Workers Compensation Summary

Workers Compensation Summary

This information is one resource to help ensure a safe environment and facilitate a smooth return to work when injuries occur. The College is committed to providing a safe work environment for all employees. We observe the laws of the State of Arizona and our own internal policies to ensure that all parties are treated fairly.

What is Worker’s Compensation?

Workers’ compensation is required by law (see A.R.S. § 23-901) which is monitored through the Industrial Commission of Arizona (ICA). Workers' compensation is a no-fault insurance system that provides coverage for costs of medical treatment and lost wages for injuries suffered on the job for employees.

Who is the insurance carrier for the College?

The insurance carrier is State Compensation Fund (SCF). You can contact them regarding the status of your claim. The address and contact information is:

SCF Western

Workers’ Compensation Insurance

PO Box 33049

Phoenix, Arizona 85067-3049

Policy #: W20039

Phone: 1.800.231.1363

Web: www.scfaz.com

Who oversees the State Compensation Fund (SCF)?

The Industrial Commission of Arizona (ICA) is a state agency that is responsible for regulating the activities of the State Compensation Fund and deciding disputes. The address and contact information is:

Industrial Commission of Arizona

PO Box 19070

Phoenix, AZ 85005

Phone: 1.602.542.4661

Web: www.ica.state.az.us

What does Workers’ Compensation cover?

It covers all accepted claims pursuant to the Industrial Commission fee schedule for reasonable and necessary medical expenses related to your work illness or injury. If time lost from work exceeds seven calendar days, it pays up to 66 2/3% of your average monthly wage, based on a statutory maximum salary amount per month.

What do I do if I have an accident/injury?

• Report your injury immediately to your supervisor.
• If life-threatening, call 911 and call Campus Police (Prescott x2185; Verde x6574)
• All employee accident/injuries are to be documented by completing a Work Comp Accident/Injury form by you and your supervisor even though medical treatment may not be necessary.
• If your supervisor is not available, contact Campus Police and/or Human Resources for help.
• All injuries must be reported and forms completed within 24 hours from the time of injury, even if medical treatment is not used.

Where do I find the Work Comp Accident/Injury Form?

On the HR website, Human Resources and Campus Police have this form.

What if I do not need medical treatment; am I still required to complete the Work Comp Accident/Injury form with my supervisor?

Yes. This is for your protection as well as the College.

Where do I go for medical treatment?

For all work related injuries, employees are required to obtain the initial medical evaluation from one of the authorized treatment locations:

For life threatening situations, call 911 for ambulance transport to the nearest hospital emergency room.

For medical treatment outside of the Tri-City area in Yavapai County, go to the nearest emergency location; however, you may be required to go to a designated provider at a later date.

Can I change my physician?

If you visit a physician more than once, it is interpreted that you have officially selected your physician. Once you have selected a physician you will need to request a change through the Industrial Commission of Arizona (ICA), PO Box 19070, Phoenix, AZ 85005-9070. The ICA will approve or deny your request. Services may be denied under workers’ compensation if you change physicians without prior approval. If your medical practitioner refers you to another practitioner for further treatment, you do not need permission to see that practitioner. However, you can only have one designated physician so the referral doctor may become the treating doctor.

What about medical treatment and bills for a work-related injury?

The first appointment for a work-related injury at one of the authorized medical treatment locations is paid by workers’ compensation 100% if the claim is approved. Upon your first visit, you must notify the authorized medical treatment center the injury was work related and fill out a Worker’s Report of Injury form at the facility. If you receive a bill, YOU must call the location you receive a bill from and notify them this was a work related injury and request they send the bill and medical documents to:

SCF of Arizona - Workers’ Compensation Ins.

PO Box 33049, Phoenix, Arizona 85067-3049

Policy #: 0C1216-5

Phone: 1.800.231.1363 or Web: www.scfaz.com

If my claim is denied, is the initial visit paid?

No. Only approved claims of reasonable and necessary medical expenses related to work illness or injury is paid.

What happens if I can’t return to work?

You need to provide a Patient Status Report from your physician to your supervisor and Human Resources as soon as possible. This status report will specify the time off. At a minimum, you must maintain weekly contact with your supervisor and/or Human Resources.

What happens when I return to work?

Upon your return to work, you must provide a doctor’s release to return to full or light work duty. If you are released to work with light or modified duty, the medical release must indicate physical limitations and approval for return to work must be granted by your immediate supervisor. The College follows the insurance carrier’s recommendations and guidelines. If an independent Medical Examination (IME) findings regarding work release differ from the treating physician, the College will follow the independent medical examination recommendations.

I’ve been released to work to full duty; however, I do not feel I can perform the work offered. Do I have to go back to work?

If you disagree with the release, you have the right to file a hearing with the ICA for determination. In the meantime, if you do not return to work you may jeopardize your workers’ compensation temporary compensation benefits and may be dismissed for job abandonment or disciplined according to attendance policies.

I have returned to work full-time and have a doctor’s appointment/therapy; do I have to use my sick time?

Yes. If, the employee is eligible for any paid leave the employee will be required to exhaust the paid leave for any work comp related doctor appointments. At each appointment, the employee must get a work status release from the doctor and provide it to their supervisor and Human Resources.

What if my release says “light duty based on certain restrictions”?

The College will make every attempt to find light duty within your dept. or elsewhere, however the College cannot guarantee “light duty” will be available.

When does Workers’ Compensation begin to pay?

If you miss work for eight or more calendar days as a result of a work-related injury, you are entitled to payment for lost wages

What is the procedure for reopening an old claim should I need additional medical treatment?

You must contact the Industrial Commission of Arizona (ICA) at (602) 542-4611 to request a form to request reopening of your claim if you have medical evidence of a new, additional or previously undiscovered condition related to your injury. You must meet statutory requirements for reopening; reopening is not automatic. You must also notify your supervisor and Human Resources to advise them of your intent.

How does workers’ compensation coordinate with my sick leave and vacation leave?

Workers’ compensation benefits are not equal to your salary and pay up to 66 2/3% of your average monthly wage. Therefore you can use sick or vacation leave in an amount necessary (33 1/3%) to make up the difference between your salary and the worker’s compensation benefits not to exceed 100% of an employee’s salary.

Does workers’ compensation leave count against FMLA entitlement?

It can. The provisions of the Family and Medical Leave Act (FMLA) may apply in situations where a work-related injury is considered a “serious condition”. FMLA and workers’ compensation leave can run together.

What happens to my health insurance while out on workers’ compensation?

If you are out for a serious condition as defined by FMLA and you meet the eligibility of FMLA, you would be on a Leave of Absence for FMLA. While on FMLA your health insurance will continue and the College will pay for the employee only coverage up to 12 weeks in a 12 month period. Dependent health insurance premiums are paid by the employee.

If you don’t meet the eligibility of FMLA, you would be on a Leave of Absence Non-FMLA with no provisions by the College to pay for your health insurance premiums.