HOP 5.1.1 Workers’ Compensation Insurance Program

Sec. 1 Purpose

The purpose of this policy is to provide for the administration of a self-insured Workers’ Compensation Insurance Program. The program is administered by U. T. System Administration’s Office of Risk Management.

Sec. 2 Principles

a)     All U.T. System Administration employees must be notified of:

1.    The availability of WCI coverage;

2.    The requirement to report all work-related injuries to a supervisor; and

3.    The requirement to treat under the certified workers’ compensation health care network (Network).

b)    All U.T. System Administration supervisors must report any knowledge of an injury to the WCI Program within 24 hours.

Sec. 3 Eligibility

All employees of The University of Texas System whose names appear on the payroll are eligible for Workers’ Compensation Insurance as provided by Chapter 503 of the Texas Labor Code.

Sec. 4 Notification of Coverage

U. T. System must give notice to all employees that Workers’ Compensation Insurance is provided.

Sec. 5 Notification of Workers' Compensation Health Care Network (Network)

U. T. System participates in a network for treatment of compensable injuries. The network is available to employees who reside within a network service area.  U.T. System is required to provide a network acknowledgement form, notice of network requirements, and HCN employee handbook to all employees at the point of hire and again at the time an injury is reported.  The acknowledgement form must be signed by the employee and maintained by U. T. System.

Sec. 6 Report of an Injury

Because U. T. System Administration operates as both carrier and employer, all claims for injuries from U. T. System Administration employees must be reported to the Workers’ Compensation Program in the Office of Risk Management within  24 hours of the time the incident occurred or was reported to the supervisor.

Sec. 7 Medical Benefits

If an employee’s injury is found to be compensable under the U. T. System Workers’ Compensation Insurance Program, the employee is entitled to all health care that

a) cures or relieves the effects naturally resulting from the compensable injury;

b) promotes recovery;

c) enhances the ability of the employee to return to or retain employment; and

d) is under the direction of a provider listed within the certified workers’ compenstation health care network, if the employee’s physical address is within the network service area.

Sec. 8 Income Benefits

An employee’s inability to work due to a compensable injury may result in the initiation of temporary income benefits (TIBS), which compensate an employee for a portion of lost wages as a result of a compensable injury. TIBS accrue on the 8th day of disability and are paid weekly. An employee's inability to work because of a compensable injury should be documented by his or her treating physician.

If unable to work, an employee may elect the following:

a) use paid leave in lieu of receiving TIBS. If this option is chosen, all sick leave must be exhausted. Once sick leave has been exhausted, the employee may elect to use any portion of other available leave to remain on the employer’s payroll.

b) be placed on leave without pay status immediately and begin receiving TIBS. An employee must be advised that there is a seven-day waiting period before TIBS are payable. If disability lasts for 14 or more days, the employee will be paid TIBS for the seven-day waiting period.

Sec. 9 Death and Survivor Benefits

9.1 If the injury or occupational disease results in the death of the employee, the current statute provides for a lump sum funeral expense benefit. In addition, the surviving spouse is eligible for a weekly benefit payable until the spouse’s death or remarriage. In the event of remarriage, a lump sum payment equal in amount to the benefits due for a period of two years will be paid to the surviving spouse. Surviving children may be eligible to share a portion of weekly death benefits.

9.2 Any beneficiary claiming entitlement to receive death benefits must first file a “Statement of Beneficiary” form with both the U. T. System Workers’ Compensation Insurance office and the Texas Department of Insurance - Division of Workers' Compensation (TDI-DWC).

Sec. 10 Nondiscrimination Against Claims

10.1 U. T. System shall not discharge or in any other manner discriminate against any employee because the employee has filed a claim; instituted, or cause to be instituted, any proceeding under the Texas Workers’ Compensation Act; or has testified or is about to testify in any such proceeding.

10.2 An employee discharged in violation of this policy will be entitled to be reinstated to his or her former position, upon appropriate adjudication.

10.3 Nothing contained in this policy shall prevent discipline or discharge of any employee for just cause, in accordance with established discipline and discharge policy.

10.4 Nothing in this policy is intended to be a waiver of any of the legal rights of U. T. System.

10.5 U. T. System shall cooperate with TDI-DWC and the Texas  Workforce Commission (TWC) in seeking to provide rehabilitation to disabled employees.

Definitions

See:  http://www.utsystem.edu/offices/risk-management/workers-compensation-insurance