Workers' Compensation

Workers' Compensation benefits are available to any employee who suffers an accidental injury or occupational disease arising out of, and in the course of, his or her employment, according to the provisions of the North Carolina Workers' Compensation Act. All University employees are eligible for Workers' Compensation benefits.

The full cost of medical treatment is covered by Workers' Compensation if the injury/illness is compensable under the Workers' Compensation Act.

Employees must give notice of an accident to his or her supervisor or manager immediately. Report any on-the-job injury to the supervisor, no matter how minor the injury may appear to be. For occupational diseases the time frame for notice to the supervisor begins when the employee is first informed by a treating medical professional.

It is the employee's responsibility to complete the Employee Incident Report and Employee Use of Leave Options form if you are missing time from work.  These forms should be filled out within 24 hours of the incident and forwarded to the Safety & Risk Management Office within 48 hours.

When a work-related injury or illness occurs, the supervisor's primary responsibilities are to assess the incident and ensure the employee receives necessary medical treatment. Employees in the Sylva area should be directed to one of the three Authorized Medical Facilities listed below.
The Supervisor is responsible for notifying the Safety & Risk Management office as soon as they are made aware of a work related injury, typically within 24 hours. The Supervisor should be prepared to provide information to the Safety & Risk Management Office regarding the time, location, and nature of the accident along with employee information for the injured worker.
The Supervisor is also responsible for ensuring that the employee completes the Employee Incident Report and Employee Use of Leave Options Form if they are missing time from work.  If there were any witnesses to the injury, all witnesses should complete the Witness Statement Form
The supervisor should complete the Supervisor Incident Investigation Report and ensure that all forms are returned to the Safety & Risk Management Office within 24 hours after the incident occurs.
The supervisor should immediately notify the Safety & Risk Management Office if an injured worker's medical status changes or there are absences due to the injury. All doctors' notes should be forward to the Safety & Risk Management Office.

Medical Treatment 

Life-threatening emergency: Immediately contact Campus Police 828-227-8911 or 911 to dispatch emergency services.
Non-life threatening emergency: Faculty, staff, and student employees are to visit one of the three approved health care facilities.

Student Health Services
Bird Health Building
Phone (828)227-7640
Hours: Monday-Friday 8AM-5PM
Saturday-Sunday CLOSED

Medwest Urgent Care
176 Wal-Mart Plaza (Next to Walmart)
Sylva, NC 28779
Phone (828)631-9462
Hours: Open 7 days a week - 8AM-6:30PM

Harris Regional Hospital ER
68 Hospital Road
Sylva, NC 28779
Phone (828)586-7000 - Hours-Open 24/7

The facilities above are the most convenient for campus. For a complete listing of authorized medical facilities outside the Sylva area, refer to the document found here. If an employee declines medical evaluation, they will need to fill out a Refusal of Treatment Report.
For injured employees, additional health care needed by a specialist will be coordinated between the Safety & Risk Management Office, the initial treating physician, and CorVel Corporation (third party administrator for Worker’s Compensation Claims).  An employee should consult with either CorVel or the Safety & Risk Management Office to facilitate healthcare with a specialist.  Employees are advised not to treat with their own physicians since CorVel will not cover treatment at facilities that are not approved by them.

Workers' Compensation Benefit Information

PAYMENT OF MEDICAL AND LEAVE BENEFITS

CorVel processes medical and leave benefits. Delays will occur if:

  • Medical treatment occurs outside of the authorized treatment facilities listed above
  • The medical provider is not informed that the injury is Workers’ Compensation
  • CorVel does not receive the charges on proper medical forms
  • CorVel does not receive medical notes for the medical services billed
  • Safety & Risk Management is not notified of the injury.

Forms

You are responsible for completing the Employee Incident Report and Employee Use of Leave Options form if you are missing time from work.  These forms should be filled out within 24 hours of the incident and forwarded to the Safety & Risk Management Office within 48 hours.

LEAVE PROCEDURES

If you are required to miss time from work by notification of a doctor’s note, then certain leave procedures are in place.

  • If an employee misses seven days or less, the employee is required to use vacation, sick, or leave without pay.
  • If an employee misses more than seven days, but less than twenty-one days, then the days that exceed seven days will be charged to Workers’ Compensation Leave.
  • If an employee misses more than twenty-one days, then the first seven-day waiting period is waived and Workers’ Compensation Leave payments begin from the first day of disability, or the employee is reimbursed at the end of the twenty-one days.
  • Employees are responsible for providing all work notes to their immediate supervisor, and notifying their supervisor of any changes in work restrictions or leave status.
  • If the doctor states the employee should not return to normal work duties, the statement must be reflected on the medical documentation.  If an employee does not return to work as scheduled, the absence is considered unauthorized unless prior to the absence the employee provides the supervisor with a written updated medical status from the authorized treating physician allowing the time off.
  • Occasionally, a doctor will order work restrictions.  In this case, a supervisor will make every effort to reasonably accommodate the limitations and the employee should comply with the doctor’s recommendations.
  • While on Worker’s Compensation leave, you do NOT need to complete your time sheets electronically through MyWCU.  The Safety & Risk Management office completes paper time sheets for those employees receiving Worker’s Compensation leave pay.  No action is required of the employee.

CONTINUATION OF BENEFITS/PAYROLL DEDUCTION INFORMATION

Retirement System membership continues while you’re on Worker’s Compensation leave but service credit does not.  Any employee who is a member of the State Retirement System may purchase credit for the period of time on an approved leave.

