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Northwestern
University employees who incur bona fide occupational related injuries or
illnesses shall be entitled to all necessary medical and hospital care.
Additionally, employees who are medically approved to be absent from work
by a University-authorized physician shall be entitled to certain disability
benefits in accordance with the Illinois Workers' Compensation and Occupational
Diseases Act and other related laws.
Northwestern
University has designated Occupational Medicine Evanston/Glenbrook Associates
(OMEGA), 1000 Central Street, Suite 800, Evanston, Illinois, and 2050
Pfingston Road, Suite 280, Glenview, Illinois, (847) 657-1700, as the
primary care facility for work-related injuries and illnesses. This facility
is set up for emergency and extended care and is well staffed and equipped
to provide University employees with superior medical services. OMEGA
in Evanston is open on Monday, Wednesday, and Friday from 8:00 A.M. to
12:00 noon. OMEGA in Glenview is open on Monday, Wednesday, Thursday, and
Friday from 7:30 A.M. to 5:00 P.M. and on Tuesday from 7:30 A.M. to 8:00
P.M.
Department
Administrators are directed to instruct their supervisors to use OMEGA
for all employees needing work-related medical care during the University
workday. Hospital emergency services shall be used only in life-threatening
medical situations, e.g. severe chest pains, gun shot wounds, severe burns,
hemorrhaging, severe head injuries, open (compound) fractures and other
situations which could be considered life threatening. Should life-threatening
circumstances occur, call 911. UP will direct the Evanston Fire Department
paramedics to the employee for treatment and transportation to the Evanston
Hospital emergency room. Injured employees taken to Evanston Hospital
should identify themselves as Northwestern University OMEGA patients as
follow-up care, if needed, will be provided by OMEGA at their Evanston
facility.
- If
an employee is injured during work hours (8:30 A.M. to 5:00 P.M., Monday
through Friday) and medical treatment is required and it is of a non-life-threatening
nature, the following procedure is to be followed:
- The
injured employee's supervisor is notified of the injury or illness.
- The
injured employee's supervisor will notify the Claims Division of
the Office of Risk Management of the injury and assist in completion
of the Supervisor's
Injury or Illness Investigation Report (Click
here if you are having
trouble opening this report).
The supervisor will also advise the Claims Division of any injury-causing
conditions which need to be corrected.
- The
Claims Manager will then contact OMEGA to arrange for an appointment
for an examination. The Claims Manager will then advise the employee's
supervisor of the appointment time and location.
- All
employees receiving either initial or emergency room follow-up treatment
at OMEGA will be given a "Duty Status Report" indicating when
they may resume their full or modified duties and whether a follow-up
visit with the doctor is required. Employees returning to the Evanston
Campus from OMEGA will deliver the "Duty Status Report" to the
Claims Division at 2020 Ridge Avenue, Suite #240. When the employee
is not returning to Evanston, it will be his/her responsibility to see
that the "Duty Status Report" is delivered to the Claims Division
as soon as possible and that his/her supervisor is notified of his/her
work status.
- If
an employee is injured between 5:00 P.M. and 8:30 A.M. or on weekends,
and medical treatment is required, the employee should seek such treatment
at the Evanston Hospital emergency room. Upon arrival at the emergency
room, employees must identify themselves as Northwestern University
OMEGA patients as OMEGA will provide follow-up care, if needed.
If
it is determined by OMEGA physicians that as the result of a work related
injury or illness, an employee is not able to perform his/her normal duties
but is able to perform other meaningful tasks, a modified duty assignment
will be provided to the employee. The following procedure will be used in
the identification of suitable modified duty and the assignment of the employee
to same.
University Departments have identified various tasks under their jurisdiction
which may be utilized for modified duty purposes. Upon delivery of the
OMEGA "Duty Status Report" to the Claims Division, the Division
Manager or his designee will check with the employee's department to determine
if modified duty within physician restrictions is available. If the employee's
department is unable or unwilling to provide appropriate modified duty,
other departments will be contacted to locate duties that are suitable
for the employee. Upon notification by OMEGA that an employee is ready
to resume normal duties, the Claims Manager will advise his/her department
of the employee's change in work status. The Claims Manager will at all
times keep the Department of Human Resources informed as to the employee's
modified duty assignment and payroll status.
- If,
after initial treatment or examination at OMEGA, the injured employee
is authorized to be absent from work and/or will require additional
treatment or medical care, he/she may be eligible for certain disability
benefits under the Illinois Workers' Compensation and Occupational Diseases
Act. This will depend on the length of authorized absence and the nature
of employment with the University.
- Any
follow-up medical/hospital expense incurred by an employee from his/her
personal physician and/or hospital facility for treatment of a work
related injury must be forwarded to the Claims Division with an appropriate
medical report explaining the charges before they can be processed for
payment or the employee can be reimbursed by the University.
- It
is the responsibility of each employee to keep the University, via the
Claims Division, informed of his/her current medical condition when
he/she chooses to be treated by personal physician rather than the University's
designated medical facility.
- Workers'
Compensation benefits may be postponed, withheld or suspended should
the employee: (a) fail or refuse to submit detailed medical reports
or other information from his/her personal physician or hospital to
the University; or (b) refuse or fail to appear for a medical examination
by a physician designated by the University.
- Employees
who sustain on-the-job injuries or illnesses may not receive Workers'
Compensation disability benefits without being first certified as disabled
by a University-authorized physician.
