Workers' Compensation

The State Government Workers' Compensation Program was established in 1985 and is administered by the Office of State Personnel. The purpose of the program is to ensure that all eligible employees who experience a work related injury or illness receive appropriate medical care and equitable benefits as provided under the Workers' Compensation Act and the Workers' Compensation section of the State Personnel Policy.The North Carolina Workers' Compensation Act provides benefits to state of NC government employees who receive an injury by accident while in the normal course of job duty. Please refer to the North Carolina State Government Workers' Compensation Employee Handbook for further definition.

• Who's Eligible?
• What Do I Do If an Employee Gets Hurt At Work?
• Who Provides Medical Treatment?
• What About Follow-up Medical Care?
• Are Prescription Drugs Covered?
• What If the Employee Can't Return To Work Right Away?
• What About Benefits?
  • Hospitalization 
  • Retirement
  • Vacation
  • Performance Increases
  • Longevity
  • Additional Benefits
• Who Manages Workers' Compensation Claims?
• Guiding Policies and Other Resources
• Forms
• Questions?

Who's Eligible?

All full-time, part-time, and temporary North Carolina School of Science and Mathematics (NCSSM) employees are covered by the North Carolina Workers' Compensation Act.  Volunteers, contractors and temporary employees contracted through temporary agencies, however, are not covered.

What Do I Do If an Employee Gets Hurt At Work?

In the case of a life-threatening emergency, immediately call 911, or direct the employee to go to the nearest emergency room.In the case of a non-life threatening injury, assess the situation, help arrange for proper medical care, and begin the injury reporting process. Before sending the employee to visit an authorized medical care facility, notify Human Resources of the injury and get the Medical Authorization Form. The attending physician must complete this form, and the employee should return the form along with any other medical notes or documentation to you after the visit. The form will also ensure that the employee does not have any out-of-pocket expenses for the physician visit or prescriptions.   The time that the employee is receiving the initial medical treatment is considered work time, and no leave should be coded.   It is important to report a work-related injury, accident or illness immediately, no matter how insignificant so that your employee gets proper care and you can quickly address any safety issues.  After the employee has received proper first aid or has been sent to the physician, then you must complete the Supervisor Accident Report Form.  Be sure to speak to any witnesses who observed the accident.  As soon as practicable, have the employee complete the Employee Statement and Leave Options. The Supervisor Accident Report Form and the Employee Statement and Leave Options forms must then be forwarded to Human Resources within 24 hours after the incident occurs. Human Resources remains available to assist in completing the forms. Make a copy of the forms for the employee also.  After the forms are complete, Human Resources will enter the accident information from the Supervisor’s form and the employee statement into the Corvel Corporation (our third party Workers’ Compensation administrator) database.  Corvel will assign a claims administrator, ensure that authorized  medical treatment and prescription drugs are paid, and the database will generate the Industrial Commission form 19 for the employee. Note: Employees are required to return to work immediately following the medical appointment to update you on the employee's status. What if the employee can't return to work right away? The injured employee's transition back to work is managed by several, including you, the supervisor, the physician, and Human Resources. Flexibility in providing light or modified duties as recommended by the treating physician will support a smooth return to full time job duties for the employee and keep the employee engaged in work. A supervisor who anticipates a gradual transition back to work after an injury should contact Human Resources as soon as possible.  How the employee codes leave for the time away from work will be determined by the Use of Leave Options choices.  You should maintain open lines of communication both with the employee as well as Human Resources particularly if light duty restrictions apply or the incident resulted in lost time from work. 

Who Provides Medical Treatment?

NCSSM faculty and staff are to visit the approved health care facilities.

What About Follow-up Medical Care?

Additional health care needed by specialists will be coordinated between Human Resources, the initial treating physician and CorVel Corporation, third party administrator for Workers' Compensation claims. An employee should consult with Human Resources to facilitate health care with a specialist.

Are Prescription Drugs Covered?

When the authorized treating physician prescribes medication, prescriptions may be filled at no cost, by most major pharmacies such as Wal-Mart, Kerr Drugs, Eckerd, or CVS, see Medical Authorization and Treating Physician Form. CorVel internally manages the prescription drug plan for the Workers' Compensation program. CorVel will provide the pharmacist with the required authorization to fill the prescription.If a pharmacy is unable to obtain the necessary authorization such as after normal business hours or during a weekend, the employee may pay for the prescription and file for a reimbursement by sending the original copy of the receipt to Human Resources.   CorVel can be reached by phone, at 1-866-441-4153. 

What If the Injured Employee Can't Return To Work Right Away?