State Health Plan Coverage will continue while on Worker’s Compensation.  The employer’s monthly contribution continues to be paid by the University; however, the employee must pay premiums for dependent coverage to the Payroll Office, (828)227-3138.

Annual Vacation and Sick Leave will continue to accrue while covered by Workers’ Compensation and are credited for use upon the employee’s return to work. If an employee does not return to work, vacation and sick leave accumulated during the first twelve months of leave should be paid in a lump sum along with other unused vacation credit. The payout of the vacation leave may exceed the 240 hours normally allowed.

Performance Increases.  Salary will be computed based on the last salary plus any legislative increases to which the employee is entitled upon reinstatement. Any performance increases that would have been granted had the employee been at work may also be included in the reinstatement salary, or it may be given on any payment date following reinstatement.

Longevity.  Employees continue to receive longevity credit and, if eligible, receive annual payments.

Other Deductions.  If you have any voluntary deductions from payroll, you are responsible for coordinating these payments with the University benefits office. You may reach the benefits office at (828)227-3138 to set up the coordination of benefits, so that these payments will still be made. If you are placed on Workers’ Compensation Leave, the voluntary deductions that normally come out of your check will not be taken out of your workers’ compensation check from CorVel, the University’s Third Party Administrator.

rETURN TO WORK

After you have been on Workers’ Compensation Leave, a physician’s statement authorizing return to work must be submitted to your supervisor prior to reinstatement to work status.

Full Duty.  When you have a physician’s statement that says you can return to full duty, then you are removed from Leave Without Pay Workers’ Compensation and returned to your normal job duties and responsibilities. The effective date will be based on the primary treating physician’s recommendations.

Modified Light Duty.  You may be authorized by a physician to return to work, where your job duties have either been restricted or time limited. If either is the case, the department is to take you back to your position and make modifications to the job duties on a temporary basis. This may involve making certain accommodations for you to be able to continue in your normal job capacity.

Never Return to Work.  If you are deemed by the primary treating physician to never return to work, then you are moved to a special position in Leave without pay, WC Status, and continue to earn vacation, sick and total State service.

Frequently asked questions

What if I can’t return to work?

An employee may choose to use sick or vacation leave, or go on Leave without pay during the 7-calendar-day waiting period.  The law provides medical and disability compensation including a weekly benefit for lost workdays after a 7-calendar-day waiting period. A weekly benefit equal to 66 2/3% of the employee’s average weekly earnings up to a maximum established by the North Carolina Industrial Commission is payable to the employee. Compensation begins on the eighth calendar day of lost work time and if the lost time goes beyond 21 calendar days, the employee is entitled to receive compensation for the first 7 calendar days.
The weekly benefit may be supplemented by using sick or vacation leave, earned prior to the injury, in accordance with the Supplemental Leave Schedule provided by the State Personnel Commission.
If the doctor states the employee should not return to normal work duties, the statement must be reflected on the medical documentation.
If an employee does not return as scheduled, the absence is considered unauthorized unless prior to the absence the employee provides the supervisor with a written updated medical status from the authorized treating physician allowing the time off.
Occasionally, a doctor will order work restrictions. In this case, a supervisor should make every effort to reasonably accommodate the limitations and the employee should comply with the doctor’s recommendations.

How do I Schedule a Doctor's Appointment?

For injured employees, additional health care needed by specialist will be coordinated between the Safety & Risk Management Office, the initial treating physician and CorVel Corporation (third party administrator for Worker’s Compensation Claims).  An employee should consult with either CorVel or the Safety & Risk Management Office to facilitate healthcare with a specialist.

Are Prescription Drugs Covered?

When the authorized treating physician prescribes medication, prescriptions may be filled at no cost, by most major pharmacies such as Wal-Mart, Rite Aide or CVS. CorVel internally manages the prescription drug plan for the Workers’ Compensation program. CorVel will provide the pharmacist with the required authorization to fill the prescription.

If a pharmacy is unable to obtain the necessary authorization such as after normal business hours or during a weekend, the employee may pay for the prescription and file for a reimbursement by sending the original copy of the receipt to the Safety & Risk Management Office.  CorVel can be reached by phone, at 1-800-563-8483 or 1-800-213-5640.

Who Manages Worker’s Compensation Claims?

The Safety & Risk Management Office establishes the procedures and processes to ensure injured employees receive the appropriate level of care and compensation in accordance with the Workers’ Compensation Act.
CorVel Corporation is the Third-Party Administrator (TPA) responsible for the overall administration of workers’ compensation claims for the State of North Carolina.  CorVel, in conjunction with the Safety & Risk Management Office, is responsible for accepting or denying liability for WCU, and is also responsible for monitoring and processing all workers’ compensation claims.  Additionally, CorVel pays medical benefits and compensation in accordance with the North Carolina Workers’ Compensation Act.
The University 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.
Payment of medical bills is not an indication of the University’s acceptance of liability for the claim. If you receive a bill from the medical facility, please contact the facility to make sure they are billing CorVel correctly. You may contact the Safety & Risk Management Office for further assistance (828)227-7443.

If a claim is denied, the employee will be notified as soon as possible, pending receipt of medical documentation, if necessary.

CONTACT INFORMATION

Supervisor-Employee Contact. Your supervisor will be required to maintain contact with you while out on Workers’ Compensation Leave.

CorVel Contact.  WCU and CorVel are in constant contact concerning your workers’ compensation case. You are always welcome to call the claims adjuster at CorVel to discuss the status of your claim. You may reach CorVel at 1-800-275-8130.

WCU Contact.  Safety and Risk Management Office, Jamie Hilton at (828)227-7443 jlhilton@wcu.edu

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