment was directed by the Office of Claims Management.
- If placed out of work, provides written medical status updates after each medical office visit and calls manager to report work status.
- Follows restricted activity while at home.
- Participates in temporary transitional work assignments when advised by medical provider.
- Works with supervisor and department representative responsible for payroll to make sure time sheets are submitted to the Office of Workers’ Compensation and Claims Management by 10 a.m. the Friday before pay week in order to receive benefits. Medical documentation must be submitted after each visit. Failure to provide accurate time sheets and medical documentation may result in a delay of benefits.
- Responsible for notifying the Office of Workers' Compensation and Claims Management of any concurrent employment.
- Informs immediate Supervisor, Payroll, and Human Resources of the status of claim so that appropriate benefts can be applied to absence from work.
Note: Be advised that in accordance with the Workers' Compensation Act of Illinois Section 25.5, it is unlawful for any person to present or cause to be presented any false or fraudulent claim for payment of any workers' compensation benefit. Section 25.5 (a) (2) of the Act states it is unlawful to intentionally make a false or fraudulent material statement or material representations for the purpose of obtaining a workers' compensation benefit.
- Facilitates the provision of medical care as needed.
- Thoroughly completes supervisor section of the First Report of Injury/Illness form within 24 hours and faxes (217-244-5152) or e-mails (WorkComp@uillinois.edu) the Office of Claims Management.
- If employee is placed out of work,
- Advises employee to submit medical status reports after each office visit and to contact the supervisor by phone after each visit to relay information regarding work status.
- Works with employee and department representative responsible for payroll to make sure time sheets are submitted to the Office of Workers’ Compensation and Claims Management by 10 a.m. the Friday before pay week, in order to receive benefits. Medical reports should be sent as soon as they are received. Failure to submit payroll and medical information before the deadline may result in a delay of payments. (Note-DRDB’s are no longer required).
- Participates in the development of a temporary transitional job bank for employees placed on work restrictions.
- Monitors employees assigned to temporary transitional work in order to ensure the employee is in compliance with medical capabilities prescribed by the physician.
- Actively works with safety professionals to investigate all accidents and implement loss prevention measures.
Medical Care Provider:
- Provides appropriate medical care based on injury/illness.
- Supplies employee and employer with written medical documentation related to treatment plan, work status, restrictions, follow-up visits, referrals, etc. after each office visit.
- Is familiar with the University’s policy on temporary transitional work availability and works closely with University employees in returning injured workers to gainful employment.
- Actively participates in departmental accident investigations and assists in identifying unsafe practices and implementing corrections.
- Makes recommendations for accident prevention.
- Monitors the implementation of safety measures.
- Acts as a resource for the employee and supervisor for questions regarding ADA, FMLA, benefits, etc.
- Notifies State University Retirement System (SURS) of employee’s work related absence.
- Restores earned benefits (sick leave, vacation, etc.) when employee returns to work and notifies employee of the appeals process if there are disputes regarding earned benefits.
- Immediately completes appropriate paperwork and adjusts earn codes as needed to place injured/ill employee on workers’ compensation leave of absence.
- Verifies payroll information with employee and supervisor. Submits accurate time sheets to Office of Workers’ Compensation and Claims Management no later than 10 a.m. the Friday before pay week in order to receive benefits. Failure to submit information by the deadline may result in a delay of payments. (Note-DRDB’s are no longer required).
- Provides/posts information relative to Workers’ Compensation Claims administration including preferred medical provider list, claims brochures, and instructional material, which can be obtained from the Office of Workers’ Compensation and Claims Management.
- Investigates and determines compensability of Workers’ Compensation claims based on Illinois Workers’ Compensation Law, using written and verbal information gathered from interviews and statements by the employee, supervisor, witnesses, and medical providers.
- Maintains contact with employee and supervisor, and acts as liaison between all parties involved in the claim, as allowed by law.
- Actively engages in assisting with safety recommendations/initiatives identified as a result of claims investigation.
- Participates as appropriate and necessary in the identification and provision of temporary transitional work duties, ADA accommodations, and FMLA compliance.
- Monitors the appropriateness of medical treatment, maintains medical documentation of the treatment plan, and utilizes case management services as needed.
- Facilitates and participates in University outreach opportunities to help educate all employees on the benefits and provisions of the Illinois Workers’ Compensation Act.
- Explains and provides notice to employee of claim status.
Who to Ask about Workers’ Compensation Benefits and Claims
Contact the Office of Workers’ Compensation and Claims Management
100 Trade Centre Drive, Suite 103 MC-686
Champaign, IL 61820