Absence With Pay (Part 21)

Section 21.8 - Workers' Compensation Program - (Part 1 of 3, C-1 through C-9)

[Go to Part 2; C-10 through C-19]

[Go to Part 3; C-20 through C-33]

C-1

Negotiating Units:

• Administrative Services Unit Article 11
• Institutional Services Unit Article 11
• Operational Services Unit Article 11
• Professional, Scientific and Technical Services Unit Article 13
• Rent Regulation Services Unit Article 13
• Security Services Unit Article 14.9
• Security Supervisors Unit Article 14.9

Effect:

The Workers' Compensation Leave provisions on pages C-10 through C-19 of this Section apply to all eligible Security Services Unit and Security Supervisors Unit employees regardless of the date of the accident or incident causing the current absence.

For employees in the other units listed above (ASU, ISU, OSU, PS&T and RRSU), the provisions on pages C-10 through C-19 apply to all eligible employees whose absence is the result of an accident or incident that occurred before April 1, 1986. For employees in one of these five units who incur or suffer an occupational injury or disease on or after April 1, 1986, the description of the benefits available for related absences begins on page C-20 of this Section.

As a handy reference, pages C-2 through C-9 of this Section contain a brief comparison of the benefits.

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C-2

ROLES AND RESPONSIBILITIES

Agency	Leave Program	Supplemental Pay Program
APPOINTING AUTHORITY	Makes independent determination of eligibility for WCL. Processes PR-75s to provide employee with paid leave. Maintains records of leave granted. Restores leave credits. May terminate employee under Section 71 CSL. Files required forms with the Workers' Compensation Board.	Determines reportability of incident based on Workers' Compensation Law criteria. Provides salary continuation benefits to employees based on determination of eligibility by the State Insurance Fund (SIF). Maintains contact with Office of the State Comptroller (OSC), SIF, employee and supervisor regarding employee's continued eligibility for benefits, payroll status, and leave credits used, recredited and restored. Maintains accurate records. Files and/or provides information for forms required by OSC, and the Workers' Compensation Board. May terminate employee under Section 71 CSL.
STATE INSURANCE FUND (SIF)	Pays Workers' Compensation Law benefits to employee. (The wage replacement portion of the benefit is credited to NYS if the employee is granted paid leave.) Determines compensability. May controvert claim.	Pays Workers' Compensation Law benefits to employees. (The wage replacement portion of the benefit is credited to NYS if the employee absence is charged to leave credits.) May controvert claim. Maintains liaison with agency and OSC.
WORKER'S COMPENSATION BOARD (WCB)	Hears, judges merits of, and issues determinations on all workers' compensation cases. Directs SIF to pay benefits to the employee or NYS as appropriate.	Resolves controversies and may direct SIF to pay Law benefits to employee or agency.

TM-6 - New or Revised Material - January 1991

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ROLES AND RESPONSIBILITIES

Agency	Leave Program	Supplemental Pay Program
OFFICE OF STATE COMPTROLLER (OSC)	Processes PR-75s submitted by agency.	Calculates amount of supplemental payment. Maintains liaison with agencies and State Insurance Fund. Administers supplemental payment system. Processes forms submitted by agency.
CIVIL SERVICE	Administers Attendance Rules provisions as modified by negotiated agreements on Workers' Compensation Leave.	Administers Attendance Rules provisions as modified by negotiated agreements on Workers' Compensation Leave and Supplemental Pay Programs. Acts as liaison between SIF and agencies.

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WORKERS' COMPENSATION PROGRAM PROVISIONS

	Leave Program	Supplemental Pay Program
APPLICABILITY	All employees covered by the Attendance Rules are eligible. Applies to any injury or illness arising from an incident that occurred prior to April 1, 1986, regardless of the date of absence for ASU, ISU, OSU, PS&T and RRSU. Applies to Security Services and Security Supervisors regardless of date of incident.	Applies to employees covered by the Attendance Rules whose injury or illness arose from an incident that occurred on or after April 1, 1986. Applies to ASU, ISU, OSU, PS&T and RRSU.
SECTION 71	Employee may be terminated after one cumulative year of absence due to occupational injury or disease, subject to certain reinstatement rights upon recovery in accordance with Rule 5.9.	No change.
WAITING PERIOD	There is an annual ten-work-day waiting period which may be waived upon request or is suspended if employee is absent for at least 20 consecutive workdays or hospitalized within first ten consecutive days of absence in calendar year. (No waiting period in Security Services and Security Supervisors Units.)	One waiting period per injury or disease. 1-7 calendar days of absence- no wage benefit payable. 8-14 calendar days - wage benefit payable beginning day 8. 15 calendar days or more - wage benefit retroactive to day one.

