WORKERS’ COMPENSATION POLICY EFFECTIVE 9/1/05

1. WORKERS’ COMPENSATION POLICY EFFECTIVE 9/1/05

2. PURPOSE OF WORKERS' COMPENSATION POLICY • To provide medical benefits and disability compensation in accordance with the NC Workers’ Compensation Act to employees who sustain compensable injuries or illnesses, which arise out of or are found to be within the course and scope of their employment.

3. Probationary employees • Regular established full-time employees • Part-time employees COVERED EMPLOYEES • Elected Officials • Temporary Employees

4. Employee Responsibility • Department Head Responsibility • HumanResourcesResponsibility Reporting Requirements

5. EMPLOYEE RESPONSIBILITY • Notify Department Head and Human Resources immediately ***Delayed reporting may result in the loss of Workers’ Compensation Benefits*** • Complete a First Report of Injury or Illness Form immediately • Contact Department Head and Human Resources PRIOR to receiving medical treatment (life threatening accidents or accidents occurring after normal 8-5 working hours may be directed to the nearest hospital

6. EMPLOYEE RESPONSIBILITY • Follow the orders of the approved treating physician • Provide all medical correspondences to the Department Head or Human Resources immediately

7. DEPARTMENT HEAD RESPONSIBILITY • Evaluate the injury and contact Human Resources to arrange for medical treatment (life threatening accidents or accidents occurring after normal 8-5 working hours may be directed to the nearest hospital • Complete a First Report of Injury or Illness Form with employee • Forward First Report of Injury or Illness Form to H.R. within 24 hours of the accident • Notify H.R. before returning injured employee to work on restricted duty (ONLY H.R. Director or County Manager may authorize waiver and allow employee to be out of work excluding the day of the injury)

8. DEPARTMENT HEAD RESPONSIBILITY • Maintain complete confidentiality of all work related injuries • Investigate accidents and complete Incident Investigation Report Form to H.R. within 48 hours of the accident • Assist in controlling the cost associated with work related injuries and illnesses • Ensure procedural notifications are posted at all work locations and visible to all employees

9. HUMAN RESOURCES RESPONSIBILITY • Ensure the employee receives NC Workers’ Compensation benefits and proper medical treatment if applicable • Oversee expenses associated with work related injuries and illnesses • Monitor designated Workers’ Compensation third-party administrator • Communicate policy and procedures to employees and management • Participate in NC Industrial Hearings • Report injuries to third-party administrator within 5 days of the date of injury as required by law

10. HUMAN RESOURCES RESPONSIBILITY • Communicate with third-party administrator to pre-approve medical treatment for injured employee • Responsible for all record keeping for injured employee • Responsible for maintenance of OSHA 300, 301 and 300A forms as required by law • Serve as HIPPA representative regarding confidentiality of medical records and information excluding treating medical professional, third-party administrator or to those on need to know basis • Report fatalities and/or hospitalization of three or more employees to OSHA

11. ACCIDENT REPORTING AND MEDICAL TREATMENT PROCEDURES • STEP 1: Report accident IMMEDIATELY to supervisor (in absence of supervisor, contact department head, human resources or County Manager’s Administrative Assistant) • STEP 2: Supervisor to contact H.R. for PRE-APPROVAL of medical treatment (life threatening accidents or accidents occurring after normal 8-5 working hours should be referred to Frye Medical Center Emergency Room) • STEP 3: Supervisor to notify H.R. of all injuries regardless of the severity of the injury and complete First Report Form within 24 hours • STEP 4: Supervisor to investigate accident and forward Incident Investigation Form to H.R. within 48 hours of the accident

12. ACCIDENT REPORTING AND MEDICAL TREATMENT PROCEDURES • STEP 5: If employee is placed on light duty work, Contact H.R. for specific return to work instructions • STEP 6: Employee must report to their department head after each doctor’s visit and provide medical notes to H.R. PRIOR to returning to work • STEP 7: If medical treatment is required, notify the treating authority that it is Workers’ Compensation. DO NOT USE MEDICAL INSURANCE CARD • STEP 8: If prescriptions are issued, notify the pharmacist that it is Workers’ Compensation. DO NOT FILE ON MEDICAL INSURANCE

13. LIGHT DUTY POLICY What is light duty? A change in an employees physical requirements, hours of work, etc. caused by a medical condition as certified by an authorized health care provider that prevents an employee from performing one or more of the essential physical duties of his/her regular position Only work related injuries will be eligible for light or modified duty ELIGIBILITY REQUIREMENTS FOR LIGHT DUTY Must have written and signed authorization from a County approved medical professional Note must detail specific physical duties that cannot be performed Note must give an anticipated duration of the condition

14. ACCOMMODATIONS • H.R. and Department Head will attempt to accommodate employee with limitations by minimizing the physical demands of his/her regular job or seeking another position within the County which meets the restriction requirements • Employee MAY not use sick leave, annual leave, or leave without pay in lieu of returning to work while on light duty status • Medical certification must be provided to H.R. PRIOR to returning to regular duty • If no light duty is available or lost time from work is required by the authorized medical professional, employee will be placed on Workers’ Compensation Leave

