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To provide the structural and procedural framework for the Workers' Compensation Program of the University.

Under the direction of the Associate Vice President for Legal Management, the Director of Risk and Claims Management is to ensure compliance and implementation of this policy. The Manager for Workers' Compensation/General Liability is charged with staff responsibility regarding all exceptions or changes.

To provide medical, time loss, permanent disability and survivors benefits to faculty and staff injured while in the employ of UMDNJ, to ensure rehabilitation back to meaningful employment at the earliest possible date and to ensure that these obligations are fulfilled in a cost efficient and responsible fashion.

The Program intent is to fulfill the University's legal obligations set forth in the State of New Jersey Workers' Compensation Act, N.J.S.A. 34:15 et. seq., serve to maintain good employer/faculty and staff relations, facilitate the efficient administration of funds, the effective utilization of loss control techniques and to reduce departmental expenses and overhead.

1.     The procedure for reporting work-related injuries and occupational diseases is as
        follows:

        a.    Faculty and staff primarily assigned to Newark Campus are to comply with
               reporting procedures set forth in EXHIBIT A, Faculty and Staff Procedures for
               reporting Workers' Compensation Incidents Newark Campus.

        b.    Faculty and staff primarily assigned to Piscataway/New Brunswick Campus and
               outreach centers are to comply with reporting procedures set forth in EXHIBIT
               B, Faculty and Staff Procedures for reporting Workers' Compensation
               Incidents, Piscataway/New Brunswick Campus.

        c.    Faculty and staff primarily assigned to Camden/Stratford Campus are to comply
               with reporting procedures set forth in EXHIBIT C, Faculty and Staff
               Procedures for reporting Workers' Compensation Incidents,
               Camden/Stratford Campus. (SOM, RWJ-Camden, EMS-Camden, etc.)

 
2.     Risk and Claims Management, in conjunction with the Attorney General Claims
        Service Section is responsible for the following functions of the Self-Insurance
        Program:

        a.    Claims and Litigation Management

        b.    Coordination and monitoring of legal counsel

        c.     Reporting to any excess insurance carriers in accordance with conditions of
                coverage

        d.     Providing necessary documentation for preparation of an independent claims
                management audit, including review of reserves, by casualty claims management
                consultant and provides said report with other pertinent documentation and data
                to independent actuary to assist completion and preparation of an actuarial
                valuation of the funding mechanism and provides said actuarial report including
                funding recommendations and internal cost center allocation to senior
                management of UMDNJ.

        e.    In conjunction with the Attorney General, providing all other necessary services
               essential to the maintenance and operations of the Self-Insurance Program.

        f.    Workers' Compensation lost wage, medical care and permanent disability
               payments are made pursuant to the statutory requirements of the New Jersey
               Workers' Compensation Act, N.J.S.A. 34:15-7 et. seq.

 
     When said payments amount to $25,000.01 and up, settlements shall require,
     upon recommendation of the Legal Management, the advance approval of the
     Claims Committee of the UMDNJ Board of Trustees.

      When said payments amount to $10,000.01 and up to and including $25,000.00,
      settlements shall require, upon recommendation of Legal Management and the
      Senior Vice President.

      Whenever the voluntary acceptance or compromise and release results in
      permanent disability payment of $10,000 or less, the advance approval of the
      Director of Risk and Claims Management shall be required.

     The Office of Legal Management shall report to the Central Administration and
     Board of Trustees any changes in its delegation of authority.
 

3.     For purposes of resolving special issues arising from claim circumstances, such as
        differences in opinion arising between UMDNJ and faculty and staff with respect to
        medical care, lost wage compensation, disability determinations, etc., the UMDNJ
        Workers' Compensation Claims Committee members shall act to appropriately
        resolve the issues based upon the Committee members' objective findings. The Claims
        Committee shall be composed of the Director of Risk and Claims Management, the
        Manager for Workers' Compensation/General Liability, the Associate Vice President
        for Legal Management, or their designees, and a representative designated by the Vice
        President for Human Resources.

4.     Lost Wage, Medical Benefits and Rehabilitation Contingencies

        a.    Full-time, permanent University faculty and staff may be eligible for payment of the
               equivalent of their full salary, Sick Leave Injury (S.L.I.), for a period not to
               exceed 12 months subsequent from the date of the original injury. To be eligible
               for S.L.I., said injury must emanate as a result of physical injury arising in and out
               of the course of the performance of assigned job duties and functions.