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	Leave Program	Supplemental Pay Program
ADVANCING LEAVE	Agencies must advance sick leave to cover ten-workday waiting period to employees who have no leave accruals unless employee requests otherwise. Credits so advanced are repaid from future accruals.	If there is evidence of compensability confirmed by the SIF, agency must place employees who have no leave accruals on advanced leave until SIF begins making payments. Advanced leave is repaid by continuing employee on award and supplement following return to work for a period equal to the period of advanced leave.
COMPENSATION BENEFITS
Rate	Employee continues to receive full salary, while on six months paid workers' compensation leave without charge to credits and subsequently while charging credits. This is followed by sick leave at half-pay for which employee may be eligible and by LWOP.	Employee receives normal full salary while charging leave credits or while on advanced leave before SIF payments begin. When SIF payments begin, employee receives net pay (gross minus income taxes and FICA) comprised of SIF wage benefit and supplemental payment while on nine-month paid benefit. After nine-month benefit, employee receives normal full salary while charging leave credits, followed by sick leave at half-pay for which employee may be eligible and by LWOP.

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C-6

	Leave Program	Supplemental Pay Program
Duration	Entitled to one year of leave of which the first six months are workers' compensation leave with full pay without charge to leave credits. The remaining six months are charged to accruals, sick leave at half-pay or LWOP.	Entitled to one year of leave of which nine months consist of net pay benefit (workers' compensation wage award plus supplement). The remaining three months are charged to accruals, sick leave at half-pay or LWOP.
STATUS	Employees on leave with pay without charge to credits are in full pay status for Civil Service Rules and Regulations.	Employees on the supplemental system are treated as though they were in full pay status for Civil Service Rules and Regulations.
LEAVE CREDITS
Earning Leave Credits	Employee earns normal biweekly leave accruals while on workers' compensation leave without charge to credits and while charging leave accruals.	Employee earns normal biweekly leave accruals while charging leave accruals, while on advanced leave and while on the supplemental pay system.
Use of Leave Credits	Leave credits may be used to cover ten-day waiting period if not waived or automatically suspended. Leave credits may be used prior to (or at any time during) the six-month workers' compensation leave upon employee request. Leave credits may be used following six months of workers' compensation leave at full-pay without charge to leave credits.	Leave credits may be used to cover 7 calendar day statutory waiting period and the period of absence until SIF begins making payments. Leave credits may be used prior to the nine-month supplemental pay benefit upon employee request. Leave credits may be used following nine months of supplemental pay benefits.

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	Leave Program	Supplemental Pay Program
Restoration of Leave Credits	Applies only to credits used following six months of paid workers' compensation leave (or used earlier at employee option). Leave credits restored cannot be used for absences due to same illness or injury.	Applies only to credits used following nine months of award and supplement (or used prior to wage benefit at employee option). Leave credits restored cannot be used for absences due to same illness or injury.
	Employee may exceed vacation and sick leave maximums for one year following restoration of credits or return to payroll, whichever occurs later.	No change.
Holidays	Employees observe holidays while charging leave accruals but not during the six months' leave with pay without charge to credits.	Employees observe holidays while on advanced leave, while charging leave accruals and when on the supplemental payment system following return to work but not while absent due to injury and on the supplemental payment system.
OTHER LEAVES
Ex: Jury, Civil Service Exams, Military	An employee disabled by an on-the-job injury remains on workers' compensation leave even though able to perform other activities.	There is no change under the plan. Employees continue on the workers' compensation benefit as long as they are disabled.

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	Leave Program	Supplemental Pay Program
CONTROVERTED OR CONTESTED CLAIMS	An employee is ineligible for workers' compensation leave if agency determines that injury is not job related or that employee is not or is no longer disabled. Agency cannot grant workers' compensation leave if SIF controverts claim until such controversion is resolved.	An employee is ineligible for supplemental payments if SIF controverts the claim on grounds that injury is not job related or that employee is not disabled.
	If contest or controversion is resolved in employee's favor by Workers' Compensation Board, agency may continue to withhold workers' compensation leave for reasons, other than controversion, of which agency advised employee in writing.	If contest or controversion is resolved in favor of employee by Workers' Compensation Board, SIF must begin making payments and employee becomes eligible for these workers' compensation benefits including supplemental pay benefits.
MEDICAL EXAMS	Decision made to grant workers' compensation leave based on employee's doctor's statement and/or EHS or SIF medical examination at agency option.	Decision on eligibility for workers' compensation benefits made by SIF or WCB.
	Return to work decision made by agency based on employee submitted documentation or EHS physical or SIF physical.	Return to work decision made by agency based on employee submitted documentation, Workers' Compensation Board awards, EHS physical or SIF documentation.
MEDICAL DOCUMENTATION	Obtained from employee's physician and EHS or SIF physicians.	Obtained from employee's physician and EHS or SIF physicians.

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C-9

	Leave Program	Supplemental Pay Program
LIMITED/ LIGHT DUTY	On a case-by-case basis at agency discretion.	No change.
PAYROLL MATTERS	Employee remains on regular payroll receiving full salary.	Employee placed on supple- mental payment system. Salary adjustments may be made while employee is on supplemental payment system.
RECORD KEEPING	Source documents include agency accident report forms, regular payroll and time records.	Additional source documents include supplemental payment records and SIF records.

TM-6 - New or Revised Material - January 1991

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