An employee may choose to use sick or vacation leave, or go on Leave Without Pay during the 7-calendar-day waiting period. The law provides medical and disability compensation including a weekly benefit for lost workdays after a 7-calendar-day waiting period. A weekly benefit equal to 66 2/3% of the employee's average weekly earnings up to a maximum established by the North Carolina Industrial Commission is payable to the employee. Compensation begins on the eighth calendar day of lost work time and if the lost time goes beyond 21 calendar days, the employee is entitled to receive compensation for the first 7 calendar days if the employee elected to use Leave Without Pay for those first 7 days.The weekly benefit may be supplemented by using sick or vacation leave, earned prior to the injury, in accordance with the Supplemental Leave Schedule set by the State Personnel Commission.If the doctor states the employee should not return to normal work duties, the statement must be reflected on the medical documentation. If an employee does not return as scheduled, the absence is considered unauthorized unless prior to the absence the employee provides the supervisor with a written updated medical status from the authorized treating physician allowing the time off.Occasionally, a doctor will order work restrictions. In this case, a supervisor should make every effort to reasonably accommodate the limitations and the employee should comply with the doctor's recommendations. As stated earlier, a supervisor who anticipates a gradual transition back to work after an injury should contact Human Resources as soon as possible.Note: Employees are obligated to accept any suitable employment provided it is within capabilities. Refusal to accept suitable employment may result in termination of compensation and may result in dismissal.

What Happens to the Employee’s Benefits?

While on Leave Without Pay - Workers' Compensation status, there will be no benefit deductions taken from the weekly workers' compensation pay. Workers' Compensation wages are mailed directly to the employee by CorVel.

Hospitalization Insurance

State Health Plan coverage may continue while on Workers' Compensation. The employer's monthly contribution continues to be paid by NCSSM; however, the employee must pay premiums for dependent coverage to the Payroll Office, 919-416-2788.

Retirement Service Credit

Retirement contributions stop while on workers' compensation leave. An employee who is a member of the State Retirement System may purchase credit for the period of time on an approved leave.

Vacation/Sick Leave

The time used at the initial physician visit is considered work time and neither sick nor vacation leave should be coded.  Annual and sick leave continue to accrue while covered by Workers' Compensation and are credited for use upon the employee's return to work. If an employee does not return to work, vacation and sick leave accumulated during the first twelve months of leave should be paid in a lump sum along with other unused vacation credit. The payout of the vacation leave may exceed the 240 hours normally allowed.

Performance Increases

Salary will be computed based on the last salary plus any legislative increases to which the employee is entitled upon reinstatement. Any performance increases that would have been granted had the employee been at work may also be included in the reinstatement salary, or it may be given on any payment date following reinstatement.

Longevity

Employees continue to receive longevity credit and, if eligible, to receive annual payments.

Additional Benefits

Depending upon the benefit plan, coverage may continue through direct pay to the vendor or Payroll. Please contact Human Resources for further information.

Who Manages Workers' Compensation Claims?

The Worker’s Compensation Administrator establishes the procedures and processes to ensure injured employees receive the appropriate level of care and compensation in accordance with the Workers’ Compensation Act.  CorVel Corporation is the Third-Party Administrator (TPA) responsible for the overall administration of workers' compensation claims for the State of North Carolina.  CorVel, in conjunction with NCSSM Worker’s Compensation Administrator, is responsible for accepting or denying liability for NCSSM, and is also responsible for monitoring and processing all workers’ compensation claims.  Additionally, CorVel pays medical benefits and compensation in accordance with the North Carolina Workers' Compensation Act.  NCSSM and CorVel try to provide the best possible medical care for injured employees to help them reach maximum medical improvement and return to work as soon as possible.Payment of medical bills is not an indication of NCSSM’s acceptance of liability for the claim. If you receive a bill from the medical facility, please contact the facility to make sure they are billing CorVel correctly. You may contact Human Resources, 919-416-2663If a claim is denied, the employee will be notified as soon as possible, pending receipt of medical documentation, if necessary. To petition further, a written notice of claim must be filed with the North Carolina Industrial Commission, 4319 Mail Services Center, Raleigh, NC 27699-4319. The notice should include

• Employee's name, address, and Social Security number
• The employer's name
• The date and nature of the injury

All information should be provided using a Form 18, provided by NCSSM’s Human Resources. 

Guiding Policies and Other Resources

 Office of State Personnel

• Workers' Compensation Administration (pdf) 
• NC State Government Workers' Compensation Employee Handbook
• Supplemental Leave Schedule (pdf)

 NCSSM

• Worker’s Compensation Quick Reference

Forms

• Medical Authorization Form
• Employee Statement and Leave Options Form
• Supervisor Accident Report Form

Questions?

Claire Miller, Worker’s Compensation  Administrator - (919) 416-2663