This Policy provides guidance to employees who sustain a work-related injury or illness and establishes the procedures to be used to process claims for Workers Compensation (WC) benefits.
All Seton Hall University (the University) employees are subject to the terms and conditions of this Policy.
All supervisors and employees are expected to be familiar with this Policy and to comply with the provisions contained herein. Employees who are away from the workplace as a result of an occupational injury or illness are responsible for communicating with the Human Resources Department (HR) regarding their continued status.
HR is responsible for processing and monitoring WC claims, for providing interface between the Workers Compensation carrier (the Carrier), the employee and the supervisor, and, in appropriate cases, for assisting in returning the injured employee to the workplace in collaboration with the employee’s department.
Workplace Injury or Illness – Any occupational injury or illness sustained by an employee as a direct result of the employee performing services for the University for remuneration.
Medical Emergency - An occupational injury or illness that poses an immediate threat to the employee's life or health that requires the intervention of a doctor or hospital trauma care unit.
In accordance with this Policy, the University will provide medical evaluation and treatment to employees who sustain an occupational injury or illness as a direct result of their respective jobs and will provide such employees with compensation in accordance with the laws of the State of New Jersey. Further, it is the policy of the University to offer an employee who is released by medical authority to return to work after a work-related injury or illness, an opportunity, when feasible, to return to full employment in the position formerly held.
Reporting, Care and Billing
When an occupational injury or illness occurs as a direct result of an employee’s job assignment, the employee or a co-worker, if the injured employee is unable, should notify the direct supervisor immediately. Depending on the circumstances, Public Safety may need to be notified. The injured employee should obtainfirst aid or other necessary medical treatment as soon as possible. The supervisor must immediately report the incident to HR by calling X-9621 or 973-761-9621, so a claim can be filed with the Carrier.
If a workplace injury or illness occurs outside the normal working hours of 8:45 a.m. to 4:45 p.m. or on a weekend or holiday, Public Safety should be notified immediately. A voice mail message should be left for HR on the phone at X-9621 or 973-761-9621 with details of the incident and a contact number, or the incident should be reported on the next work day to HR.
For critically serious injuries, employees (or their co-workers or supervisors) should call 9-1-1 and Public Safety at X-9300. Public Safety Officers will evaluate and determine the appropriate course of action.
In the event of a less serious Medical Emergency, employees should immediately seek treatment at the nearest emergency room location.
- Employees located at the South Orange campus - go to Saint Barnabas Medical Center, 94 Old Short Hills Road, Livingston
- Employees located at the Newark Law School campus - go to Saint Michael’s Medical Center, 111 Central Avenue, Newark
Employees who seek treatment at any location other than those indicated above, should advise the medical provider that all bills should be sent directly to the Carrier for payment.
Include the date of injury, name of employer - Seton Hall University - and the policy number 2315R926 on all bills.
The University’s current Carrier is:
Travelers Insurance Co.
P.O. Box 1900
Morristown, NJ 07962
After the emergency room visit, immediately report the incident to HR at X-9621 or 973-761-9621, if it has not already been reported.
Employees on leave for an approved WC claim should contact HR at 973-761-9621 immediately after a visit to the physician, to update HR about their health status and provide information about their expected return to work date.
Workers Compensation Benefits
Under the New Jersey Workers Compensation program, employees are compensated for absences due to work-related injuries/illnesses after the time lost from the workplace is more than seven (7) days (including weekends and holidays). The seven (7) days need not be consecutive; intermittent time can be counted towards fulfilling the requirement.
An eligible employee who has satisfied the seven (7) day waiting period and who receives medical care approved by the Carrier is eligible for a benefit amount of seventy percent (70%) of his/her gross weekly wages for lost time up to a maximum rate established by the New Jersey Commissioner of Labor. In appropriate cases, permanent partial benefits, permanent total benefits and death benefits may be awarded.
Employees must keep HR informed of any change in health, return-to-work status and/or treatment plan to ensure proper compensation continuation.
If a dispute arises between the employee and the Carrier over the availability, type or amount of benefits, the employee should file a formal Claim Petition or an Application for an Informal Hearing with the New Jersey Division of Workers Compensation (DWC), the agency responsible for resolving such disputes. More information can be found at the DWC’s website at http://lwd.dol.state.nj.us/labor/wc/workers/workers_index.html.
