Administrative Policies and Procedures Manual - Policy 3630: Workers' Compensation
Date Originally Issued: 02-05-1996
Subject to Change Without Notice
Pursuant to the laws of the State of New Mexico, Chapter 52, Article 1 NMSA 1978, The University of New Mexico (UNM) provides coverage and certain forms of compensation to employees who incur an injury or illness arising out of and in the course of their employment. The NM Workers' Compensation Program administers these compensation payments and covers any person receiving a salary or wage from and acting in the service of the University. This policy sets forth the University's commitment to prevention of on-the-job accidents; treatment, care, and rehabilitation of an injured employee; and the employee's rights and responsibilities when an on-the-job injury occurs.
2. Safe Work Environment
The University strives, through various programs, to make the workplace a safe and healthy environment for all persons, including students, faculty, staff, and visitors. The key to a safe work environment is the prevention of on-the-job accidents before anyone can suffer an injury. This responsibility is shared by all, and everyone is encouraged to bring work-related health and safety concerns to their supervisor's attention and/or the University Department of Safety & Risk Services as soon as possible. Supervisors are encouraged to conduct periodic safety inspections of all work areas under their control. Assistance is available from the Department of Safety & Risk Services.
Employees will perform their jobs in a safe manner, with concern and care for their safety and the safety of others. Employees who perform their jobs in an unsafe manner or who engage in behavior or activities that endanger the health or safety of themselves or others, are subject to disciplinary action, up to and including dismissal.
3. Medical Treatment
An employee who experiences a work-related injury or illness shall obtain medical care according to the following procedures.
3.1. Employees Working In Bernalillo County
An employee who experiences a work-related injury or illness during the regular work hours, between 7:30 a.m. and 4:30 p.m. Monday through Friday, must seek medical care at the University Employee Occupational Health Services (EOHS,) Room 232, Family Practice Center, 2400 Tucker N.E. This building is located on the north campus at the University Health Sciences Center.
A health care professional(s) at EOHS will treat the employee and/or refer the employee to a medical specialist depending upon the nature of the medical problem. This decision will be at the discretion of an EOHS health care professional. If an employee, within the first sixty (60) days, chooses to seek medical care for a work-related injury or illness without being referred by a health care professional at EOHS, the employee jeopardizes coverage under the Workers' Compensation Act (Section 52-1-49/ NM Workers' Compensation Statutes.)
3.1.1. Outside Regular Work Hours
An employee who experiences a work-related injury or illness after 4:30 p.m. and before 7:30 a.m., Monday through Friday, or any hour during a weekend and/or holiday shall seek medical care at the University Hospital. The employee is to identify himself or herself as a University employee with a work-related injury and ask for a doctor from the Family Practice Division of the School of Medicine. Any follow-up treatment must be with EOHS and not a regular University Hospital physician.
3.2. Employees Working Outside Bernalillo County
An employee who works outside the boundaries of Bernalillo County may visit a medical care provider of his or her choice. The employee must identify himself or herself as a University employee and state that the need for medical care results from a work-related injury. The employee shall instruct the health care provider to submit all bills for treatment, with treatment notes attached, per Section 4.2. herein.
When an injury or illness is life threatening in nature, such as loss of a limb or a severe burn, the employee shall go to the nearest emergency facility. Any follow-up treatment must be with EOHS and not the medical staff from the emergency facility. If possible, the employee should identify himself or herself as a University employee and state that the need for medical care results from a work related injury. The employee shall instruct the emergency facility to submit all bills for treatment, with treatment notes attached, per Section 4.2. herein.
4. Reporting Procedures
4.1. Accident Report - Employee Electing Treatment
All work-related accidents and/or illnesses must be reported to the employee's immediate supervisor. The immediate supervisor will ensure that the Department of Safety & Risk Services receives a UNM First Report of Accident within twenty-four (24) hours from the time the employee's supervisor was informed of the accident. UNM First Report of Accident - E1.1. forms are available from the Department of Safety & Risk Services. Visits to EOHS for treatment of work-related injuries or illnesses are considered time worked per "Paid Time" Policy 3300, UBP.
4.1.1. Accident Report - Employee Not Electing Treatment
If an employee chooses not to receive medical treatment, the employee must complete a Notice of Accident form to preserve his or her rights under Workers' Compensation. The form is available from the Department of Safety & Risk Services. The employee should complete the form as soon as possible, but no later than fifteen (15) days after the injury occurs. The employee should send the form to the Department of Safety & Risk Services. Failure to meet the fifteen (15) day deadline could jeopardize coverage under the Workers' Compensation Program.
4.2. Medical Bills
All bills for medical treatment and related items should be sent to The University of New Mexico, Department of Safety & Risk Services, Onate Hall Room 137, Albuquerque, NM 87131-3182.
