POLICY 11
INJURED EMPLOYEES Revised 11/24

SECTION INDEX: Injured Employees

1 Purpose

2 Reference

3 Application

4 Guidance

4.1 Ready Rebound

4.2 Off the Job Injury

4.3 On the Job Injury

a. No Medical Needed

b. Medical Treatment Needed

c. Serious Injury or Death

d. Accident/Incident

4.4 Time Loss Compensation

4.5 Extended Leave & Benefits

5 Forms

5.1 Employee Injury/Illness Form

5.2 Return to Work Physical Capacity Evaluation (non-work related)

5.3 Death or Life-Threatening Injuries

5.4 Activity Prescription Form (APF) Sample

5.5 Light Duty Form

5.6 Accident Report Form (motor vehicle damage)

5.7 Incident Report Form (property damage)

5.8 Claim Roles and Checklists

5.9 Washington State L&I Guide to Workers’ Compensation for Injured Workers

1. PURPOSE

To provide a modern and flexible work environment and maintain the City of Olympia as an employer of choice to recruit and retain employees, the City offers a program allowing parents to bring their infants to work. This would assist with parents maintaining work life balance, promote parent-child bonding, and create more flexibility for a parent to work in lieu of taking leave.

2. REFERENCE

Chapter 51 RCW; RCW 51.12.035; RCW 51.32.110; Chapter 51.32 RCW; WAC Title 296; City of Olympia Policy 5 Drug and Alcohol; City of Olympia Policy 13 Leave, Americans with Disability Act (ADA); Washington State Labor and Industries Guide to Workers’ Compensation Benefits for Injured Workers.

3. APPLICATION

This Policy applies to all individuals employed by the City of Olympia, unpaid interns and volunteers injured in the performance of City functions, unless modified by contract or statute (e.g., civil service rules, union contract, individual employment contract or memorandum of understanding). An employee that sustains an injury because of an accident on the job, or an occupational disease because of the nature of their work for City, must follow this Policy.

Failure to comply with this Policy may result in disciplinary action including separation from City service.

4. GUIDANCE

Effective October 1, 2024, City of Olympia employees are insured through the Department of Labor and Industries (LNI) for the purpose of Workers Compensation (WC) for injuries occurring on the job. For injuries sustained prior to October 1, 2024, contact Human Resources for assistance in filing a claim.

4.1. Ready Rebound

Ready Rebound is an optional benefit available for all employees, retired city employees, city officials, volunteers and their immediate family members for both on and off duty injuries. Ready Rebound is a healthcare navigator team that assists injured people to receive rapid, high quality orthopedic care. Ready Rebound can be reached at 800.781.2320 (24/7 Hotline).

4.2. Off the Job Injury

If any employee sustains an injury while off the job, the employee will seek treatment using their own insurance and must inform their supervisor of any work restrictions or medications (including over the counter) that may interfere with the worker’s ability to perform their regular duties safely. The supervisor may request a doctor’s note or a Physical Capacity Evaluation Return to Work Form (non-work related) for absences exceeding three (3) days.

If an employee is at work but feels ill due to a non-work-related medical condition (faints, has a seizure, or is sick, etc.) and the employee needs care from a medical provider, the employee should not file a workers’ compensation claim unless they sustained an injury from the illness (ex: injured during a fall from fainting). The employee should instead, use their own insurance benefits or other means to pay for the treatment. However, the employee and supervisor should complete and submit an Employee Injury/Illness Report form for any medical issue that happens while at work.

4.3. On the Job Injury

An accident or occupational disease occurs when:

• The injury is a result of trauma (e.g. a physical wound or injury, such as a fracture or blow) that occurred while the employee was at work and completing the duties of their position);

• The injury occurred while performing required training for a City job;

• The injury occurred after a chemical or biofluid exposure;

• The injury arises as a disease or infection that arises naturally and proximately out of employment;

• For Fire department employees, when the injury occurred within six (6) hours of a working fire response or other activity where a Self-Contained Breathing Apparatus (SCBA) was used by the employee.

a. No Treatment Needed

If an employee is injured while at work in any of the ways described above and does not require medical attention, the injured worker will complete the top portion of the Injury/Illness Report and submit it to their supervisor. The supervisor will complete the bottom portion of the Injury/Illness Form and forward to HR. Human Resources will keep the Injury/Illness Report on file. If the employee’s condition worsens, they may file a claim within one (1) year from the date of physical injury or two (2) years from date of diagnosis for occupational exposure or disease.

b. Medical Treatment Needed

The injured worker may file a claim with Department of Labor and Industries in one of three ways:

1. Online: https://www.lni.wa.gov/FileFast (available 24/7)

2. By phone: 1.877.561 FILE (3453) Mon.-Fri. 8 a.m.-5 p.m.

3. At a doctor’s office (if the Report of Accident is completed at a doctor’s office, the provider files the form on behalf of the employee)

An injured employee may seek medical attention from any medical care provider for the initial visit. For minor injuries, employees are strongly encouraged to seek medical attention from an urgent care facility where patients are treated effectively and quickly compared to the wait time and cost at a hospital emergency room. For serious injuries, go to a hospital emergency room or call 911.

