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To provide medical benefits and disability compensation in accordance with the NC Workers’ Compensation Act to employees who sustain compensable injuries or illnesses, which arise out of or are found to be within the course and scope of their employment.

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Probationary employees

Regular established full-time employees

Part-time employees

Elected Officials

Temporary Employees

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Employee Responsibility

Department Head Responsibility

Human Resources Responsibility

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• Notify Department Head and Human Resources immediately

***Delayed reporting may result in the loss of Workers’ Compensation Benefits***

• Complete a First Report of Injury or Illness Form immediately

• Contact Department Head and Human Resources PRIOR to receiving medical treatment (life threatening accidents or accidents occurring after normal 8-5 working hours may be directed to the nearest hospital

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• Follow the orders of the approved treating physician

• Provide all medical correspondences to the Department Head or Human Resources immediately

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Evaluate the injury and contact Human Resources to arrange for medical treatment (life threatening accidents or accidents occurring after normal 8-5 working hours may be directed to the nearest hospital

Complete a First Report of Injury or Illness Form with employee

Forward First Report of Injury or Illness Form to H.R. within 24 hours of the accident

Notify H.R. before returning injured employee to work on restricted duty (ONLY H.R. Director or County Manager may authorize waiver and allow employee to be out of work excluding the day of the injury)

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Maintain complete confidentiality of all work related injuries

Investigate accidents and complete Incident Investigation Report Form to H.R. within 48 hours of the accident

Assist in controlling the cost associated with work related injuries and illnesses

Ensure procedural notifications are posted at all work locations and visible to all employees

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Ensure the employee receives NC Workers’ Compensation benefits and proper medical treatment if applicableOversee expenses associated with work related injuries and illnessesMonitor designated Workers’ Compensation third-party administratorCommunicate policy and procedures to employees and managementParticipate in NC Industrial HearingsReport injuries to third-party administrator within 5 days of the date of injury as required by law

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Communicate with third-party administrator to pre-approve medical treatment for injured employeeResponsible for all record keeping for injured employee Responsible for maintenance of OSHA 300, 301 and 300A forms as required by lawServe as HIPPA representative regarding confidentiality of medical records and information excluding treating medical professional, third-party administrator or to those on need to know basis Report fatalities and/or hospitalization of three or more employees to OSHA

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STEP 1: Report accident IMMEDIATELY to supervisor (in absence of supervisor, contact department head, human resources or County Manager’s Administrative Assistant)

STEP 2: Supervisor to contact H.R. for PRE-APPROVAL of medical treatment (life threatening accidents or accidents occurring after normal 8-5 working hours should be referred to Frye Medical Center Emergency Room)

STEP 3: Supervisor to notify H.R. of all injuries regardless of the severity of the injury and complete First Report Form within 24 hours

STEP 4: Supervisor to investigate accident and forward Incident Investigation Form to H.R. within 48 hours of the accident

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STEP 5: If employee is placed on light duty work, Contact H.R. for specific return to work instructions

STEP 6: Employee must report to their department head after each doctor’s visit and provide medical notes to H.R. PRIOR to returning to work

STEP 7: If medical treatment is required, notify the treating authority that it is Workers’ Compensation. DO NOT USE MEDICAL INSURANCE CARD

STEP 8: If prescriptions are issued, notify the pharmacist that it is Workers’ Compensation. DO NOT FILE ON MEDICAL INSURANCE

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LIGHT DUTY POLICY What is light duty? A change in an employees

physical requirements, hours of work, etc. caused by a medical condition as certified by an authorized health care provider that prevents an employee from performing one or more of the essential physical duties of his/her regular position

Only work related injuries will be eligible for light or modified duty

ELIGIBILITY REQUIREMENTS FOR LIGHT DUTY Must have written and signed authorization from a

County approved medical professional Note must detail specific physical duties that cannot

be performed Note must give an anticipated duration of the

condition

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H.R. and Department Head will attempt to accommodate employee with limitations by minimizing the physical demands of his/her regular job or seeking another position within the County which meets the restriction requirements

Employee MAY not use sick leave, annual leave, or leave without pay in lieu of returning to work while on light duty status

Medical certification must be provided to H.R. PRIOR to returning to regular duty

If no light duty is available or lost time from work is required by the authorized medical professional, employee will be placed on Workers’ Compensation Leave

