Frequently Asked Questions
Insurance Services
Post Doctoral Fellows
Q. Is there a dental plan available under this plan?
A. A dental plan is available on a voluntary basis and you can be enrolled directly through UHP by contacting them at 1-800-437-6448
Q. Are eye examinations covered under this plan?
A. No, you will need to apply elsewhere for this type of coverage.
Q. Can a post doc be enrolled on a short-term basis?
A. No, you must be enrolled for at least 6 months.
Q. When does the plan terminate?
A. In order for Risk and Claims to terminate a post doc from the plan, the department must forward a request to delete said post doc on a timely basis. Any paperwork done in Human Resources regarding new post docs or the deletion of a post doc should be forwarded to R&C. This is the only way we can add/terminate. The effective date for terminations is the last day of retention with UMDNJ.
Workers' Compensation
Q. Is the employee eligible for Workers' Compensation lost wages benefits if he or she continues to work at his or her other employment while being unable to work at the University?
A. No. Workers' Compensation benefits can apply only if the employee does not receive any salary, regardless of source. Acceptance of Workers' Compensation benefits under the previously mentioned circumstances may constitute fraud and may result in serious penalty.
Q. Is every injury that occurs at work covered under Workers' Compensation?
A. No. Only injuries that occur out of and in the course of employment covered under Workers' Compensation. Injuries which may not be covered include, but may not be limited to, those occurring (1) as a result of intentional infliction of harm to oneself, (2) as a result of alcohol or drug use, (3) as a result of criminal or malicious conduct, (4) as a result of altercations, disputes or fights with co-workers or third parties, (5) as a result of skylarking or fooling around on the job.
Q. Are the costs of prescriptions covered?
A. The costs of prescriptions ordered by the authorized treating physician are covered providing the employee provides appropriate documentation of payment. If a prescription card is utilized, the University's Workers' Compensation Program will reimburse the employee for the deductible.
Q. What should an employee, manager, or supervisor do when they believe a co-employee is misusing the Workers' Compensation system?
A. If a co-employee is known to have falsely reported an injury as being work-related or is otherwise known to be abusing their privileges under Workers' Compensation, report this information immediately to your supervisor and to Risk and Claims Management.
Workers Compensation FAQs (continued)
Q. Can I opt to receive treatment under Workers' Compensation from my personal physician?
A. No. Under New Jersey Workers' Compensation law, the employer - not the employee - has the right to select the authorized treating physician. An authorized treating physician will be assigned by the University's Risk and Claims Management administrator. Only medical services provided for and lost wage benefits authorized by the University's authorized treating physician will be paid by the University's Workers' Compensation Self-Insurance Program.
Q. What do I do if I am dissatisfied with the medical services or claims handling services provided to me under Workers' Compensation?
A. Report the reasons for your dissatisfaction immediately to your supervisor and to the Risk and Claims Management administrator.
Q. What should I do if I am injured on the weekend or off-hours but do not require emergency treatment?
A. If the injury does not require emergency treatment, the employee should contact Risk and Claims Management on the next business day for a doctor's appointment. It is important to note that if the employee's injury is so severe that he/she is in need of emergency treatment, the injured person should be sent to the nearest hospital's emergency room. Risk and Claims Management should be notified on the next business day.
Q. Why are employees in certain cases requested to travel outside their immediate area of work for a medical evaluation?
A. This is a standard procedure and may be based on various factors including, but not necessarily limited to the following:
Availability of a particular physician
Need for a specific type of clinical specialist
Need for Functional Capacity or Work-Hardening Evaluation and follow-up
Q. What is RAP?
A. Workers' Compensation Rehabilitation Adjustment Program
The New Jersey's Compensation Act NJSA 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. Workers' Compensation physicians and insurance experts have determined 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. As a result, new injuries or aggravation of existing injuries can occur on a frequent basis. An employee who falls victim to this reoccurrence syndrome will develop an unnecessary dependency on a system that is primarily designed to compensate employees for serious disabilities, rather than to limit their potential to pursue meaningful employment.
Authorized treating physicians may prescribe RAP assignments in conjunction with their program of treatment, therapy and rehabilitation. The employee and the University benefit from an employee's return to modified work assignments. The longer an employee is unable to return to work following an injury, the less likely his/her return to meaningful employment becomes.
RAP is not prescribed automatically. RAP is prescribed subject to a maximum number of entailed workdays amounting to no more than 45-60 days. RAP is intended to assist an injured employee's return to the work environment in circumstances in which the authorized treating physician believes that the employee will eventually be able to fulfill all of the employee's job responsibilities.
Vehicular Liability Insurance
Q. What are the procedures for reporting an accident while driving a UMDNJ Vehicle?
1. Stop the vehicle away from moving traffic.
2. Assess the extent of injuries to others, if any.
3. Obtain assistance for the injured, if any.
4. Call the local police and complete police report.
5. Obtain the names, addresses and telephone numbers of witnesses, if any.
6. Obtain the names, addresses and telephone numbers of the other driver and his/her passengers, if any.
7. Note the seat location of each person.
8. Obtain the name of the other driver's insurance company and policy number.
9. Write down the time, location of accident, directions of vehicles, condition of road and weather.
10. Closely examine and note the damage to the other vehicle.
11. Make no statements regarding who may be at fault.
12. Complete both of the Accident and Incident reports. Obtain a copy of the police report and forward the report to Transportation Services.
13. Notify Transportation Services within twenty-four (24) hours of incident.
Medical Malpractice
How do I obtain a letter proving I am covered for malpractice by the University?
You must first contact the medical school of your affiliation and request proof of coverage. Faculty should contact the office of Faculty Affairs and residents contact the office of Graduate Medical Education. You will be asked for the name of the credentialing institution seeking this information. Before the letter stating there is coverage under the UMDNJ Self Insurance Program issues from the Office of Risk & Claims, confirmation of employment status and the subsequent authorization of the respective medical school is required.
What should I do if I receive a subpoena?
Contact the Risk & Claims office at 973-972-6277 immediately. A subpoena may be for either your medical records on a patient or for your testimony. In either case, Risk & Claims should be notified. You will be advised on how to proceed. You should not discuss these matters with anyone other than a representative of the Risk & Claims staff.
What should I do if I am served with suit papers?
Immediately contact the Risk & Claims office at 973-972-6277. Suit papers are more particularly referred to as a Summons and Complaint and they are time-sensitive documents. There are rules governing how these papers must be served and the timeframe within which the recipient must respond to the Court. Be prepared to tell the Risk & Claims representative when and how they came into your possession. You will be asked to forward the papers to our office, to provide us with contact information (e.g., work/home addresses, work/home/pager numbers), and will be informed about the conduct of the litigation and your role in it. Again, it is important that you not discuss matters of litigation with anyone other than a representative of the Risk & Claims office: not the patient, not the patient's attorney, not your colleagues.
What types of things should I report to Risk & Claims?
Unanticipated outcomes of a procedure or course of treatment, requests for records from attorneys representing patients, threats of legal action by patients should all be reported to Risk & Claims. Early notification allows us to acquire critical information on matters which may develop into a claim while memories are still fresh.
