Human Resources - Summary of Workers' Compensation Insurance
Workers’ Compensation benefits are available to you if you suffer a work-related injury or work-related disease. These benefits provide income while you are unable to work and cover the cost of related medical care. If you are injured at work, no matter how slightly, or if you suspect a work-related disease, your supervisor must be notified immediately and proper medical attention should be sought. A delay in reporting injuries may result in denial of benefits.
What Is A Work-Related Accident or Injury?
Any occupational injury or illness directly resulting from the performance of an employee's work-related duties are generally considered compensable. A non-work related condition that is aggravated by a work-related accident or injury may also be compensable.
Managed Care System
The State of Connecticut provides a managed care program administered by Gallagher Bassett Services, Inc., a specialist in work-related injuries. Gallagher Bassett Services has created a statewide network of doctors, hospitals and rehabilitation services. Gallagher Bassett Services staff members will call throughout your recovery to ensure that your progress is going well. Gallagher Bassett Services may contact your doctor and work with the University to identify modified duties, which will allow you to return to work as soon as possible.
Steps When A Worksite Injury Occurs
- If an employee sustains a non-emergency workplace injury, the employee should report the injury to their immediate supervisor and the Payroll Department. The Payroll Department will provide you with a Participating Provider Directory for Workers’ Compensation and the employee may select a doctor or treatment center convenient to where they live or work. (Or, call Gallagher Bassett Services. Hotline at 1-800-828-2717 if the Payroll Department is unavailable.) It is mandatory, under current State law, that an employee who sustains a non-emergency workplace injury receives medical treatment from a managed care network provider to be eligible for State Workers’ Compensation benefits.
- If an employee sustains an emergency workplace injury, the employee should proceed to the nearest emergency facility for medical treatment, regardless of whether the medical facility is in the participating network.
- Your supervisor shall call the Injury Hotline, 1-800-828-2717, to make the first report of injury. After seeking immediate medical attention for you in the case of an emergency, the supervisor will confirm the facts of the injury, and contact the Payroll Department (X-78364). The Payroll Department will forward a First Report of Occupational Injury Form
(below link) to your supervisor to be completed and signed.
http://www.das.state.ct.us/workerscomp/wcForms/PER_WC_207.pdf
- Your supervisor shall return the form to the Payroll Department, where it will be processed. All other necessary wage and personnel forms are completed and filed thereafter if lost time is involved.
- All claims of injury must be reported; the decision to approve, deny or contest a workers' compensation claim is not made by the supervisor, department or the University, although reports of possible fraudulent or false claims can be brought to the attention of the Workers’ Compensation carrier by the University.
Payment For Lost Wages
If your claim is found to be compensable under Workers’ Compensation, compensation for lost wages is paid after you have been totally or partially incapacitated for more than three (3) calendar days, excluding the day of injury. Workers’ compensation for lost wages begins with the fourth day of incapacity. Beginning with the seventh day, you will be eligible for workers’ compensation for lost wages retroactive to the first day of incapacity.
Third Party Claims
If the workers’ compensation injury results from the actions of a third party, and you take legal action or attempt to settle the claim, the law requires notification to the Attorney General’s Office. Please notify the Payroll Department for details on reporting.
Medical Bills
After you receive medical treatment from a provider within the managed medical care network, your physician or medical service provider must send medical bills and reports to the third party administrator - Gallagher Bassett Services. The third party administrator will make payment of medical bills after all necessary forms are submitted, reviewed, and accepted for payment.
Medical Progress
Specific questions concerning a workers’ compensation claim, such as payment for lost time, percentage and accuracy of payment, overpayments, payment of medical bills or other benefits due should be directed to the Payroll Department. Detailed instructions on the preparation and transmission of forms and determination of benefits can be found in the Workers’ Compensation Manual. A copy of this Manual is kept in the Payroll Department.
Questions
Any questions, please contact the Payroll Department at 203-837-8365.
