Length of time to pay employee on sick leave

tad552 · February 2005

Good morning,
Can someone please help me? I work for a choice school in Milwaukee. We do not get sick days until we have been with the company for 5 years, although the CEO usually pays the employees for sick days if they do not abuse them. We have an employee who has been out on sick leave since the 2nd of February. The employee got hurt while on the job - this employee is saying that they re-injured themselves.
The CEO has been paying this employee their regular salary.
Today the CEO asked me to find out how long school has to pay this employee their regular salary before the school can start paying the employee a percentage of their salary.

Whatever · February 2005

I have a lot more questions than answers.
1. Why wasn't a claim filed with the wc carrier?
2. Is there a policy concerning leave of absence?
3. Are you subject to FMLA, ADA?

tad552 · February 2005

This employee choose not to accept the insurance from the school. They said that they were on their spouses insurance.
Regarding leave of absence, this is given at the discretion of the administration office.
I'm not sure if we are subject to FMLA or ADA. I think so but I'm not 100% sure.
Thanks for your questions though...

pork1 · February 2005

TAD552: Welcome to the forum! W/C rules and procedures for payment for other than W/C are different in our published Policy. If injured on the job our "insurance carrier" picks up payment of 2/3 gross after the employee has been out for greater than 5 days and they pay every two weeks until the physician releases the injuried party to return to work in some format. When the injured party comes back, we may pay the employee a lesser amount based on light duty pay schedules. The Insurance carrier is informed and they make up the difference up to the 2/3 rate. This happens until the physician releases the employee to full duty with no restrictions. If injuried away from the job, carrier pays nothing and again it is the physician's determination as to when short term disability starts or doesn't start. FMLA may then kick in and the rules for such payments is governed by our company policy!

I'm not in the school business, so my information may not be "worth a hoot" to you. I would turn to my published procedures or your W/C carrier's policy and published procedures.

PORK

2445428 · February 2005

TAD,
Does the school system have a worker's comp insurance carrier? If so, the injury should have been reported to them and they should be paying the employee. In Louisiana, after an employee has been out with a job related injury for 7 days, including weekends, then the w/c carrier begins to pay them 2/3 of their gross for as long as they remain out of work. (An employee's first 7 days is only compensable if they have PTO in their leave bank.) Once a Doctor releases them to return to work full time, the w/c payment stops. If they are released to return to work on a part-time schedule, w/c continues paying them 2/3's of their missed salary. FMLA is started immediately upon the employee missing work and runs concurrent with their worker's comp leave. Every state has different worker's comp laws. I would check with your legal counsel regarding "how long school has to pay this employee their regular salary.."

Crout · February 2005

I assume you're a private school and not affiliated with MPS. Even so, you must have a WC carrier. Was the initial injury reported to WC?

tad552 · February 2005

No you are right we are not with MPS. The injured person decided not to take the health insurance that was offered because they said that their spouse has insurance.

mushroomHR · February 2005

File the claim with your workers' compensation carrier. If this employee files with the company's health insurance carrier and the employee states they hurt themselves on the job, in all likelihood the company's health insurance carrier will deny the claim. When someone gets hurt on the job they usually don't have a choice as to whom to file the claim with--it goes to the bureau of workers' compensation.

pork1 · February 2005

TAD552: You are missing our messages, there are two insurances here. One covers the employee while working on the job and the employee has no right of refusal. The employee gets injured on the job the company pays 100% of the cost and the employer carrier pays the 2/3 rate for disability.

The 2nd is personal medical attention which may be employer supported and the employee has the right of refusal for any reason.

Now, which is it a W/C claim or a personal illness claim? We can normally help you resolve your concerns, if we have all of the facts or else our information as previously stated is not worth a "pig's squeal"!

PORK

LindaS · February 2005

Tad -

I think you are getting regular health insurance mixed up with W/C. An employee does not "elect" to participate in worker's compensation, they are automatically covered as long as they are an employee. Talk to whoever takes care of the insurance for your school to find out who the carrier is. Once you find out, contact them about filing a WC-12 (First Report of Injury or Disease). Once this is filed the W/C insurance company will begin paying that individual approx. 60% of their regular weekly wage going back 52 weeks prior to the date of the injury, once the EE has been off 7 working days.

This should have been done right away because now you have the issue of the W/C company being required to make the payments for the days missed plus you paid the EE their full wage and somewhere that money will need to be repaid.

As for how long to pay the EE, that will be determined by the W/C carrier based on the injury, healing period, etc. If you qualify, and the EE, for FMLA get that paperwork out right away so you can begin counting the time.

Whatever · February 2005

First of all, wc is mandatory coverage. The state requires every employer to cover every employee for on the job injury or illness. There is no option.
Second, there is also mandatory coverage for disability (weekly income, not medical).

Therefore, you need to become familiar with these two laws. It appears that claims have never been filed under these laws. Once you are familiar with the laws, you can advise the CEO on what policy should be considered (most companies pay for a limited number of sick and/or personal days each year). Paying for sick days if an ee does not abuse them sounds like a non-policy that could create problems in future.

Judith · February 2005

I agree with whatever and sounds like you have a mess on your hands. Not only do you need to kick this into the W/C and FMLA arena you should probably call your legal counsel or someone higher in HR (?) If that is you and you are new to HR you may want to consult your legal advice to find out how to bring this non-compliance issue somewhere close to compliance. And I would document everything on this situation very carefully so that if W/C denies it you will be able to go back to some type of defense before your school pays the entire disability bill -- medical and all!! Good luck!!

Length of time to pay employee on sick leave

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