4.3. Missed Work
The employee's supervisor must notify the University Payroll Department and the Department of Safety & Risk Services, in writing, when an employee misses five (5) or more days of scheduled work due to a work-related injury or illness. The employee is paid for a full day's work on the date of injury without charging the absence to sick leave, regardless of the time of day the injury occurs.
5. Wage Compensation
The Workers' Compensation Program provides compensation benefits to an employee for a portion of the time the employee is absent from the job due to an injury or illness covered by the applicable laws. Employees may pick up compensation checks at the Department of Safety & Risk Services.
5.1. First Seven (7) Days of Absence
Workers' Compensation payments do not begin until the employee has been unable to work for seven (7) calendar days following the date of incident. The employee's pay for the first seven (7) days is charged to sick leave, annual leave, or leave without pay (if the employee does not have sick or annual leave available).
If the period of disablement extends past the twenty-eighth (28th) calendar day, Workers' Compensation will then pay the employee the amount allowable by law for the first seven (7) days of the disablement. If the University paid the employee sick and/or annual leave for the first seven (7) days of the disablement, the University will deduct an amount equal to this Workers' Compensation payment for the first seven (7) days from the employee's next regular University paycheck. The University will return the equivalent sick and/or annual leave to the employee's leave accounts.
5.2. After Seven (7) Days of Absence
Beginning with the eighth (8th) calendar day of disablement, Workers' Compensation will pay two-thirds (2/3) of the employee's gross weekly wage up to the maximum established by law. An employee may use any accrued sick leave to augment Workers' Compensation up to his or her base salary; however, the total of leave with pay and Workers' Compensation may not exceed one hundred percent (100%) of the employee's gross wages. If sick leave is exhausted, the employee may elect to use annual leave at the same rate. An employee may not borrow against future accruals.
5.3. Leave Without Pay
If an employee's sick and annual leave banks are exhausted, or the employee elects not to use annual leave, the employee will be placed on Medical Leave Without Pay due to a work-related injury. The employee's department must send a Personnel Action Notice (PAN) to the applicable source data station.
5.4. Family and Medical Leave
If an employee experiences a work related injury or illness, the supervisor shall notify the employee that he or she may qualify to request unpaid FMLA leave. The amount of unpaid FMLA leave an employee would be eligible to take will be reduced by time off covered under Workers' Compensation. Refer to "Family and Medical Leave" Policy 3440, UBP.
6. Return to Work Procedures
In accordance with the NM Workers' Compensation Act, the University administers a return to work program for all its employees. When an injury or illness covered by the Workers' Compensation Program involves any lost time, a medical release from the employee's health care provider (EOHS, if applicable) is required before an employee may return to work. If an employee is only able to return to his or her existing job with restrictions on certain job activities, the return to work is encouraged but must be approved by the employee's health care provider (EOHS, if applicable), the appropriate dean, director, or department head, and the Department of Safety & Risk Services.
6.1. Early Return to Work Program
The University is committed to an effective program for the treatment, care, and rehabilitation of an injured employee. This program is called the Early Return to Work Program and is administered by the Department of Safety & Risk Services. An injured employee will be encouraged to return to work as soon as he or she is released by his or her health care provider. If reasonable accommodations can be made to the essential functions of the job in order to allow an injured employee to return to duty, such accommodations shall be made. These accommodations are known as "restricted duty." The employee's supervisor should work with the employee's health care provider (EOHS, if applicable); the appropriate dean, director, or department head; and the Department of Safety & Risk Services to develop these accommodations.
6.2. Americans With Disabilities Act
In certain cases, an on-the-job injury may give rise to a disability covered by the Americans With Disabilities Act, 42, USC 12101. In those instances, reasonable accommodations that allow the employee to perform the essential functions of that job shall be made. The employee's supervisor should work with the employee's health care provider (EOHS, if applicable); the appropriate dean, director, or department head; the Department of Safety & Risk Services; and the University Office of Equal Opportunities to develop these accommodations.
6.3. Temporary Disability
If a temporary disability prevents an employee from performing essential job duties, the supervisor, in consultation with the health care provider (EOHS, if applicable), may temporarily reassign the employee to other duties that do not adversely affect the disability. The reassignment should not affect the employee's pay scale. The employee must provide a statement from the health care provider that the employee can perform the reassigned or limited job duties without adverse effect on the temporary disability or the safety of others.
6.4. Unable to Perform Job
If it is determined, after Maximum Medical Improvement (MMI), that an injured employee is no longer able to perform the essential functions of the job at which the employee was injured, with or without accommodation, that employee shall then be placed on the layoff roster. Individuals on the layoff roster receive first priority for vacant positions at the University of similar or lower classification. For reemployment and benefit rights refer to "Separation of Employment" Policy 3225, UBP. In addition to the requirements stated in Policy 3225, the individual's health care provider must certify that the individual is medically capable of performing the duties of a job offered as a result of layoff status. The University is not required to create a job that does not currently exist or that is not vacant or funded.