The FMLA/Personal Leaves of Absence
To the extent an employee on WC leave has leave available under the Family and Medical Leave Act (FMLA) (see the University’s FMLA Policy), the employee’s FMLA leave will run concurrently with his/her WC leave and the employee cannot add FMLA leave time to his/her WC leave. An employee with available FMLA leave will be required to provide any documentation required for purposes of FMLA leave in addition to any documentation required for WC leave. The FMLA does not require the University to hold open the position of an employee who continues to be disabled after the expiration of FMLA leave.
An employee whose period of WC leave will exceed his/her FMLA leave must, before FMLA leave is exhausted, or as soon thereafter as is practicable, request from HR a Personal Leave of Absence in order to maintain his/her status as an employee. The University will grant or deny the request based on the individual circumstances of each case. The University may require the employee to provide additional medical documentation to support the request for a Personal Leave of Absence, which documentation must include an anticipated return-to-work date. Failure to timely present requested medical documentation for a Personal Leave of Absence request or to return to work when the Personal Leave of Absence has expired will result in termination of employment, unless the employee was prevented from doing so by reason of extreme emergency.
Return to Work
When the authorized treating physician certifies that maximum medical recovery has been reached in the treatment of a work-related injury or illness – meaning no further medical improvement can be expected, then at that time no further WC benefits (including medical treatment) will be paid, and the employee, if medically cleared to return to work, must report back to work on the next workday. Failure to report to work on the next workday after being medically cleared to return may result in disciplinary action up to and including termination of employment.
Employees must report to HR on the first day of their return to work with a note from the doctor attesting to full clearance to return to work without restrictions.
Return to Work with Accommodations or in a Modified Duty Temporary Position
An employee who is absent from work because of a work-related injury or illness whose ability to perform his/her job is in some way limited because of the injury or illness may return to work under the following circumstances:
(1) The employee can perform the essential functions of his/her job with reasonable accommodations. The employee shall advise HR of the accommodations the employee requires and provide supporting medical documentation as requested by the University. Thereafter, the University will attempt to reach an agreement with the employee as to which, if any, accommodations are appropriate.
(2) An employee (a) who cannot perform the essential functions of his/her job with or without accommodations and (b) whose disabilities are temporary, may request a modified duty temporary position. The University will determine the duration of any temporary position offered on a case-by-case basis. The University may require that a request for a modified duty temporary position be supported by a certification from the employee’s healthcare provider that the employee is able to perform all of the duties of the temporary position. The University retains complete discretion over whether to offer the employee a modified duty temporary position and when to terminate the position.
An employee released to return to work either with or without restrictions, must contact HR as soon as the information becomes known. HR will inform his/her supervisor. If an employee is offered a modified duty assignment, the employee must be available to begin work on the date the position is established. An employee who does not return to work on his return to work date or who fails to follow normal callout procedures with a valid reason for not doing so will be terminated.
An employee who, in connection with a claim for WC benefits, makes a false or misleading statement, representation or submission concerning any fact that is material to that claim for the purpose of wrongfully obtaining the benefits, will be subject to immediate termination of employment in addition to all other remedies available to the University and the Carrier under the WC statutes.
It is unlawful for an employer to discharge or in any other manner discriminate against an employee as to his/her employment because the employee has claimed or attempted to claim WC benefits or because the employee has testified or is about to testify in a WC proceeding.
Senior Visiting and Visiting Fellows, as well as Visiting Professors are employees of their home institution and are not Seton Hall University employees for purposes of this Policy, and, therefore, are ineligible for WC benefits from the University. These individuals must apply to their home institution or university for those benefits.
Likewise, volunteers and independent contractors are not Seton Hall University employees for purposes of this Policy, and, therefore, are ineligible for WC benefits from the University.
Employees who sustain an injury while on jury duty are ineligible for WC benefits from the University. They may, however, be entitled to benefits under the University’s Temporary Disability Benefits Policy.
This Policy does not create a contract of employment or alter the at-will employment relationship between the University and its employees. Nothing contained in this Policy shall limit the right of either the University or the employee to terminate the employment relationship at any time, with or without cause.
By A. Gabriel Esteban, President, on the recommendation of the Executive Cabinet on April 22, 2016.
April 22, 2016