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1.1 In accordance with the Pennsylvania Workers' Compensation Act, Robert Morris University will provide income continuation and medical benefits to employees who incur an occupational illness, disease or injury.
2.1 This policy applies to full-time, regular part-time, and part-time employees.
3.1 An employee of the University who has suffered an occupational illness, disease or injury must report this injury to the Human Resources Department.
3.1.1 The employee must give notice immediately after the occurrence itself or at the time when the employee realizes that the illness, disease or injury is job-related.
3.1.2 If the employee does not give notice of an occupational illness, disease or injury within 21 days, compensation and/or medical bills may not be paid until notice is given to the Human Resources Department. Compensation and/or payment of medical bills may be denied entirely if notice is not given within 120 days.
3.2 Once an occupational illness, disease or injury is reported to the Human Resources Department, an Employee's Report of Occupational Injury or Disease is completed by the Human Resources Department.
3.2.1 The original copy is sent to the University's administrator of Workers' Compensation with copies provided to the University Workers' Compensation consultant, the employee, the employee's physician and the employee's Workers' Compensation file.
3.2.2 Subsequent information and any medical bills are forwarded by the employee to the Human Resources Department and then sent to the insurance group with copies maintained in the employee's Workers' Compensation file.
3.2.3 A copy of this report will also be sent to the Bureau of Workers' Compensation within 48 hours if the accident results in a death or within 10 days if the accident results in lost time of more than 7 days which do not have to be consecutive. A Change of Status form will be mailed to the Bureau only if there is a change from the normal injury date.
3.3 The decision whether or not an illness, disease or injury is compensable will be made by the University's Workers' Compensation Carrier and, in disputed cases by the Pennsylvania Bureau of Workers' Compensation.
3.3.1 In the event that compensation for an illness, disease or injury is denied, employees may elect to utilize sick leave days, absent days, or any other paid time off that the employee has accrued. If the decision is later reversed and the injury or illness is then found compensable, all sick leave days, absent days, or other paid time off must be repaid by the employee.
3.3.2 The employee cannot collect workers' compensation benefits and utilize paid time off from the University simultaneously.
3.4 If the employee is going to be off work for an extended period of time, the Human Resources Department will make an effort to contact the employee for updates concerning his/her condition.
3.5 Employee Status and Fringe Benefits While on Workers' Compensation
3.5.1 An employee who is off work and receiving Workers' Compensation benefits will remain employed by the University for 18 months. If the employee does not return within this time period, subject to any other applicable policies and procedures, he/she may no longer be employed with the University.
3.6 Medical and dental benefits will continue during the time that an employee is on Workers' Compensation based on the following schedule which includes a contemporaneous COBRA period:
|0-5 years of service
||3 years at 100% of cost
|6-9 years of service
||3 years at 50%;
another 3 years at 100% of cost.
|10+ years of service
||6 years at 20% or current
employee contribution rate;
to age 65 at 100% of cost.
3.6.1 Medical and dental benefits will discontinue after the above stated periods.
3.7 Long Term Disability and life insurance coverages continue based on the insurance policies in place at the time. In the event that the life insurance coverage ceases, the employee may be able to convert his/her life insurance to a direct pay basis. Refer to the LTD booklet for circumstances under which the coverage may be converted.
3.8 Pension matching funds are paid only when the employee is actually receiving a paycheck from the University for time actually worked.
3.9 An occupational illness, disease or injury may also constitute a serious health condition under the Family and Medical Leave Act (FMLA). An employee's time off work due to an occupational illness, disease or injury may be designated simultaneously as FMLA leave.
3.10 Employees who file a false claim or who provide false or misleading information regarding their reported occupational illness, disease or injury will be subject to disciplinary action, up to and including termination from employment.
4.0 Definition of Terms
4.1 COBRA - Consolidated Omnibus Budget Reconciliation Act requires employers to offer continued health and dental coverage to employees and/or their dependents. The offer is made to employees enrolled in the health/dental plans who separate from employment when willful misconduct is not involved.