 
    Worker's Compensation Temporary Disability (W.C.T.D.), as promulgated by the
     N. J. Workers' Compensation Act, shall apply in other instances.


        b.   Return-to-work clearance for faculty and staff shall be certified by the physician,
              authorized to provide medical care by the physician, authorized to provide medical
              care by Risk and Claims Management. Employee Health Service (E.H.S.)
              clearance is not required, unless E.H.S. has been expressly authorized by Risk and
              Claims Management to provide medical care.

        c.   The University is committed to rehabilitation of faculty and staff injured in the
              course of employment with UMDNJ. Therefore, the University has promulgated
              and implemented the UMDNJ's Workers' Compensation Rehabilitation
              Adjustment Program (R.A.P.). A description of R.A.P. is set forth in EXHIBIT
              D. All University departments shall establish alternative job duty descriptions or
              provide modified work assignments for faculty and staff consistent with the R.A.P.
              parameters prescribed by the authorized treating physician.

 
    Should a conflict arise with respect to whether or not alternate job responsibilities
    can be implemented, the faculty or staff member's department will contact a Risk
    and Claims Management representative who will arrange for a professional
    rehabilitation specialist to review and make recommendation with respect to the
    proposed alternate job responsibilities. If any conflict of opinion remains
    unresolved, the matter will be referred to the Director of Risk and Claims
    Management, the Associate Vice President for Legal Management and the Senior
    Vice President for Administration and Finance for review and final determination.

    Failure of any injured faculty or staff member, who is prescribed a R.A.P. work
    assignment, to carry out these duties, may result in a termination of eligibility to
    receive lost wage compensation as described in section a.

A.    Faculty and Staff Procedures for Reporting Worker's Compensation Incidents -
        Newark Campus

B.    Faculty and Staff Procedures for Reporting Worker's Compensation Incidents -
       Piscataway/New Brunswick Campus

C.   Faculty and Staff Procedures for Reporting Worker's Compensation Incidents -
       Camden/Stratford Campus

D.   UMDNJ Workers' Compensation Rehabilitation Adjustment Program
 

_________________________________________
Senior Vice President for Administration and Finance

1. Faculty and staff are to notify their immediate supervisor, upon the occurrence of an incident or first sign of an occupational disease.

2. All work-related injuries, occupational diseases, or dangerous situations are to be reported to Risk and Claims Management, Room 1313, Administration Complex (973) 972-6277 or by FAX (973) 972-7257.

3. The supervisor (or the next higher level of authority, if the immediate supervisor is not present) shall complete the Incident Report (UMDNJ Form #70, which can be obtained from Stationery & Lab Supplies) and shall answer every question presented.

4. If emergency medical care is required, the supervisor is to arrange to have the faculty or staff member examined at University Hospital's Emergency Room. Emergency Medical Services can be contacted at (973) 972-6290. (Emergency care is defined as a life threatening condition or a condition so severe that immediate medical attention is imperative or reasonably necessary to safeguard the injured faculty or staff member's well being; emergency care is further defined as treatment rendered in a hospital ER on a one-time basis).

5. The supervisor is to obtain the names of all parties and note the name, type, and model number of any equipment involved in any incident.

6. Upon either the completion of the incident report or release from the ER, the injured faculty or staff member will be instructed by the supervisor to report to Risk and Claims Management for the purpose of obtaining authorized medical care.

7. If the faculty or staff member is severely injured and hospitalized, the supervisor is required to notify Risk and Claims Management on the date of occurrence, to ensure the commencement of loss control services.

8. If the incident occurs on weekends, holidays or during hours in which Risk and Claims Management staff are not available, the incident is to be reported to Risk and Claims Management on the next business day (Monday - Friday).

9. Unauthorized medical care or lost time may prejudice the claim.

10. If in doubt regarding any work-related incident, contact the Risk and Claims Management Department (973) 972-6277 or by FAX (973) 972-7257.

1. Faculty and staff are to notify their immediate supervisor upon the occurrence of an incident or first sign of an occupational disease.

2. All work-related injuries, occupational diseases, or dangerous situations are to be reported to Risk and Claims Management, Room 1313, Administration Complex (973) 972-6277 or by FAX (973) 972-7257.

3. The supervisor (or the next higher level of authority, if the immediate supervisor is not present) shall complete the Incident Report (UMDNJ Form #70, which can be obtained from Stationery & Lab Supplies), and shall answer every question presented.

4. If emergency medical care is required, the supervisor is to arrange to have the faculty or staff member examined at Robert Wood Johnson University Hospital or at a medical facility located near the place of incident. (Emergency care is defined as a life threatening condition or a condition so severe that immediate medical attention is imperative or reasonably necessary to safeguard the injured faculty or staff member's well being; emergency care is further defined as treatment rendered in a hospital ER on a one-time basis).

5. The supervisor is to obtain the names of all parties and note the name, type, and model number of any equipment involved in any incident.

6. Upon either the completion of the incident report or release from the ER, the injured faculty or staff member will be instructed by the supervisor to telephone Risk and Claims Management for the purpose of obtaining authorized medical care.

