Policies & Procedures

Administrative Procedure: 7111

WORKERS’ COMPENSATION

All active employees are covered by New Jersey Workers’ Compensation law which provides medical treatment, wage replacement, and permanent disability compensation to employees who suffer job-related injuries or illnesses. Necessary and reasonable medical treatment, prescriptions, and hospital services related to the work injury are paid by the insurance carrier. The employer and/or its insurance carrier have the right to designate medical providers for all work-related injuries. If an injured worker is disabled for a period of more than seven (7) days (the days do not have to run consecutively), he/she will be eligible to receive temporary total benefit, retroactive to the first day of lost time, when the eighth (8th) day of lost work time occurs. The benefit will be paid at a rate of 70% of the worker’s average weekly wage, not to exceed the statutory maximum rate or fall below the statutory minimum rate established annually by the Commissioner of Labor and Workforce Development. Go to for more information on New Jersey Workers’ Compensation benefits. These benefits are provided until the worker has either returned to work, has reached maximum medical improvement, or has reached the statutory 400-week maximum.

It is the responsibility of all employees to inform their supervisor as soon as they are injured, even if the injury is minor and does not appear to require treatment; or if they believe they have developed an illness related to their work.

The employee’s supervisor will be responsible for ensuring that both Human Resources (HR) and Security are notified of the incident. An Exhibit Z – Report of Job Accident form and associated forms should be completed within 24 hours of the incident and must be completed as soon as is practical if the employee/patient requires transport via ambulance to a hospital. HR will submit all completed forms to the Workers’ Compensation Carrier. A workers’ compensation claim number cannot be assigned until the required paperwork is submitted. The supervisor will complete the forms on the employee’s behalf if the employee is unable to complete the forms (see list below).

Instructions

• Contact Human Resources
• Exhibit Z – Report of Job Accident (This form is located on the Portal under the Human Resources section), pages 1-2 – Employee/Patient completes and Supervisor signs off on page 2.
• Page 3 (personal information, previous injuries and treatment)
• Page 4 – Requesting Leave under Workers’ Compensation
• Page 5 – NOTICE – Employee/Patient must sign to acknowledge they received the information. Informs the claimant that wrongfully obtaining Workers’ Compensation benefits is a crime of the fourth degree, punishable by imprisonment of up to 18 months and fines of $10,000, as well as civil liability for all damages, costs, and attorney fees payable to the injured party.
• Pages 6 and 7 Authorization for Release of Information in Connection with Workers’ Compensation – Human Resources completes the top of page 6 and the Employee/Patient reads, signs and dates on page 7. HR submits the completed forms to the Workers’ Compensation Carrier.
• Page 8, employee/patient lists their primary care physician and any other doctor or medical facility they may have used in the last five (5) years.
• “Report only” injuries/illnesses where no treatment is requested and no claim is generated – complete only the Exhibit Z – Report of Job Accident (pages 1 and 2) form and submit to the Workers’ Compensation Carrier.

Security

• Security Incident Report
• Medical Refusal Form, if appropriate

Supervisor Responsibilities

• Gloucester County Insurance Commission Supervisor’s Incident Investigation Report (paper or electronic fillable version) – The purpose of this report is to prevent further injury or illness by analytically determining:
• the root cause of the incident;
• the barriers to safe behavior, if any, that contributed to the incident; and
• corrective and/or preventive action.
• The Supervisor Incident Investigation Report should be completed as soon as practical following the reported incident after appropriately tending to the injured, (no later than 3 business days, depending on the resources required to complete the investigation).
• Prompt, initial investigation for all safety incidents, including Report Only and Near Misses that could have resulted in serious injury and/or property damage, for the purpose of preventing further injury or illness.

• Prompt and thorough investigation affords increased accuracy in recording conditions at the time of the incident:
• Weather;
• Lighting;
• Walking surfaces;
• Object or substance that contributed to/caused the injury;
• Placement of people, equipment, furniture, fixtures;
• Traffic (pedestrian, vehicle, powered industrial trucks);
• Use of Personal Protective Equipment (PPE) or lack thereof (proper use; condition of PPE);
• Contributing acts or conditions; e.g., fatigue, posture, physical condition, sudden movement, etc.; and
• Equipment

• Witness Statements
• Interview the victim, each witness and potential witness(es) independent of each other;
• Keep witnesses separate from each other so each witness’s statement is based solely on their own observations and is free from bias or influence;
• Ask for the facts as the victim/witness recalls—what was the time frame, start to finish; where it occurred; scope of what/whom they could see; etc; and
• Ask open-ended questions to encourage detail without suggesting what may have occurred. For example: What happened next? Is there anything else you can recall about that? What do you think caused the incident? What do you think might have prevented the incident?

HR will inform the employee of their options regarding workers’ compensation benefits and will request authorization for treatment as appropriate and in compliance with State Workers’ Compensation Law.