- In
accordance with the Illinois Workers' Compensation and Occupational
Diseases Act and applicable rules of the Illinois Industrial Commission,
any employee absent from work as a result of a work related injury which
has not been certified by a University-authorized physician, will be
either on his/her own accumulated sick time, if available, or will be
off the payroll.
- Should
there arise a difference of opinion between the University-authorized
physician and the employee's personal physician regarding the employee's
length of disability, the University, in most cases, will rely on the
medical opinion of the University-authorized physician and the medical
differences, if any, may be resolved before the Illinois Industrial
Commission.
- Any
questions regarding workers' compensation claim status, payment of medical
bills, modified duty, or other matters associated with this Policy should
be made to the Claims Division at (847) 491-5582.
What
can I expect from Northwestern University if I am injured at work?
The University will pay for medical treatment and will pay you for time
lost because of the injury. The University will also make every effort to
return you to work as quickly as possible, either to your regular job or
to duties defined by your physical capabilities during rehabilitation.
How
much will I be paid if I am injured at work and unable to return to my
regular duties?
Injured employees who are unable to work in any capacity are entitled
to "temporary total disability" (TTD) payments equal to 2/3 of their normal
salary with a maximum that is currently $885.53 per week (this figure
is adjusted for inflation periodically by the Illinois Industrial Commission).
The Illinois Workers' Compensation Act states that TTD payments shall
not be made for the employee's first three days off work unless the employee
is off ten or more days, however Northwestern University does pay full-time
employees for the first three days off. TTD payments are non-taxable and
are made bi-weekly on regular University pay days. TTD payments are based
on time reports so it is essential that a copy of the initial time report
and any subsequent time reports be sent by the employee's supervisor to
the Claims Division for all pay periods during which an employee is entitled
to receive TTD. Employees who return to a modified duty position will
be paid 100% of their normal salary.
What
about benefits?
Personal floating holidays, sick time, and vacation do not accrue while
an employee is on temporary total disability. Because the Payroll Division
of Human Resources does not issue TTD checks, deductions for benefits
such as health and dental insurance, life insurance, accidental death
and dismemberment insurance, credit union, union dues, and the retirement
plan are not made. It is thus the injured employee's responsibility to
make sure that he or she makes payment to the Benefits Division, the Credit
Union, and/or the employee's union to ensure continued coverages. Benefits
do accrue normally for persons on modified duty.
What
type of accidents need to be reported?
All accidents and injuries, even if no medical attention is required,
must be reported to your supervisor. By failing to report an accident
you jeopardize your workers' compensation benefits, especially in the
event symptoms do not appear for an extended period of time.
Are
all injuries at work considered workers' compensation?
No. To be a workers' compensation case (compensable) the injury must be
job related and arise as a result of one's work activities. Examples of
injuries sustained that may not be compensable are: injuries while on
break or at lunch; injuries from falls when entering the workplace; injuries
sustained during intentional violations of safety rules or from starting
a fight with a co-worker; and injuries sustained while impaired by drugs
or alcohol. This is a rather complicated legal area that frequently changes
with new court rulings. All Northwestern cases are carefully reviewed
and written notification is made to employees when the case is deemed
non-compensable. Claim denials can be appealed to the Director of Risk
Management.
Can
I see my own doctor?
Yes. The Workers' Compensation Act requires employers to pay for up to
two physicians, other than the employer's designated providers, selected
by employees for treatment of work related injuries. It is important to
note that payment to an employee-selected physician can only be made upon
receipt by the University of a medical report from that physician. If
medical reports are not provided, payment remains the employee's responsibility.
What
do I do with medical bills and/or doctor's reports?
All medical bills and physician's reports should be forwarded to the Claims
Division at 2020 Ridge Avenue, Suite #240, Evanston Campus. If you have
already paid a bill for a doctor visit, prescription, etc., submit a receipt
showing that payment has been made and you will be reimbursed.
Will
I be paid for work time taken when I go for follow-up treatment (doctor
visits, physical therapy, etc.)?
Full-time employees will be paid for visits to University-designated providers.
Those employees seeking treatment from providers other than those designated
by the University will not be paid for treatment during work hours, however
they may use sick time for this purpose. Part-time and temporary employees
must use sick time, if available, for all follow-up visits to medical
providers during working hours.
What
should I do with bills I might receive from collection agencies?
There are two main reasons that you may receive a bill from a collection
agency. The first is when a treating physician or hospital fails to submit
required medical reports to the University. If this happens, forward the
bill to the Claims Division. The University will submit a second request
to the medical provider, however, payment will only be made upon receipt
of medical status reports. It should be noted that the University-recommended
medical provider, OMEGA, invoices the University directly so employees
should never see either a bill or collection notice from OMEGA. The second
situation in which you may see a bill from a collection agency occurs
when a University preferred provider organization (PPO) who has contracted
with the University to discount bills, receives the agreed upon discounted
payment and fails to credit a patient's account for the discount taken.
Under these circumstances, submit the collection notice to the Claims
Division so the problem can be resolved as quickly as possible.
In the event you have any other questions regarding the University's Workers'
Compensation Program, work status, doctor's appointments, bills, benefits,
pay status, etc., call either the Claims Division at (847) 491-5582 or
the Office of Risk Management at (847) 491-5610.
Northwestern
University
Office of Risk Management
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