15. WORKERS’ COMPENSATION LEAVE POLICY • If employee has been directed to be out of work by authorized physician, sick leave/annual leave may be used for the first seven 7-day waiting period • If absence from authorized physician becomes at least 21 days Workers’ Compensation will pay for 7-day waiting period. • Beginning the eighth (8th) day of authorized absence, employee will receive 66 2/3 of gross wages (calculated on one year prior to the date of injury) • Compensatory sick leave or annual leave may be supplemented while on leave • Payment cannot exceed normal compensation • Supplemental pay will be subject to State and Federal tax withholdings and Social Security • Supplemental pay will not be subject to 6% retirement withholdings

16. USE OF LEAVE FOR ADDITIONAL MEDICAL TREATMENT • Employee shall not be charged sick leave or annual leave for time away from work for doctors appointments for work related injuries • Paid time should be limited to reasonable time for treatment and travel • Employee shall be charged sick/annual leave/leave without pay if time used for doctors appointment is abused • Appointments should be scheduled at a time most convenient for work unit • Employee is expected to return to work after medical treatment unless approved authorized healthcare provider has prohibited return to work • Qualified employees will be placed on FMLA if eligible which will run concurrent with Workers’ Compensation

17. BENEFITS WHILE ON WORKERS’ COMPENSATION LEAVE • Employee medical and dental insurance premiums will be paid by County • Medical/dental premiums for dependant coverage must be paid by the employee • Longevity pay will continue to be paid while on Workers’ Compensation leave • COLA’s, bonuses, merit increases, etc. that employee did not receive due to leave will be reinstated to the employee upon returning to work

18. BENEFITS WHILE ON WORKERS’ COMPENSATION LEAVE • Employee shall continue to accumulate annual and sick leave for use upon returning to work • Other benefit payroll deductions will be the responsibility of the employee • Employee is entitled to collect 31 cents a mile for medical treatment provided travel is 20 or more miles roundtrip • Employee must notify H.R. of possible travel reimbursement

19. ACCIDENTS INVOLVING COUNTY VEHICLES • Must be reported immediately whether or not accident results in a injury • Report to Department Head, H.R. Department or County Manager • All County policies and procedures for reporting the accidents must be followed

20. ALCOHOL AND CONTROLLED SUBSTANCE TESTING • Employee will be tested for drugs and alcohol following an on-the-job accident or illness that requires medical treatment by a licensed physician and/or involves one or more of the following: • A fatality • Injury to an employee or other individual • Accident involving a county owned vehicle • After a sequence of minor accidents or injuries that may not require medical treatment from a licensed physician

21. ON-THE-JOB DEFINED: • On company property, including parking lots; at job sites; driving or riding as a passenger in a company vehicle or private vehicle for which the company has authorized reimbursement; on company time even if off company premises (including lunch and rest breaks)

22. TESTING GUIDELINES • Employee is to be tested as soon as possible following an accident • Testing must not exceed eight (8) hours for alcohol testing and 32 hours for drug testing (employee involved in an accident must refrain from alcohol use for eight (8) hours following the accident or until he/she undergoes a post accident alcohol test • It is the employees responsibility to refrain from the legal use of alcoholic beverages until testing is completed, NO EXCEPTIONS

23. DISCIPLINE AND CONSEQUENCES • Failure to Report Injury • Disciplinary action up to and including termination • May be subject to denial of benefits under NC Workers’ Compensation Act • Failure to Seek Authorized Medical Treatment • Payment of bills incurred possibly denied • Disciplinary action up to and including termination

24. DISCIPLINE AND CONSEQUENCES • Drug and Alcohol Testing • Positive drug and alcohol testing will be subject to termination • Refusal to submit to alcohol and drug testing will be subject to termination • Additional information on Discipline, Grievance Procedures and Substance Abuse Policy is located at www.co.alexander.nc.us

25. SUMMARY WRAP-UP • It is the responsibility of each employee to follow set procedures when an accident or illness occurs that is found to be within the course and scope of their employment. • Failure to follow the procedures set forth in the Workers’ Compensation Policy, Article IX in the Alexander County Personnel Policy may result in loss of Workers’ Compensation benefits and disciplinary action up to and including termination of employment

26. IN THE EVENT OF AN ACCIDENT, EMPLOYEE SHOULD: • REPORT THE INJURY TO DEPARTMENT HEAD AND HUMAN RESOURCES IMMEDIATELY • COMPLETE A “FIRST REPORT OF INJURY OR ILLNESS FORM” WITHIN 24 HOURS OF THE ACCIDENT • NOTIFY DEPARTMENT HEAD AND HUMAN RESOURCES PRIOR TO RECEIVING MEDICAL TREATMENT (life threatening accidents or accidents occurring after normal 8-5 working hours may be directed to the nearest hospital)

27. IN THE EVENT OF AN ACCIDENT, EMPLOYEE SHOULD: • FOLLOW THE ORDERS OF THE APPROVED HEALTH-CARE PROVIDER • REPORT TO DEPARTMENT HEAD AFTER EACH DOCTOR VISIT AND PROVIDE MEDICAL NOTES TO HUMAN RESOURCES PRIOR TO RETURNING TO WORK • IF PLACED ON LIGHT DUTY WORK, OR OUT OF WORK BY AUTHORIZED MEDICAL PROFESSIONAL CONTACT HUMAN RESOURCES FOR SPECIFIC RETURN TO WORK INSTRUCTIONS