Responding to a Work-Related Injury

Emergency Situation

Call 9-1-1 for any serious injury (head trauma, eye trauma, severe laceration or back/neck injury) and have employee/patient taken immediately to the Emergency Room. Have someone else immediately notify (1) Security and (2) the President’s Office that an ambulance was called. Stay with injured party until emergency personnel arrive.

• Give your name and your location: RCSJ street and city/town, Building Name, and nearest door or room number;
• Give status of injured: type of injury, alert and talking, breathing OK, bleeding controlled, etc.; and
• When injured is stable and under the care of medical personnel, follow steps below.

Post Emergency/Non- Emergency

• Report all injuries to a supervisor and notify HR (extension 2113 or 4564).
• An Exhibit Z – Report of Job Accident form must be completed as soon as practical (especially if the injured is being transported to a hospital), as a workers compensation claim cannot be opened without the required form. All claims should be submitted within (24) hours.
• You will never “get in trouble” for reporting an injury in good faith.
• If the injury occurs after hours:
• Notify the supervisor and HR Associate Vice President, Coryndi McFadden, at or 856-341-0293 or Director, Pension and Benefits, Lauren Vilimas, at [email protected] or 856-200-4564.

The employee’s supervisor will be responsible for insuring that an Exhibit Z Report of Job Accident form and a Supervisor Incident Investigation Report are completed in a timely manner. The supervisor will complete the forms on the employee’s behalf if the employee is unable to complete the forms.

Treatment Centers

The scheduling of appointments MUST be done by the Worker’s Compensation Carrier via HR.

• During regular working hours (8 am to 6 pm, Monday through Friday), contact the HR office directly.
• After hours and weekends (make sure HR is notified at least by email): Notify the supervisor and HR Associate Vice President, Coryndi McFadden, at or 856-341-0293 or Director, Pension and Benefits, Lauren Vilimas, at or 856-200-4564.

Following is a list of the only authorized Urgent Care Centers to which you can go for work-related injuries and illnesses. All listed Urgent Care centers are open 8 am to 8 pm. Urgent Care is NOT an emergency room. Off-hour Emergency Room visits will be covered if the work-related injury or illness warrants emergency care.

INSPIRA URGENT CARE RIVERSIDE MEDICAL

CENTERS GROUP URGENT CARE CENTERS

Glassboro Vineland

200 Rowan Boulevard Maintree Shopping Center

Suite A 301 South Main Road

Glassboro, NJ 08028 Vineland, NJ 08360

856-682-1500 856-692-0502

Mantua Vineland East

Timberline Shopping Center 3403 South Delsea Drive

660 Woodbury-Glassboro Road Vineland, NJ 0836

Suite 26 856-293-6974

Sewell, NJ 08080

856-415-6188 Woodbury

Southwood Shopping Center

Mullica Hill 875 Mantua Pike

201 Tomlin Station Road Woodbury, NJ 08096

Suite B 856-384-5949

Mullica Hill, NJ 08062

856-241-2500

Vineland

East Vineland

1297 W. Landis Avenue

Vineland, NJ 08360

856-507-8548

Vineland

3722 E. Landis Ave.

Vineland, NJ 08361

856-213-5900

Washington Township

372 Egg Harbor Road

Suite 4A

Sewell, NJ 08080

Woolwich Township

101 Lexington Road

Suite 530

Woolwich Township, NJ 08085

856-542-1300

Light Duty

The College will make reasonable accommodations, on a temporary basis, for light duty assignments for employees who, because of work-related injury or illness, are unable to accomplish the usual requirements of their job. Each case will be considered on an individual basis with the needs of the College in meeting its stated goals and objectives, a principal factor in reaching a decision. HR, in consultation with the employee’s supervisors and with input from the employee’s physician, will determine if reasonable accommodations can be made on a temporary basis.

If the employee is able to return to work with temporary restrictions, often referred to as “light duty,” it is the joint responsibility of the employee and the supervisor to ensure that the employee performs work within the restrictions only. If the employee is asked to perform work outside their restrictions, it is the employee’s responsibility to remind the requestor of the restrictions. It is also the employee’s obligation to inform the supervisor of work status immediately following all doctor’s appointments, treatments, and physical therapy. Keep in mind that these restrictions carry over into the activities away from work as well.

• When the employee, under medical care for a work-related injury, calls out or schedules a day off, the employee must inform HR who tracks workers’ compensation days away from work.
• If the employee is medically authorized to be out of work for more than seven (7) days, he/she is entitled to collect workers’ compensation benefits. Contact HR to further discuss these benefits.
• Please be aware that Inservco, the College’s third party administrator for workers’ compensation benefits, may authorize surveillance of the employee’s activities while the claim is active.
• The College’s workers’ compensation provider network includes many specialists that cover multiple medical disciplines to meet the employee’s needs.
• The law provides for fines and imprisonment for the unlawful disclosure of an employee’s medical information in a workers’ compensation case.

In the event that a reasonable accommodation in the form of a light duty assignment is approved and offered, the employee’s failure to accept the temporary assignment will be considered voluntary termination on the part of the employee.

References:

Rowan College of South Jersey Board of Trustees Policy Manual, 7111 Workers’ Compensation