7. If the faculty or staff member is severely injured and hospitalized, the supervisor is required to notify Risk and Claims Management on the date of occurrence, to ensure the commencement of loss control services.

8. If the incident occurs on weekends, holidays or during hours in which Risk and Claims Management staff are not available, the incident is to be reported to Risk and Claims Management on the next business day (Monday - Friday).

9. Unauthorized medical care or lost time may prejudice the claim.

10. If in doubt regarding any work-related incident, contact the Risk and Claims Management Department (973) 972-6277 or by FAX at (973) 972-7257.

1. Faculty and staff are to notify their immediate supervisor upon the occurrence of an incident or first sign of an occupational disease.

2. All work-related injuries, occupational diseases or dangerous situations are to be reported, by telephone to Risk and Claims Management, Room 1313, Administration Complex, (973) 972-6277 or by FAX (973) 972-7257.

3. The supervisor (or the next higher level of authority, if the immediate supervisor is not present) shall complete the Incident Report (UMDNJ Form #70, which can be obtained from Stationery & Lab Supplies), and shall answer every question presented.

4. If emergency medical care is required, the supervisor is to arrange to have the faculty or staff member examined at Cooper Medical Center, John F. Kennedy Memorial Hospital or at a medical facility located near the place of incident. (Emergency care is defined as a life threatening condition or a condition so severe that immediate medical attention is imperative or reasonably necessary to safeguard the injured faculty or staff member's well being; emergency care is further defined as treatment rendered in a hospital ER on a one-time basis).

5. The supervisor is to obtain the names of all parties and note the name, type, and model number of any equipment involved in any incident.

6. Upon either the completion of the incident report or release from the ER, the injured faculty or staff member will be instructed by the supervisor to telephone Risk and Claims Management for the purpose of obtaining authorized medical care.

7. If the faculty or staff member is severely injured and hospitalized, the supervisor is required to notify Risk and Claims Management on the date of occurrence, to ensure the commencement of loss control services.

8. If the incident occurs on weekends, holidays or during hours in which Risk and Claims Management staff are not available, the incident is to be reported to Risk and Claims Management on the next business day (Monday - Friday).

9. Unauthorized medical care or lost time may prejudice the claim.

10. If in doubt regarding any work-related incident, contact the Risk and Claims Management Department (973) 972-6277 or by FAX at (973) 972-7257.

The New Jersey Workers' Compensation Act, N.J.S.A. 34:15-15, requires an employer to furnish medical care necessary to cure and relieve the injured worker from the effects of work-related injury.

Under UMDNJ Workers' Compensation Rehabilitation Adjustment Program (R.A.P.), a faculty or staff member absent from work due to an employment injury/illness who is eligible for SLI, can return to work should the treating physician deem it necessary as part of the authorized medical management. The R.A.P. philosophy is based upon the supposition that:

The mental health of an injured faculty or staff member should be cared for as well as the physical injury. The longer a faculty or staff member remains out of work due to an injury, the lower his/her self-esteem becomes. In addition, due to inactivity, the body loses conditioning related to a specific activity, new injuries or an enervation of the preexisting condition can occur on a frequent basis. Any faculty or staff member who falls victim to this reoccurrence syndrome will develop an unnecessary dependency on a system that is primarily designed to compensate employees for serious permanent disabilities, rather than to limit their potential to pursue meaningful employment.

Authorized treating physicians prescribe R.A.P. assignments in conjunction with their program of treatment, therapy, and rehabilitation.

When a faculty or staff member returns to work under R.A.P., the department is to classify his/her time as Workers' Compensation (SLI) on the timesheet. Since Workers' Compensation (SLI) benefits are being utilized, the department can justify the need for temporary staffing assistance should the need arise. Accordingly, staffing problems are avoided and the injured faculty or staff member's needs are met.

The injured faculty or staff member's department is to provide modified work assignments within the parameters set by the treating physician and the applicable job description. The rehabilitation specialist can be consulted through Risk and Claims Management for proper modified work assignments. The rehabilitation specialist in conjunction with Risk and Claims Management will ensure that modified work assignments comply with existing job descriptions. Should a conflict arise, it is to be handled in accordance with section 4c of this policy and procedure.

In instances where R.A.P. faculty or staff members does not report to duty either due to illness or vacation, his/her time is to be classified with the appropriate code. Should the R.A.P. faculty or staff member miss an unexcused day from work, Risk and Claims Management is to be contacted at once or on the next business day.

R.A.P. is not prescribed automatically. The authorized physician must designate modified work assignments subject to Risk and Claims Management approval. The R.A.P. program as described is not to be utilized in situations concerning a non-work related injury/illness, since the program is created to work within the social scheme of N.J.S.A. 34:15 et. seq., manifesting the intent of the New Jersey State Legislature and the University's Workers' Compensation Self-Insurance Program. 
 

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