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Administration

Workers’ Compensation Responsibilities

The University is required to fully cooperate with the SORM to properly administer the state employee workers’ compensation program.

 

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Supervisor’s Immediate Responsibilities

The supervisor has a key role in the Workers’ Compensation claim process. The supervisor must be familiar with University policies and procedures related to workers’ compensation, including those forms for which the supervisors and employees are responsible. Responsibilities include:

First Things First–Medical Attention and Notification

a.

Ensure proper medical attention is provided for the employee should it be required. Use the following link for:

Find a medical Provider on the IMO Provider Search Directory

b.

Immediately report to the Claims Coordinator (713-221-8443) any serious injury to an employee, incidents, or work-related illness or injury resulting in the death of an employee.

 The ESO Compensation and Benefits Administrator serves as the Claims Coordinator for Workers’ Compensation.

In addition, immediately contact the EHS manager at 713-221-8040 to investigate the accident/incident to ensure needed safety processes are identified and implemented to prevent future incidents/accident from occurring.

Contact Police Dispatch at 713-221-8065 if neither the Claims Coordinator or the EHS manager is not available.

Reports and Investigation

c.

Work with the Claims Coordinator to assist in completing the Employer’s First Report of Injury or Illness (DWC-1S)(PDF) within 24 business hours to meet stipulated deadlines. The Claims Coordinator submits the Employer’s First Report of Injury or Illness on-line to theSORM.

d.

Ensure all witnesses for the accident complete Witness Stateme​nt(s) (SORM-74) (PDF) and that they forwards the statements to the Claims Coordinator.

e.

Assist with the proper investigation of claims by documenting any additional information regarding the circumstances that are known or reported by coworkers. This is crucial for the denial of fraudulent claims.

f.

Work with EHS to determine actions to prevent similar accidents from reoccurring in the future.

Inform Employee(s)

g.

Inform employees that work status information must be provided if they lose time from work due to the work-related injury or illness. The employee must submit a doctor’s excuse/slip/release from their treatment to cover each day off work, and call the supervisor and the Claims Coordinator weekly to give updates on work status.

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Supervisor's Notification Responsibility 

h.

Notify the Claims Coordinator immediately upon receipt of notification that an employee has reported on-the-job injury or occupational exposure.

i.

Notify the Claims Coordinator if an employee loses time for an on-the-job injury or occupational exposure.

j.

Notify the Claims Coordinator immediately if an employee gives notice of retirement or resignation, or is terminated while on Workers’ Compensation Leave.

k.

Notify the Claims Coordinator and ADA Coordinator for assistance when modified/light duty can be provided to employees on work restriction release to work. 

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Employee’s Responsibility

An injured employee has clear responsibilities in order to establish a claim for compensation, including:

Work Related Injury/Illness Exposure Reporting and Notification

a.

The injured employee must notify supervisory or management personnel about an on-the-job injury not later than the 30th day after the injury occurs, or if the injury is an occupational disease, not later than the 30th day after the employee knew or should have known that the disease might be related to the employment. The Employee’s Report of Injury (SORM-29) (PDF) should be completed and submitted to the Claims Coordinator. No benefits can be paid until a first report of injury is received and processed by the SORM.

b.

The employee is the key to ensuring his/her claim is processed properly through prompt and accurate notification to the supervisor. Submitting notice is solely the responsibility of the employee and neither the University of Houston-Downtown nor the SORM, has any legal responsibility in the matter.

c.

The injured employee is required to notify the Claims Coordinator prior to seeking non-emergency treatment for and injury, illness or exposure.

d.

If the injury is an occupational disease, the employee must report the disease no later than five days after the employee knew or should have known that the disease was related to the employment.

e.

The employee should notify the Claims Coordinator when released by the doctor to return to work. The Claims Coordinator will review and approve the release, then coordinate with the supervisor for the return to work date.

Medical Treatment and Reports and Notification

f.

If medical attention is necessary, the employee should seek treatment at a doctor’s office or medical facility within the Workers’ Compensation Health Care Network(PDF) and request that his/her doctor file a medical report of the injury or illness promptly with SORM. The doctor’s bills may not be paid until a report of the employee’s condition is filed with the SORM.

If the employee seeks medical care:

  • The Authorization for Release of Information (SORM 16)(PDF) must be signed by the employee and forwarded to the Claims Coordinator within 24 hours of the medical care, and
  • The employee should provide the Claims Coordinator with the name and address of the health care provider(s) who has treated them.

g.

A Request for Travel Reimbursement(PDF) must be completed by the injured/ill employee for travel expense reimbursement if it becomes reasonably necessary for him or her to travel more than thirty miles in order to obtain appropriate and necessary medical care. This form must be received by the SORM no later than the 30th calendar day after the date of travel.

Lost Time Reports and Notifications

h.

Employees who are losing time must contact their immediate supervisor and the Claims Coordinator on a weekly basis. However, they must also submit a doctor’s excuse/slip/release from their treating doctor to cover each day off work. This contact is mandatory, failure to maintain contact with their immediate supervisor and the Claims Coordinator regarding work status could result in disciplinary action up to and including termination.

If lost time is anticipated, the employee must complete the Employee’s Election Regarding Utilization of Sick and Annual Leave (SORM-80)(PDF). This form provides the employee options for using all accrued sick and/or annual leave before receiving weekly compensation benefits or using only portions of accrued sick and annual leave.

i.

If the employee remains at work after an injury/illness but is absent at a later date due to the injury/illness, he or she must notify the immediate supervisor and the Benefits Coordinator at the beginning of the first day’s absence

j.

Upon returning to work, an employee must provide his/her supervisor a copy of the Physician’s Release to Work prior to resumption of normal duties.

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Last updated 7/19/2016 2:49 AM


Last updated 5/5/2017 5:00 AM