Benefits
Employee Workers' Compensation Information
Workers' compensation is a special type of medical insurance that may pay for medical expenses and, if appropriate, a percentage of lost wages in all compensable (approved) claims if you suffer a work-related injury or illness.
Unlike normal illnesses/injuries that are treated on a client-physician basis, workers' compensation closely involves the university, your supervisor, and the insurance carrier (MC Innovations).
Steps
Please seek medical treatment if you are seriously injured.
Please inform your supervisor of your at work injury as soon as possible.
Employees must complete a First Report of Accident if they wish to file a workers’ compensation claim. All questions should be answered with as much detail as possible.
This report must be received by the Benefits team within three (3) days of the date of injury.
Completed forms should be submitted to the benefits office at benefits@gmu.edu, by fax 703.993.2601, interoffice mail MSN 3C3 or hand-delivered to the HR office.
Employees must select a Panel Physician(s) or medical facility provided by the Workers' Compensation Office for treatment unless there is an emergency situation or prior release has been obtained. Employees must comply with all treatment protocols and appointments as prescribed.
The Panel of Physicians form should be signed and returned to benefits@gmu.edu.
Please contact the Benefits Team at 703-993-2600 or benefits@gmu.edu.
Before any medical appointments and/or physical therapy appointments, be sure to notify your Benefits administrator in advance.
While at your doctor, be sure to:
- Notify your doctor that this is a possible workers' compensation claim.
- Provide them with the name and contact information for the state's workers' compensation (WC) vendor.
- Keep all notes
- After visiting your panel doctor, provide your supervisor and the Benefits team with a copy of the doctor's notes.
- Any bills, doctor’s notes, disability slips, and other documents received by the employee should be emailed or mailed to:
Benefits
Human Resources 4400 University Drive, MSN 3C3
Fairfax, VA 22030
(703) 993-2600
Please be sure to follow your doctor's recommendations.
Important Information
Virginia Sickness and Disability Program (VSDP) participants must notify Reed Group at (877) 928-7021 if the injury results in a physician releasing you from work. If your claim is approved under Workers’ Compensation, Workers’ Compensation will be the primary benefit and VSDP will supplement the benefit, up to the income replacement level approved by Reed Group.
In order to maintain consistency with the original leave accrual system and VSDP, all employees will be required to use personal leave for the first seven (7) calendar days (waiting period) to cover time off if they wish to be paid.
In cases when an employee is out of work for more than 7 calendar days on an approved claim, Workers’ Compensation will begin paying at a rate of 66 2/3% his/her average weekly wage.
*All* time off for a work-related injury must be established in writing by the treating health provider. The written release must denote a specific time period along with the physician's signature and must be presented to the Benefits Administrator. The treating physician must also verify the return to work status in writing to the benefits office prior to reinstatement.
Any time missed from work that has not been prescribed by your physician will be charged to annual leave, sick leave, or Leave without Pay (LWOP) as appropriate.
If the claim is accepted by workers' compensation, the employee will be paid 66 2/3% of his/her average weekly wage. A VSDP participant may be eligible to receive more than the 66 2/3% depending on his/her length of service by initiating a Short-Term Disability claim. Continuation of salary at 100%, while a compensability decision is being made, is contingent on the amount of available personal leave and the establishment of a Short-Term Disability Status (STD) by Reed Group.
Wage employees, should the work-related Temporary Total Disability exceed seven days; a percentage of lost time wages will be paid directly to the employee from MCI. All employees (faculty, classified and wages) must provide written notification to the benefits office of a physician medically releasing them from work before benefits can be paid.
If the injury/illness recurs after your physician has certified you as recovered, please notify the benefits office immediately. MC Innovation will be notified and provide instructions on seeking treatment.
In some cases, the insurance carrier may determine that the injury/illness is not compensable (denied). For employees who are covered under one of the state's medical insurance plans, workers' compensation may pay for the initial visit, provided the Assignment of Benefits form is returned within thirty days of receipt of the denial letter. This form allows MCI to reimburse carriers and medical providers at the allowable rate. It is the employee's responsibility to complete and file the Application for Benefits form with MCI.
In accordance with Mason policy, leave is also covered under the Family Medical Leave Act (FMLA) and runs concurrently with all time out due to the injury and/or illness.
Compensability is not a determinate factor for an employee to be considered protected under the Americans with Disabilities Act (ADA). If you feel that your injury/illness qualifies you for accommodation, please contact Ruth Townsend, Associate Director/ADA Coordinator at 703.993.8730 to discuss your concerns.
Please read carefully the information provided by The Virginia Workers' Compensation Commission. The Application for Benefits is entirely employee-driven.
In the event you feel that you have not been treated fairly regarding your claim for a work-related injury/illness or for the compensation for lost time and wages, you may appeal the matter to the Virginia Workers' Compensation Commission.