Reporting Procedures and Responsibilities
When an employee experiences an injury or illness arising out of and in the course of his or her work duties for the University of Illinois system, system procedures must be strictly followed in order to ensure the employee receives prompt medical attention!
Many individuals participate in the "management" of workers' compensation claims, and each has vital responsibilities to fulfill. Learn what your responsibilities are and familiarize yourself with what each of the following parties must do:
Employee
If you experience an injury or illness arising out of and in the course of your work for the University of Illinois system, you must always:
- Report the incident to your supervisor immediately! Giving immediate notice of an injury or illness allows for a vigorous investigation of the claim to begin and a timely determination to be made concerning compensability, causation, and prevention.
- Complete and sign the First Report of Injury/Illness form (PDF) within 24 hours of the incident and email it to WorkComp@uillinois.edu
- Seek medical attention as needed and provide a written medical status update to the Office of Workers’ Compensation and Claims Management ("Claims Management") and your supervisor after each doctor's office visit.
- Cooperate with the accident investigation process.
- Schedule all follow-up appointments either before or after work and attend those appointments. (Costs associated with treatment such as mileage, parking, meals, partial lost workdays, and so on are not reimbursable per the Illinois Workers’ Compensation Act, unless a treatment was directed by the Claims Management.)
- Notify Claims Management of any concurrent employment.
If your medical provider places you out of work, you must also meet these additional obligations:
- Inform your immediate supervisor, Payroll, and Human Resources of the status of claim so that appropriate benefits can be applied to absence from work.
- Submit written medical documentation after each medical care visit; provide these status updates to your supervisor and Claims Management, to report your availability for work.
- Follow restricted activity while at home.
- Participate in temporary transitional work assignments when permitted by your medical provider.
- Work with your supervisor and department's payroll representative to make sure that your time sheets are submitted to Claims Management by 10 am the Friday before pay week. Punctual time sheet submission is required in order for you to receive benefits.
- Failure to provide accurate time sheets and medical documentation may result in a delay of benefits.
Note: According to the Workers' Compensation Act of Illinois, Section 25.5, it is unlawful for any person to present or cause to be presented any false or fraudulent claim for payment of any workers' compensation benefit. Section 25.5 (a) (2) of the Act states it is unlawful to intentionally make a false or fraudulent material statement or material representations for the purpose of obtaining a workers' compensation benefit.
Supervisor
You must participate in prompt and complete reporting for your employees who have experienced a work-related injury or illness. Your workers compensation related duties are as follows:
- Facilitate the provision of medical care as needed.
- Complete the supervisor section of the First Report of Injury/Illness form (PDF) form within 24 hours and fax or email it to Claims Management. (Fax and email instructions are on the form.
When an employee is placed out of work due to an incident, you must also perform these duties:
- Advise your employee to submit a medical status report to you and Claims Management after each medical office visit.
- Work with the employee and your unit's payroll representative to make sure time sheets are submitted to Workers’ Compensation and Claims Management by 10 am the Friday before pay week, in order to receive benefits. Failure to submit payroll and medical information before the deadline may result in a delay of payments.
- Participate in developing a temporary transitional job bank for employees placed on work restrictions.
- Monitor employees assigned to temporary transitional work in order to ensure they are in compliance with medical capabilities prescribed by the physician.
- Actively work with safety professionals to investigate all accidents and implement loss prevention measures.
Medical Care Provider
The medical professional determining treatment for an employee must provide appropriate medical care for any injury or illness. Your workers compensation obligations also require you to:
- Supply the employee and employer with written documentation related to work status with or without restrictions after each office visit.
- Supplies the Claims Management with written medical information necessary to medically manage claim benefits.
- Familiarize yourself with the system's policy on temporary transitional work availability and work closely with system employees to return injured workers to gainful employment.
Safety Advisor
As a safety officer, your duties for any claim is to:
- Actively participate in departmental accident investigations.
- Assist in identifying unsafe practices and implementing corrections.
- Make recommendations for accident prevention.
- Monitor the implementation of safety measures.
Unit Payroll Representative
Prompt and accurate time reporting is essential for an eligible employee to receive workers’ compensation benefits. When an employee in any unit for which you prepare payroll records reports an injury or illness, you must
- Complete the appropriate paperwork and adjust earn
codes as needed to place the injured/ill employee on workers’ compensation leave of absence.
- Verify payroll information with the relevant employee and supervisor.
- Submit accurate time sheets to Workers’ Compensation and
Claims Management no later than 10 am the Friday before pay week. Failure to submit information by the deadline
may result in a delay of payments.
Human Resources
The HR agent is obligated to provide the following services and information to employees and departments regarding workers' compensation claims:
- Act as a resource for the employee and supervisor for questions regarding the Americans with Disabilities Act (ADA), the Family and Medical Leave Act (FMLA), and other relevant benefits.
- Notify the State University Retirement System (SURS) of an employee’s work-related absence.
- Restore earned benefits (sick leave, vacation, and so on) when an employee returns to work.
- Notify employee of the appeals process if there are disputes regarding earned benefits.
Office of Workers' Compensation and Claims Management
Claims Management’s primary mission is to investigate workers’ compensation claims and determine whether they are compensable according to Illinois Worker’s Compensation law. Our related obligations for each and every workers’ compensation claim is to:
- Gather investigation materials, using written and verbal information from interviews and statements by the employee, supervisor, witnesses, and medical providers.
- Maintain contact with the employee and supervisor and act as liaison among all parties involved in a claim, as allowed by law.
- Actively assist with safety recommendations and initiatives identified as a result of a claims investigation.
- Participate as appropriate and necessary to identify and provide temporary transitional work duties, ADA accommodations, and FMLA compliance.
- Monitor the appropriateness of medical treatment, maintain medical documentation of treatment plans, and utilize case management services as needed.
- Facilitate and participate in outreach opportunities to help educate all employees on the benefits and provisions of the Illinois Workers’ Compensation Act.
- Explain and provide notices to employees of their claim status.
Who to Ask