University employees must promptly report on-the-job injuries/illnesses to the employee's supervisor. Within 24 hours of the employee's report the supervisor shall complete the First Report of Injury and the Employee Incident Report forms and forward these to the University's vendor and a copy to the University Workers' Compensation Department.
Exclusions
If an injury is a potential life-threatening emergency call 911.
Special Situations
The Employee Incident Report and the First Report of Injury forms is to be faxed to:
- Sedgwick Claims Management Services at 952-826-3785
- and the University of Minnesota's Workers' Compensation Department 612-624-6070
These should be reported as soon as possible to ensure timely processing and to avoid "late reporting" fines levied by the Minnesota Department of Labor and Industry. If the University is fined for late reporting, any fine, of up to $2,000 may be charged back to the department responsible for the late reporting.
Fraud Warning: Fraud costs the University, taxpayers, and therefore all employees money.
It is a crime to lie or give false information to an insurance company to receive workers' compensation benefits. The law states:
"[A]ny person who, with intent to defraud, receives workers' compensation benefits to which the person is not entitled by knowingly misrepresenting, misstating or failing to disclose any material fact is guilty of theft and shall be sentenced pursuant to section 609.52 subdivision 3."
Employers and other parties who lie or give false information to gain at the expense of others are also subject to prosecution for fraud. Information about workers' compensation fraud should be sent to the Minnesota Department of Labor and Industry's Investigative Services Unit at 651-297-5797 and the University's Workers' Compensation Department at 612-624-6054.
This policy is intended to provide employees with a comprehensive response to on-the-job injuries/illnesses, prompt medical care; a timely return to work; and an effective management of workers' compensation benefits. Minnesota Statutes cover the management of workers' compensation claims, Chapter 176 in addition to administrative rules.
Procedures have been established for reporting injuries, seeking medical attention, and communicating work status. Not reporting injuries in a timely manner can delay employees' medical treatment and payments and can result in monetary penalties being imposed on the University.
*An employee may choose to receive treatment from one of the clinics or a doctor of the employees choice.
| Campus |
Designated medical provider |
Contact Info | Office Hours |
| Twin Cities |
Minnesota Occupational Health Clinic
|
1661 St. Anthony Ave.
St. Paul, Minnesota 55104
651-842-5300 |
Monday-Friday
8:00am-5:00pm |
| Twin Cities |
Airport Medical Clinic |
7750 34th Ave
Bloomington, MN 55450
952-993-9700 |
Monday-Friday
8:00am-8:00pm
Saturday
9:00 AM-3:00 PM |
| Twin Cities |
Columbia Park |
4000 Central Avenue N.E.
Fridley, MN 55414
763-572-5700
763-572-5719 for hearing impaired employees |
Monday-Friday
8:00am-5:00pm
After hours care is at the Fridley Plaza Location (6341 University Ave NE
hours 5:00 pm-9pm Monday-Friday and
9:00am-6:00pm Sat and Sun.) |
| Twin Cities |
Fairview Riverside
Medical Center
Emergency Center |
2450 Riverside Avenue
Minneapolis, Minnesota 55454
612-672-6402 |
Urgent care
7:00 am-Midnight |
| Crookston |
Northwestern Clinic |
400 South Minnesota
Crookston, Minnesota 56716
218-281-3184 |
Monday-Friday
8:00am-5:00pm |
Crookston
(after-hours) |
Riverview Hospital
Emergency Room |
323 South Minnesota
Crookston, Minnesota 56716
218-281-4682 |
when Northwestern Clinic
is closed |
| Duluth |
Work Right
Duluth Clinic, Ltd |
400 East Third Street
Duluth, Minnesota 55805
218-786-3392 |
Monday-Friday
8:00am-5:00pm |
Duluth
(after-hours) |
St. Mary's
Medical Center
Emergency Room |
407 East Third Street
Duluth, Minnesota 55805
218-726-4357 |
when Workright
is closed |
| Duluth |
UMD Health Services |
815 East University Circle
Duluth, Minnesota 55812
218-726-8155 |
September-May
8:00am-4:30pm
June-August
9:00am-3:00pm |
| Morris |
Morris Medical Center |
23 Montana Avenue
Morris, Minnesota 56267
320-589-3232 |
Monday-Friday
8:00am-5:00pm |
Morris
(after-hours) |
Stevens Community
Medical Center
Emergency Room |
400 East 1st Street
Morris, Minnesota 56267
320-589-1313 |
when Morris Medical Center
is closed |
- Employee
- This generally includes faculty, staff, and student employees who are working on paid appointments for the University. It generally excludes students, visiting professors, consultants, volunteers and temporary employees. For specific information on who is considered an employee for Workers' Compensation purposes contact the University of MN Workers Compensation Administration Department.
- Supervisor
- An employee designated by management, who exercises major supervisory functions over another employee or employees. These functions include hiring, evaluating, assigning work, disciplining, and dismissing.
- Employee
-
Report any work-related injury or illness to your Supervisor on the date or shift that it occurs, unless incapacitated, Fill in and sign an Employee Incident Report as soon as possible when an injury occurs. Obtain an Employer's Authorization for Care, Explanation of Benefits Pamphlet, and a Work Status Report Form (Workability) from the Supervisor. The employee may seek treatment from a doctor of his or her choice. The University encourages the use of the designated clinics.
- Supervisor
- In the best interest of employee safety and timely response to employee injuries, Supervisors are required to handle all work related injury and illnesses in compliance with these established procedure. The supervisor is also required to complete an Accident/Investigation Form within 24 hours.
- Department
- Promptly report injuries to Sedgwick Claims Management Services and the University's Workers' Compensation Department. The Minnesota Department of Labor and Industry can issue fines and penalties of up to $2,000 for failure to report injuries promptly and failure to report employee absences due to disability as a result of work related injuries promptly. These fines or penalties assessed to the University due to late reporting may be charged back to the department budget if the department is responsible for the delay.
- University Workers Compensation Administration
- Implements University of Minnesota Workers Compensation policy, responds to employees/supervisors or the State's questions, and provides workers compensation management. Establish and Maintain a confidential centralized filing system for all work injuries and illnesses. Copy work status reports and medical records for the internal file and forward the originals to the University's claims management vendor.
There are no appendices for this policy.
Amended: August 2003 - Updated contacts section and procedures to reflect phone and fax number changes within the Workers Compensation Department.
Amended: July 2002 - Updated contacts section.
Amended: October 2001 - Updated contacts and responsibilities sections. Updated policy and both procedures to clarify that employees may choose to receive treatment from a doctor of their choice. Added the Minnesota Workers' Compensation System Employee Information Sheet to the forms section.
Amended: December 2000 - Updated contacts section to reflect change of designated clinic for the Twin Cities campus from Healthworks to the Minnesota Occupational Health Clinic.
Amended: June 2000 - Updated Contacts Section and minor corrections on Workability and Supervisor Incident Report Forms. Procedure responsible offices changed from University Workers' Compensation Administration to Office of Risk Management and Insurance.
Amended: May 2000 - Changed the responsibility from the University's Workers' Compensation Department to the supervisors and managers for directly reporting injuries to the claims administrator. Clarified the choice of medical provider and increases the choices of designated clinics. Revised and added new forms.
- Effective:
- January 1999
Supercedes:1/1/99 Memo from Terry Teachout, Workers Compensation Director Re: Workers Compensation Policy and Procedures Revision 1999
-
To obtain a copy of a historical policy,
e-mail the U Policy Librarian at policy@umn.edu or call 612-624-4372.
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