The injured employee is responsible for:

Contacting their supervisor immediately after all medical appointments to notify them of their ability to return to work (with or without restrictions).

Submitting any/all medical provider evaluations or return to work forms to supervisor or directly to HR.

Communicating with supervisor regarding any/all return to work, physical restrictions, light duty, accommodations or ergonomic assessment needed as a result of injury as prescribed by a medical provider; Refer to Light Duty Form if applicable)

Notifying supervisor of any/all prescriptions or medications that may affect ability to perform duties safely.

c. Serious or Life-Threatening Injuries

In the event of serious injury or fatality, the supervisor is required to follow the directions contained in the Serious or Life-Threatening Injury Procedures. If the injured worker is taken by ambulance for medical care, the supervisor may need to assist the injured worker in filing a claim.

The Department Director, Safety Officer and HR must be notified immediately for serious injuries listed below.

• amputation of limb (including loss of tip of finger)

• loss of eye

• in-patient hospitalization,

• the workplace death of an employee

d. Accident/Incident Injuries

If an employee is injured due to an accident or incident causing property damage, the employee together with their supervisor are required to complete an Accident Report Form (motor vehicle) and/or an Incident Report Form (property damage) in addition to all other WC injury paperwork and submit to the City’s Claims Manager in the Legal Department.

Post-accident drug and alcohol testing may be required if an employee is involved in an accident while on duty if:

1) There is a fatality;

2) An injury is treated away from the scene;

3) The driver receives a citation under state or local law;

4) One of more vehicles is towed from the scene;

5) The supervisor has reasonable suspicion to believe the employee involved in the accident might be under the influence of alcohol or drugs.

Refer to the City of Olympia Policy 5 Drug and Alcohol

4.4. Time-loss compensation for work related injury (wage related replacements benefits)

Time-loss compensation payments will not be as much as a regular paycheck. The benefit amount is approximately 60 to 75% of the wages the employee was earning, depending on marital status and dependents. The minimum and maximum L&I can pay is set by the state legislature.

The employee does not receive time loss for the day of the injury or for the first (3) three calendar days (benefit waiting period) after the injury unless they are unable to work for 7 days after the date of the injury. Employees or designated timekeepers will code time as sick leave (or PTO) once sick leave is exhausted, other applicable paid leave will be used including vacation, compensatory time, or floating holidays time (in that order). If the employee has exhausted all paid leave accruals, then available unpaid leave types may be used such as Washington state’s Family & Medical Leave (FMLA).

The employee will receive their first time loss check within 14 days from the date that LNI receives notice from a doctor that the employee is unable to work. Checks are mailed or sent electronically twice a month as long as a provider certifies that the employee cannot work in accordance with LNI policies.

All employees who have used leave accruals to cover their absence will be paid via accrued leave pending their receipt of time loss benefits from LNI. Since workers’ compensation only pays a percentage of full wages, an employee can “buy back” the percentage of the leave their time loss sum represents. Generally, the employee will not suffer an income loss while receiving workers’ compensation benefits so long as the employee has a paid leave balance available to supplement the difference between state benefits and compensation for normal working hours. If the employee wishes to participate in voluntary paid leave buy-back, they must submit their workers’ compensation time loss check to payroll within two (2) weeks of the check date. Requests to buy-back leave that was used more than two (2) months prior to the check date will not be accepted. Payroll will notify an employee when all available paid leave has been used. If an employee has no leave available, they will not be able to buy back leave and will keep their compensation from LNI. (Refer to Leave Buy Back Form)

If the injured worker is working, there is no time loss compensation for attending ongoing medical appointments related to a work-related injury. Travel expenses may only be reimbursed through LNI when there are no providers within 15 miles (one way from your home or work) that can treat your condition. However, an injured worker may ask for reimbursement for time loss and travel to attend a mandatory Independent Medical Evaluation (IME) related to the claim.

Employees working light duty due to a WC injury, may qualify for loss of earning power (LOEP) compensation as determined by LNI depending on their timesheet hours each pay period.

Refusal of Light Duty:

In the event an employee refuses available light duty which has been approved by their primary car provider/doctor, the employee will be required to use a form of paid leave instead of time loss compensation for workers WC injuries.

(Refer to Light Duty Form)

4.5. Extended Leave and Benefits

For injured workers (regardless of whether the injury occurred on or off the job) who have been absent from work for an extended period of more than two weeks should contact HR (360.753.8442) to determine if they qualify for additional benefits and job protections such as:

• Family Medical Leave Act (FMLA)

• Paid Family Medical Leave (for off the job injuries/illness only)

• Shared Leave

• Leave Without Pay

• Accident and/or Short-Term Disability (AFLAC)

• Long Term Disability

• Community Chest

• Employee Assistance Program (EAP)

• Americans with Disabilities (ADA) accommodation

Refer to City of Olympia Policy 13 Leave Policy