To receive workers' compensation benefits, you must be injured while performing some activity which falls within your scope of employment. In other words, the accident which causes an injury to you must be related to your work. These are referred to as compensable injuries. Examples of compensable injuries include a clerk who strains a shoulder when lifting an archive box or a highway worker who is hit by a car while controlling traffic at a construction site. You should be aware that not all accidents which happen at work will be compensable under the workers' compensation law. What you are doing when the injury occurs may be more important than where you are.
No clear cut definition is available to describe when an injury is or is not compensable. The best advice for all university employees is to perform the duties of your job in a careful manner and to report any conditions in your workplace which are hazardous to the appropriate officials. It is every employee's responsibility to help prevent accidents and to assist in providing a safe workplace.
Injuries/illnesses to ETSU employees and RSWP students, while they are at work and/or while they are performing services for the University may be compensable; and claims are submitted to the Office of Human Resources to be forwarded to Sedgwick Claims Management Services. All injuries/illnesses of ETSU employees and RSWP students should be reported to the immediate supervisor and to the Office of Human Resources (423-439-4787) as soon as possible.
Visitors and students other than RSWP that receive an injury/illness while on the ETSU campus must submit their claim to the Division of Claims Administration of the State Treasury Department. This form can be obtained from the Office of Financial Services, Box 70732, Burgin Dossett Administration Bldg., 2nd floor, Room 202, phone: 423-439-4414.
The failure to file an accident report and/or a
claim within a reasonable time may result in denial of the
claim. Contact the Office of Human Resources for additional
information on available benefits to injured State employees and
how to file for benefits.
WHO IS COVERED:
Sedgwick CMS, Knoxville
PO Box 14484
Lexington, KY 40512-4484
PAYMENT OF WORK RELATED INJURY
Hospitals, doctor's offices, labs, etc. should bill Sedgwick CMS and not the employee. Please do not present personal health insurance card for payment.
If the employee is unable to work due to a work-related injury, then, they may be eligible to receive temporary total disability benefits. These benefits are called "lost time pay". The employee must have a physician's statement for all time off from work due to the injury, and must have a physician's order to return to work with or without limitations/restrictions.
To receive "lost time pay", the employee must be off ETSU payroll and on leave without pay. The employee has a choice of using accumulated sick leave, annual leave, or compensatory time instead of accepting "lost time pay". " Lost time pay" is 66 2/3 percent of salary.
To be eligible for "lost time pay", the employee must be off from work due to an injury for 7 days. "lost time pay" begins to accrue on the 8th day, and if off from work due to an injury for 14 days or more, then, the 7-day waiting period will be waived and "lost time pay" will be paid for all 14 days. If off from work due to injury for 3 days, employee must complete a Family Medical Leave form. Family Medical Leave and Workers' Compensation run concurrently.
If the healthcare provider has prescribed a RX to be filled, as a result of a work-related injury, it should be billed to Sedgwick CMS by the pharmacy to prevent delay. Most local and major pharmacies (i.e. CVS, Food City Pharmacy, Walgreens, Wilson Pharmacy, etc.) can handle this for the employee.
Mileage to and from the doctor's office or facility for visits related to work injury can be reimbursed but the mileage must be at least 30 miles round trip.
OSHA Form No. 301 and Accident Report are available on-line at:
A complete list of providers for the entire state of Tennessee may be accessed on the Internet at http://tn.prime-health.net/
More information concerning Workers' Compensation may be obtained at http://www.tn.gov/treasury/wc
For more information on ergonomics visit: