City of St. Louis Department of Personnel Joint Regulation NO. 4

DISABILITY LEAVE AND WORKERS' COMPENSATION

Effective: August 23, 2010

I. AUTHORITY:

The Compensation Ordinance of the City of St. Louis sets forth the City's policy on workers' compensation and disability leave. The policy provides that employees in the City Service who suffer personal injury by accident or occupational disease arising out of and in the course and scope of their employment with the City of St. Louis receive benefits as required under the Missouri Workers' Compensation Law.

II. PURPOSE:

The purpose of this Joint Regulation is to establish the guidelines and procedures for the granting of leave and the payment of benefits under the Missouri Workers' Compensation Law to employees in the City Service of the City of St. Louis.

III. ADMINISTRATION:

A. Under the contract between Cannon Cochran Management Services, Inc. (CCMSI) and the City of St. Louis, the scope of services provided by CCMSI includes the evaluation of claims. Such evaluation includes determining, after adequate investigation, whether a claim is covered by the Missouri Workers' Compensation Law (the "Law"). Such determinations are not required under the Law until thirty days after a claim has been filed. Investigations do not begin until after reports of injury are received, and conclusions cannot be reached until facts are assembled and diligent investigations are completed. Under the Law, initial determinations may be changed if later warranted by the facts.

B. Whether to accept or deny coverage is a determination ultimately to be made by the City, through the Law Department or its authorized representative; however, such determinations should strongly consider the claim evaluation by CCMSI. Accordingly, any representations of coverage or non-coverage should come only from authorized employees or representatives of the Law Department and only after consideration of CCMSI's formal evaluation. All other employees or representatives of the City should refrain from giving assurances of coverage or non-coverage until such formal determination has been made.

IV. REPORTING OF ON-THE-JOB ACCIDENTS:

A. Under the Missouri Workers' Compensation Law, the City of St. Louis is required to report on-the-job injuries to the State of Missouri in a timely fashion. Failure to do so places the City's insurance status at risk, and could result in unfavorable sanctions from the State. It should also be noted that claims based on accident reports that are filed in an untimely manner may result in unnecessary processing delays and penalties; moreover, claims based on unreported accidents could be denied.

B. To ensure that employees comply with the State reporting requirements and the requirements of this Joint Regulation, appointing authorities shall: (1) establish policies to encourage all employees under their authority to report on-the-job accidents at the earliest possible moment, and (2) take the steps necessary to ensure that all employees, including management, supervisory and clerical personnel, are familiar with and follow the reporting procedures below, as well as the other provisions of this Joint Regulation.

C. Reporting Procedures:

1. Employees are to report on-the-job accidents immediately to their supervisor, or as soon after the accident as possible.

2. Supervisors who receive a report of an on-the-job accident resulting in an injury or receive a report of an occupational disease must complete a Report of Injury form. When completing the Report of Injury form, the supervisor should follow the instructions provided on the back of the form (see blue copy).

3. Appointing Authorities or their designees are to review the Report of Injury form to ensure that the form has been completed in a timely and accurate manner.

When it is found that the Report of Injury form was not completed accurately and/or in a timely fashion, steps should be taken immediately to determine the cause for the inaccuracy or the delay. Once the cause is identified, corrective action, including any disciplinary action that is warranted, should be taken to avoid similar problems and/or reporting delays in the future.

4. Payroll clerks should, within 24 hours of an accident, forward the white copy of the Report of Injury form to our third party administrator Cannon Cochran Management Services, Inc., (CCMSI), 133 South 11th Street, 4th Floor, St. Louis, Missouri 63102. A transmittal form should accompany the Report of Injury form sent to CCMSI . The pink copy of the Report of Injury form should be forwarded to the Department of Personnel, Attention: Safety Officer, 1114 Market Street, Room 700, St. Louis, Missouri 63101. The blue copy of the Report of Injury form is retained in the operating department's file.

