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PROCEDURES FOR LEAVES DUE TO WORK RELATED INJURY 
   

Work Related injuries - Medical Leave  

1. Supervisor completes First Report of Injury (TWCC-1) and sends it to the Risk Manager (MS 91).

2. The Workers Compensation Carrier sends the employee a copy of the First Report of Injury.

If more than five working days (or the equivalent) are lost from work, the following procedures apply:

1.    The Risk Manager sends a copy of the First Report to Human Resources.

2.    The employee must submit to his or her department a physician's statement authorizing the absence and documenting the first date of absence and expected date of return to work or reevaluation.

3.    The department attaches the physician's statement to a Leave of Absence form and sends both to Human Resources.

4.    Pay for the first five days of lost time is drawn from Benefit Time, if available. Otherwise, the first five days are without pay.

5.    After the five working day waiting period, the Workers Compensation Carrier begins to pay the wage benefit on the eighth calendar day and the employee is placed on Medical Leave.

6.    If possible, the employee should make arrangements with Human Resources to pay his or her contribution to insurance premiums. Human Resources will bill the employee if payment is not made in advance.

7.    Employee must submit physician's statement authorizing return to work and specifying functional limitations, if any, to Human Resources and Risk Management.

8.    To reinstate an employee to active status, the department completes a Personnel Action Form, noting the date of return and attaching the physician's release.

9.    Note: FMLA (Family & Medical Leave Act) leave runs concurrently with Workers' Compensation Leave.

June 21, 2000

See Policy 407-94

This page is maintained by HR ( people@rice.edu ).  

Updated: February 2003