Workers' Compensation Frequently Asked
Questions
Supervisor's
First Report of Injury
First
Report of Injury form (pdf)
Is the date of injury counted in
determining whether or not an employee has lost more than one
day of work due to a work-related injury?
Yes. If an employee actually loses time from
work on the date of injury, that lost time should be counted
in determining whether or not the employee has missed more
than one day of work. For instance, if an employee misses half
a day on the date of injury and then misses the next full day,
he or she has missed more than one day of work. [Note: Lost
time from work need not be consecutive].
Are partial days missed from work counted in determining
whether or not an employee has missed more than one day
of work due to a compensable injury?
Partial days missed from work should be counted
if an employee is absent because he or she is "disabled." For
instance, if an employee's regular daily shift is eight
hours long, but the employee is only able to work four
hours per day pursuant to doctor's orders, the employee
will have lost more than one day of work due to his or
her injury after the third day of working only four hours
per day.
- "Disability" is defined as the inability to
obtain and retain employment as a result of a compensable
injury.
If an employee's supervisor knows the employee has sustained
a work-related injury, but the employee never formally reports
the injury, must the form be filed if the employee misses more
than one day of work due to the injury?
Yes. An employee who is injured on the job
is not required to "formally" report the injury if his or her supervisor
(or anyone with supervisory responsibilities) has actual knowledge
that the injury was sustained in the course and scope of employment. The
supervisor/department should complete a Supervisors' First
Report of Injury as soon as they are made aware of the
incident.
Who
should complete the Supervisor's First Report of Injury?
The Supervisor's First Report of Injury shall be completed
and signed by someone designated to act on behalf of the employer.
Texas Workers' Compensation
Commission Work Status Report (TWCC 73)
TWCC 73 form (pdf)
If an employee is missing intermittent periods
of time from work, how often must a Texas
Workers' Compensation Commission Work Status Report (Form 73)
be submitted to the employer/supervisor?
A new form should be submitted each time the employee returns
to work after having lost time from work and/or each time the
employee, after returning to work, experiences an additional
day or days of disability as a result of the injury. This
is to be completed by the medical provider.
Is time taken off for appointments with the doctor or physical
therapist considered lost time?
No. Lost time is that period of time during which the injured
employee is physically unable to work due to a compensable
injury.
Request For Paid Leave
(Form 23)
Paid
Leave form (pdf)
When an employee experiences intermittent periods of lost time,
does the employee have to complete a new form each time?
Yes. A new Request For Paid Leave (Form 23) should
be completed each time an employee misses work due to an on-the-job
injury.
How should the form be filled out if the employee
is unable to come in and sign the form?
It is very important to get the employee's signature on the
form. However, if this is not possible, the next best alternative
is to get the employee's spouse or relative to sign the form
on behalf of the employee. If neither the employee nor one
of the employee's relatives is able to sign the form we recommend
that you call the employee on the telephone and document the
employee's decision on the form. After the employee's decision
is recorded on the form, please sign the form as follows:
APPROVED BY PHONE (DATE)
_______________________________
Signed: (Department Rep Signature)
Is an employee required to use
all of his or her sick and annual leave before
he or she is entitled to receive workers' compensation
benefits?
No. The employer cannot require an employee to exhaust all
accrued leave even if the employee elects to take leave pursuant
to the Family Medical Leave Act.
Wage
Statement
(This form is currently completed
by the Workers' Compensation Advisor in Risk
Management & Insurance)
What should be done when the employee did not work for
thirteen consecutive weeks prior to the date of injury
and there is no same or similar employee who worked for
thirteen consecutive weeks prior to the date of injury?
If no same or similar employee worked for thirteen full weeks
prior to the date of injury, use the number of days and hours
the employee actually worked and the gross amount the employee
earned in wages or salary for each week listed.
If uniforms are provided to an employee, but the uniforms
must be returned upon termination of employment, are they
considered a "Fringe
Benefit?"
Although there has been no definitive ruling on this matter,
it is our policy not to consider uniforms a fringe benefit
for purposes of calculating an employee's average weekly wage
if the uniforms remain the property of the employer and must
be returned upon termination of employment.
Should the total
amount paid for health insurance during the thirteen weeks
covered by the Wage Statement be listed under "Fringe
Benefits" on the Wage Statement, or should only the
monthly contribution be listed?
List
only the monthly contribution for health insurance in the "Amount" column
under Fringe Benefits. To calculate the weekly amount for
a fringe benefit that is paid monthly, divide the monthly
amount by 4.34821.
If a fringe benefit is suspended during the
course of a claim, is it necessary to submit a revised wage
statement?
Yes. If a fringe benefit is identified as being continued,
and the employer later suspends that benefit, the employer
must file an amended TWCC-3 within 7 days, reporting the date
of suspension.
Employees Workers Compensation
Benefits
If an employee is receiving weekly workers' compensation benefits
for loss of wages, how does it affect the State contribution
toward benefits?
An employee who is off work and receiving
weekly workers' compensation benefits is in a "Leave Without Pay" status.
If the leave without pay covers a period of one month or
more in which no paycheck is to be received, the employee
is not entitled to the State contribution toward his or
her insurance premiums. This does not mean that the employee
may not retain his or her insurance coverage by paying
premiums. Questions regarding continuation of insurance coverage
should be directed to the institutional Benefits Office.
May an injured employee who is receiving workers'
compensation benefits intermittently use sick and/or vacation
leave in order to retain entitlement to the State contribution
toward insurance premiums?
No.
Is an employee entitled to mileage reimbursement
when he or she must travel to receive medical care?
An employee will be entitled to reimbursement for travel if
it becomes reasonably necessary to travel more than 20 miles
(one way) in order to obtain appropriate and necessary medical
care.
Can an employee who is receiving workers' compensation benefits
also be eligible for Long Term Disability, Unemployment Compensation,
and/or Social Security Disability benefits?
Yes. Receipt of workers' compensation income
benefits does not automatically make a person ineligible for
the benefits listed above. However, the amount of benefits
due under other programs may be affected by receipt of workers'
compensation income benefits. The institutional Benefits Office
should be contacted for specific information regarding eligibility
for Long Term Disability.
Are workers' compensation benefits taxable?
Workers' compensation benefits are currently not subject to
federal income taxation. If an employee has specific questions
about this matter, we recommend the employee be directed to
the Internal Revenue Service or to his or her legal advisor.
When do medical benefits become available to
an employee who sustains an on-the-job injury?
Medical
benefits are available immediately to a worker who is injured
in the course and scope of employment. [NOTE: An employee
should not use his or her health insurance card to obtain
medical treatment for a compensable on-the-job injury.]
What
if an employee attempts to obtain workers' compensation
benefits to which he or she is not entitled?
An employee who attempts to obtain workers' compensation benefits
to which he or she is not entitled should be warned that there
are serious penalties for making false or misleading statements,
misrepresenting or concealing material facts, and/or fabricating,
altering or concealing documents in order to obtain workers'
compensation benefits. Monetary penalties of up
to $5,000 may be assessed against an employee by the Texas
Workers' Compensation Commission for any of these deceptive
actions. Additionally, it is a criminal offense
(up to a second degree felony, depending on the dollar amount
involved) to knowingly commit any of the above listed acts
in an attempt to wrongfully obtain workers' compensation benefits.
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