NOTE: Employees who suffer injuries and/or diseases that are not work related are not eligible for benefits provided under the City's workers' compensation and disability leave program. Therefore, injuries and/or illnesses that are not worked related need not be reported. (If there is a question of whether a particular accident or illness should be reported, contact CCMSI at 231-4094.)

V. TREATMENT OF WORK-RELATED INJURIES:

Only employees who suffer work-related injuries and/or occupational diseases should be referred for medical treatment under the workers' compensation and disability leave program. Employees who become sick while at work with personal, non-work related illnesses should not be referred for medical treatment under the program, but should be advised to seek appropriate medical treatment under the terms of their individual health insurance plans. Bills resulting from the treatment of non-work related illnesses will not be authorized for payment unless the circumstances leading to the treatment clearly dictate otherwise. The expense of such treatment shall be borne by the employee who receives the unauthorized treatment.

A. Employees who suffer injuries shall be referred or transported to the authorized facility for diagnosis and treatment when the injury is severe enough to require medical attention.

B. Employees who require treatment of work-related injuries or occupational disease should be referred for initial treatment to their department's assigned treatment provider as authorized by CCMSI.

There are two exceptions to this rule:

1. In life threatening emergencies employees should be taken to the nearest appropriate medical facility. (This will usually be determined by emergency medical service personnel.)

2. When a "for cause" drug and/or alcohol test is required, the employee must be sent to an approved testing facility designated by the Department of Personnel, pursuant to Department of Personnel Administrative Regulation 120 (A) or Department of Personnel Administrative Regulation 120 (B).

C. It should be explained to the employee that the City's health insurance plans do not cover the treatment for work-related injuries. Under the Missouri Workers' Compensation Law, the City is required, at its expense, to provide medical treatment for on-the-job injuries. In requiring the City to provide this treatment, the Law gives the City the right to select the treating physician and/or treatment facility. The employee may, however, select a different physician and/or treatment facility if he or she so chooses, but he or she must do so at his or her own expense (i.e., the City will not be responsible for any expense incurred). It should be further explained that under the Law, the City retains the right to require the employee to undergo a medical examination by a physician designated by the City Counselor even though the employee is receiving medical treatment from a private physician. The expense of the examination will be borne by the City of St. Louis.

D. Employees referred for treatment should be provided with a Treatment Authorization and Fitness for Duty Form completed by their supervisor. When injured City employees report for treatment, they should identify themselves as City employees and present the authorization form.

E. The employee will be treated for the work-related injury and/or occupational disease.

On completion of the employee's treatment, the following should occur:

1. The attending physician or other medical personnel at the treatment facility will fill out the required forms and provide the employee with a copy of the Treatment Authorization and Fitness for Duty Form.

2. The employee should promptly give or forward the Treatment Authorization and Fitness for Duty Form to his or her supervisor. The supervisor should then forward the Treatment Authorization and Fitness for Duty Form to the appointing authority.

3. The appointing authority shall forward a completed copy of all medical documents including the Treatment Authorization and Fitness for Duty Form, to CCMSI, 133 South 11th Street, 4th Floor, St. Louis, Missouri 63102, as soon as possible after treatment and upon submission of the Workers' Disability Form, if required.

VI. COMPENSATING EMPLOYEES FOR PERIODS OF DISABILITY:

When an employee is placed on temporary total disability, the options available under the City's workers' compensation and Fire Fighter disability leave program must be explained so that the employee can make an informed decision about the available options.

A. Payroll Deductions:

1. Supervisors must advise the injured employee that State law prohibits non-voluntary deductions, including taxes, from the workers' compensation payment he or she receives. If an employee wishes to continue any deduction presently in effect, he or she must immediately notify his or her payroll clerk of his or her desire to continue the deduction(s). To prevent the lapse of any in-place health, life, dental, or other coverage, the payroll clerk must indicate that the employee wishes to continue the deductions during the period of temporary total disability.