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If employee has been directed to be out of work by authorized physician, sick leave/annual leave may be used for the first seven 7-day waiting periodIf absence from authorized physician becomes at least 21 days Workers’ Compensation will pay for 7-day waiting period.Beginning the eighth (8th) day of authorized absence, employee will receive 66 2/3 of gross wages (calculated on one year prior to the date of injury)Compensatory sick leave or annual leave may be supplemented while on leavePayment cannot exceed normal compensationSupplemental pay will be subject to State and Federal tax withholdings and Social SecuritySupplemental pay will not be subject to 6% retirement withholdings

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Employee shall not be charged sick leave or annual leave for time away from work for doctors appointments for work related injuriesPaid time should be limited to reasonable time for treatment and travelEmployee shall be charged sick/annual leave/leave without pay if time used for doctors appointment is abusedAppointments should be scheduled at a time most convenient for work unitEmployee is expected to return to work after medical treatment unless approved authorized healthcare provider has prohibited return to workQualified employees will be placed on FMLA if eligible which will run concurrent with Workers’ Compensation

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Employee medical and dental insurance premiums will be paid by County

Medical/dental premiums for dependant coverage must be paid by the employee

Longevity pay will continue to be paid while on Workers’ Compensation leave

COLA’s, bonuses, merit increases, etc. that employee did not receive due to leave will be reinstated to the employee upon returning to work

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Employee shall continue to accumulate annual and sick leave for use upon returning to work

Other benefit payroll deductions will be the responsibility of the employee

Employee is entitled to collect 31 cents a mile for medical treatment provided travel is 20 or more miles roundtrip

Employee must notify H.R. of possible travel reimbursement

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Must be reported immediately whether or not accident results in a injury

Report to Department Head, H.R. Department or County Manager

All County policies and procedures for reporting the accidents must be followed

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TESTING

• Employee will be tested for drugs and alcohol following an on-the-job accident or illness that requires medical treatment by a licensed physician and/or involves one or more of the following:

» A fatality» Injury to an employee or other individual» Accident involving a county owned

vehicle» After a sequence of minor accidents or

injuries that may not require medical treatment from a licensed physician

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On company property, including parking lots; at job sites; driving or riding as a passenger in a company vehicle or private vehicle for which the company has authorized reimbursement; on company time even if off company premises (including lunch and rest breaks)

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Employee is to be tested as soon as possible following an accidentTesting must not exceed eight (8) hours for alcohol testing and 32 hours for drug testing (employee involved in an accident must refrain from alcohol use for eight (8) hours following the accident or until he/she undergoes a post accident alcohol testIt is the employees responsibility to refrain from the legal use of alcoholic beverages until testing is completed, NO EXCEPTIONS

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• Failure to Report InjuryDisciplinary action up to and including

terminationMay be subject to denial of benefits

under NC Workers’ Compensation Act

• Failure to Seek Authorized Medical TreatmentPayment of bills incurred possibly deniedDisciplinary action up to and including

termination

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• Drug and Alcohol TestingPositive drug and alcohol testing will be subject

to terminationRefusal to submit to alcohol and drug testing will

be subject to termination

• Additional information on Discipline, Grievance Procedures and Substance Abuse Policy is located at www.co.alexander.nc.us

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It is the responsibility of each employee to follow set procedures when an accident or illness occurs that is found to be within the course and scope of their employment.

Failure to follow the procedures set forth in the Workers’ Compensation Policy, Article IX in the Alexander County Personnel Policy may result in loss of Workers’ Compensation benefits and disciplinary action up to and including termination of employment

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REPORT THE INJURY TO DEPARTMENT HEAD AND HUMAN RESOURCES IMMEDIATELY

COMPLETE A “FIRST REPORT OF INJURY OR ILLNESS FORM” WITHIN 24 HOURS OF THE ACCIDENT

NOTIFY DEPARTMENT HEAD AND HUMAN RESOURCES PRIOR TO RECEIVING MEDICAL TREATMENT (life threatening accidents or accidents occurring after normal 8-5 working hours may be directed to the nearest hospital)

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FOLLOW THE ORDERS OF THE APPROVED HEALTH-CARE PROVIDER

REPORT TO DEPARTMENT HEAD AFTER EACH DOCTOR VISIT AND PROVIDE MEDICAL NOTES TO HUMAN RESOURCES PRIOR TO RETURNING TO WORK

IF PLACED ON LIGHT DUTY WORK, OR OUT OF WORK BY AUTHORIZED MEDICAL PROFESSIONAL CONTACT HUMAN RESOURCES FOR SPECIFIC RETURN TO WORK INSTRUCTIONS