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Workers' Compensation Benefits

Section 520

Eligibility

All employees of Smith College are covered by the Massachusetts Workers' Compensation Insurance Law. Workers' Compensation Insurance provides partial income replacement and medical care payments for employees who experience a job-related injury or illness. If death results, benefits are payable to a surviving spouse and dependents or to the employee's estate as defined by law. Coverage is automatic upon employment. Workers' Compensation Insurance is paid for entirely by the college.

Reporting an Accident

If you are injured at work or while performing a job-related function required by the college, you must report the accident to your supervisor as soon as possible and complete a First Report of Job-Related Accident form within 24 hours.

The college must report all accidents to the workers' compensation insurance company. The insurance company has the responsibility for investigating all claims and determining eligibility for workers' compensation benefits.

Reimbursement for Medical Treatment

If you are determined by the insurance company or the Massachusetts Department of Industrial Accidents to be entitled to workers' compensation, you will be reimbursed by the insurance company for any necessary medical treatment and care that you receive.

If a job-related accident requires treatment, you may be seen and treated by an occupational health specialist retained by the college. If you subsequently choose to be seen by another physician, that physician must be advised that the visit and any treatment are work related. The physician is required to fill out workers' compensation forms in order to receive payment for services.

If you receive medical treatment for a work-related injury at a hospital, doctor's office, or health center, you should:

  • inform the provider of services that the injury is work related and request that all bills for services be forwarded to: Meadowbrook, 10 New England Business Center, Suite 303, Andover, MA 01810;
  • submit receipts for prescription medications, crutches, or other medical equipment to: Meadowbrook, 10 New England Business Center, Suite 303, Andover, MA 01810 for reimbursement by the insurance company;
  • provide the Office of Human Resources with documentation regarding referrals, treatment, and work notes.

Charges or bills for medical treatment or prescriptions resulting from a work-related injury should not be submitted to your medical insurance carrier.

Workers' Compensation Leave

Should a work-related injury prevent you from working, you may be eligible for workers' compensation leave, with disability payments and injury-related medical benefits paid by the college's workers' compensation insurance carrier.

Reimbursement for Lost Wages

Should your injury result in time off from work, you may qualify for disability payments to compensate you for lost wages. The disability payments from the insurance company are set by law at approximately 60% of your average weekly earnings (plus allowances for dependents) up to a maximum benefit which is subject to change. Weekly disability payments are nontaxable.

The college will advance your regular salary for the first week of disability. Should you ultimately receive workers' compensation benefits for the first week from the carrier, you must repay to the college the amount advanced.

Supplemental payments

For regular full- and part-time administrative and administrative support staff, the college will, upon request, pay any differential required to continue regular salary up to 80% for the first three months of the disability from any accrued sick time. Supplemental payments will be discontinued after three months; however, employees will continue to receive workers' compensation payments from the insurance company for the duration of any approved absence for a work-related injury, or as long as provided by law.

Eligibility for Paid Time Off and Benefits

During a workers' compensation leave ,you continue to be eligible for paid time off as follows:

  • you continue to accrue personal time;
  • you accrue vacation and sick leave during the first 12 weeks;
  • you are not eligible for paid holidays, paid funeral or jury duty leave, or any other paid leave.

You continue to receive employee benefits for up to six months, as outlined below. If you are on workers' compensation for longer than six months, you are expected to apply for long-term disability (LTD) insurance; if your LTD application is approved, you will be granted an LTD leave, and benefits may continue under the terms of that plan.

Health, Dental, Life, and LTD Insurance Plans

You may continue to participate in the college's group health, dental, life, and LTD insurance plans for up to six months from the beginning of a workers' compensation leave. Your life and LTD insurance will continue at the salary level in effect at the time the workers' compensation leave began. You remain subject to the specific terms of each insurance contract.

The college will continue to pay its normal share of the premiums toward your coverage and you will be billed for your share. You must pay your share of the premiums within 30 days of the billing date to ensure continued coverage.

If you do not qualify for LTD leave after six months, you may elect to participate in the health and dental plans under COBRA, and you have the option to convert to nongroup life and LTD insurance policies.

Tuition Assistance Program

You continue to be eligible for tuition benefits for up to six months from the beginning of a workers' compensation leave.

Retirement Plan

For eligible employees, the college will pay retirement contributions on any supplemental payments. Contributions are not made on workers' compensation income benefits.

Application Procedures

The Office of Human Resources is responsible for the filing and processing of workers' compensation claims and for monitoring workers' compensation leaves.

If you are absent on workers' compensation leave, you should contact your supervisor at least once a week to report on your estimated or actual return-to-work date, unless you and your supervisor agree to another reporting schedule.

Whenever possible, the duties of a position may be modified temporarily to enable employees to return to work during a lengthy recovery period.

The date the individual returns to work and any subsequent absences from work due to the work-related injury or illness must be reported to the Office of Human Resources so that benefits can be coordinated and state-mandated records accurately maintained.

Return to Work Certification

If you are cleared to return to work (whether full- or part-time), you should ask your doctor to complete the Physician's Approval to Return to Work form. You must provide your department head and the Office of Human Resources with this completed form prior to returning to work. To ensure your ability to resume the duties of your job, the college may require an examination by a college-designated physician before your return to work.

Extended Absence

Extended absences due to work-related injuries, illness, and/or inability to meet the requirements of the position can be reason to file for long-term disability insurance benefits, or may prompt other action as deemed necessary by the department and/or the college.

In the case of a job-related disability which may extend beyond six months:

  • employees eligible for the college's LTD insurance plan should consult with the Office of Human Resources about filing for LTD benefits;
  • employees not eligible or approved for LTD benefits may be eligible for a leave without pay (see Leave Without Pay);
  • employees who are not eligible for LTD benefits or a leave without pay will have their employment terminated. However, termination of employment will not affect the employee's continued eligibility for workers' compensation benefits and other rights under the workers' compensation statute.

Replacement of Staff on Medical Leave or Disability

Under normal circumstances, the college will hold a position open for a regular full- or part-time employee with a serious illness or disability during the first 12 months of an authorized paid or unpaid leave. During such an authorized leave the employee's position will normally be filled on a temporary basis only. Following 12 months of absence, the staff member's employment will be terminated. Termination of employment will not affect the employee's eligibility to continue receiving workers' compensation benefits and other rights under the workers' compensation statute.

The college reserves the right to fill a position on a regular basis prior to 12 months in situations such as the following: 1) in the case of senior administrators who occupy strategic positions; 2) when the college's or the department's needs require this action; or 3) where it appears highly unlikely that the employee will be able to return to work. The decision to fill a position prior to 12 months must be approved by the Associate Vice President for Human Resources.