2. The employee may also elect to use his or her accrued medical leave and/or sick leave for the first three work days of temporary disability, provided he or she has sufficient medical leave and/or sick leave accrued. Thereafter, the employee will be compensated at the rate mandated by the Missouri Workers' Compensation Law. If the period of disability extends more than fourteen (14) calendar days, the three work days of medical leave and/or sick leave used during the first three work days of disability will be restored to the employee's balance from which it was taken, i.e., medical leave or sick leave balance.

B. Reductions in Workers' Compensation Benefits for Safety Violations:

The Missouri Workers' Compensation Law allows for a twenty-five (25) to fifty (50) percent reduction in the benefits provided hereunder when the injury is caused by the failure of the employee to use safety devices where provided or by the failure to obey any reasonable rule adopted for the safety of the employee. In an effort to reduce injuries, the City of St. Louis will apply this reduction in benefits as allowed by statute. Applicable safety rules include those contained in any safety manual promulgated by the employee's department or division.

C. Compensation:

Employees of the City of St. Louis who suffer an injury or occupational disease arising out of and in the course of employment, may be eligible for benefits provided under the Missouri Workers' Compensation Law. The amount of said benefits will be determined in accordance with the Missouri Workers' Compensation Law and the compensation ordinance.

VII. COMPLETING THE WORKERS' DISABILITY FORM:

In order for an employee to receive compensation for any period of temporary total disability, a Workers' Disability Form must be completed and submitted in accordance with the procedures listed below.

A. If the injured employee is unable to report to work on or subsequent to the day following the accident as determined by authorized medical personnel, a Workers' Disability Form must be submitted by the operating department at the end of each pay period during which the employee is or was unable to work. This form must list the pertinent data and salary information, as well as determinations as to whether the employee will be using medical leave and/or sick leave for the first three work days of temporary disability and whether any present deductions are to be continued (under workers' compensation).

B. The Workers' Disability Form must be sent to the Workers' Compensation Section of the City Counselor's Office, 133 So. 11th Street, Suite 430, St. Louis, MO 63102 and received by 3:00 p.m. the workday before payroll closes for further processing. A copy of the Treatment Authorization and Fitness for Duty Form from the authorized treatment facility must be attached to the Workers' Disability Form.

VIII. STATUS OF INJURED EMPLOYEES:

When all pertinent information is received, the City Counselor shall render a decision concerning the status of the injured employee. The City Counselor's decision may include:

A. To keep the employee on disability leave or workers' compensation as requested by the appointing authority

B. To remove the employee from disability leave or workers' compensation

C. To refer the employee back to a medical facility for additional evaluation

D. To modify the request of the appointing authority and maintain the employee on disability leave or workers' compensation for a longer or shorter period of time.

IX. GENERAL:

A. Payments for Temporary Total Disability are to be made from the operating budget of the department where the injured employee works or worked when injured.

B. Appointing authorities are encouraged to utilize employees who are medically cleared to work in a temporary light duty capacity. It may be that an injured employee, though not able to perform his or her regular and usual duties at full capacity may be able to perform other needed and useful functions or tasks. All light duty assignments should be clearly defined and have a specified starting and ending date.

C. Prior to the dismissal of an employee who is on temporary total disability or who is unable to perform the essential functions of his/her position, the appointing authority should review the provisions of Joint Regulation No. 2 and Department of Personnel Administrative Regulation No. 133 to determine the applicability of either or both regulations.

D. Questions concerning the legal aspects of existing disability leave or workers' compensation cases should be referred to the Workers' Compensation Section of the City Counselor's Office at 622-4714 or 622-4708.

E. The policies and procedures established by this regulation have been jointly adopted by the Director of Personnel and the City Counselor and are effective upon issuance.

CITY COUNSELOR'S OFFICE Patricia A. Hageman City Counselor

DEPARTMENT OF PERSONNEL Richard R. Frank Director of Personnel

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