The State Government Workers’ Compensation Program (SGWCP) was established in 1985 and is administered in the Office of State Personnel. The purpose of the program is to provide benefits to employees who sustain job related injuries or contract occupational diseases during the course and scope of their employment. Benefits are in the form of compensation for medical expenses and lost work time due to injury or illness.
Scope: Applies to all university employees regardless of status or type of appointment. Students working on campus are also covered by this procedure. Volunteers are not covered by this procedure.
Purpose: Explains university policies and procedures concerning workers’ compensation claims filed against Winston-Salem State University and the reporting of workplace injuries or illnesses.
Policy: All employees of the university are covered by the North Carolina Workers’ Compensation Act. Any employee who suffers an accidental injury in the course of employment or contracts an occupational disease within the meaning of the Workers’ Compensation Act is entitled to medical attention at the expense of the university. If applicable, the injured employee is also entitled to disability compensation, including a weekly compensation benefit for the time lost from work.
North Carolina Industrial Commission: This agency established the rules and regulations under which the Workers’ Compensation Act is administered. Determination of liability and all bills for payment as a result of the injury will be processed according to these rules and regulations. In case where the university and the injured employee cannot agree on liability or compensation, the Commission will hold hearings. Go to NC Industrial Commission website: http://www.ic.nc.gov/
Employer Responsibility: All Workers’ Compensation claims are handled by a Third Party Administrator (TPA) which is contracted by the state. The TPA currently responsible for handling all WSSU claims is CorVel Corporation, located in Charlotte, NC. The TPA is responsible for accepting or denying, processing, and monitoring claims. CorVel is responsible to pay all medical benefits and compensation in accordance with the North Carolina Workers’ Compensation Act. WSSU and CorVel try to provide the best possible medical care for injured employees to help them reach maximum medical improvement and return to work as soon as possible.
Employee Responsibility - to report an injury: The responsibility for claiming compensation is on the injured employee. All on-the-job injuries, regardless of severity, must be reported and recorded by your Workers’ Compensation administrator and Supervisor (or) Department Head immediately, in any event within the allotted time required, delay in reporting job injuries may result in the loss of benefits (if any are due), or the employer may refuse compensation. North Carolina requires that these injuries be reported to the North Carolina Industrial Commission within five (5) days. Winston-Salem State University requires that Form 18 (Notice of Accident to Employer) be completed by the employee and forwarded to Human Resources immediately. You are responsible to accept the medical treatment provided by your employer. Once the treating physician is established, you cannot change treating physicians for the injury unless the employer approves a referral. Any absences from work related to the injury must be authorized by the treating physician. Form 18
Supervisor’s Accident Report: The Supervisor must complete The Supervisor’s Accident Report form (F19) immediately after an employee report a work-related injury or illness, and forward to Human Resources, along with form 18 (which should be completed by the employee). The Supervisor or department head shall specify what corrective action are need or taken to prevent this accident from reoccurring. Form 19
Reporting Accidents: When Winston-Salem State University employees have on-the-job accident, the injured employee shall take a CorVel Corporation WC authorization form and Concentra’s form number C3431Auth to Concentra for medical treatment. WC Authorization Form; C3431AuthConcentra Medical Center 4410 Providence Lane, Suite I Winston Salem, NC 27106 336-896-9999
Employees are not authorized to go to their family physician or other medical personnel. In the event of a very serious accident that needs immediate special care, employees are taken to Forsyth Medical Hospital. Employees are expected to return to work after being treated by a Physician following a work related accident, unless instructed differently from the treating Physician. No leave will be charged to the employee on the day of injury or illness if instructed by treating Physician not to return to work.
Disability: In accordance with the Workers’ Compensation Act, no compensation will be paid for the first seven (7) calendar days of disability resulting from a compensable injury. If the compensable injury results in a disability lasting more than 21 days, compensation will be paid from the date of disability.
An employee may use accumulated sick or vacation leave during the required waiting period to remain in a pay status before going on Workers’ Compensation leave and begin to draw weekly benefits. An employee may also take leave without pay before receiving Workers’ Compensation weekly benefits.
If unable to work after the seven-day waiting period, an employee will begin to receive sixty-six and two-third percent (66 2/3%) of their weekly average earning.
Continuation of Benefits: When you, as a State employee, are injured on the job or if you contract an occupational disease and are placed on workers’ compensation leave, you are taken off payroll and placed in a leave without pay – workers’ compensation leave status. While in this pay status there will be no deductions made from your workers’ compensation weekly benefits. If you have payroll deductions made from your regular pay such as credit union, loans, etc., it is your responsibility to take care of these deductions while on workers’ compensation leave. While on workers’ compensation leave you are eligible for continuation of the following benefits:
Vacation/Sick: You will continue to accumulate vacation and sick leave to be credited to your account for use upon return to work. If you do not return to work, vacation and sick leave accumulated during the first twelve months of workers’ compensation leave will be paid in a lump sum along with other unused vacation credit which was earned prior to the injury.
Hospitalization Insurance: While on workers’ compensation leave, you are in pay status and will continue coverage under the State’s health insurance program. The State will pay the portion of the monthly premium covered under the State health plan for employee only. You will be responsible for all premiums for any dependent coverage or additional costs applicable to their coverage.
Performance Increases: Upon reinstatement, your salary will be computed based on the last salary plus any legislative increase to which you are entitles. Any performance increases which would have been given to you had you been at work may also be included in the reinstatement salary, or it may be given on any payment date following reinstatement.
Longevity: While on workers’ compensation leave status you will continue to receive longevity credit and, if eligible shall receive annual payments.
Retirement Service Credit: As a member of the State Retirement System, you do not receive retirement service credits while out on workers’ compensation. You may purchase credits for the period of time out on approved leave of absence upon return. The Retirement System will provide a statement of the cost and a date by which purchase must be made by.
Other employment benefits: An employee state health insurance plan monthly contribution will be paid by the employer while on Workers’ Compensation leave. It is the employees responsible to continue his/her dependent coverage monthly contribution and it must be paid directly by the employee.
An employee will not receive retirement credits while on Workers’ Compensation leave. An employee who is a member of the retirement system may purchase credit for the period of time on an approved leave of absence.
If you have questions about your workers compensation claim, call the University Workers’ Compensation Administrator at (336) 750-8656.