Workers' Compensation Poster (Form 17)
The Workers' Compensation Act provides medical benefits, compensation for lost time from work and compensation to employees for any permanent or permanent partial disability that results from a compensable job related injury.
DOC participates in the State Government Workers' Compensation Pilot Program. This means that all employee claims are handled by a third party administrator (TPA). The TPA is CorVel. CorVel decides whether a claim is compensable under the workers' compensation laws.
Compensation paid under the Workers' Compensation Act is based on the average weekly wage earned by the employee including any special allowances (i.e., shift premium, overtime, longevity, etc.), during the 52 weeks before the injury. The employee will receive 66 2/3% of the average weekly wage not to exceed the maximum amount payable as set-forth by the North Carolina Industrial Commission.
There is a seven (7) day waiting period. No compensation for time from work shall be allowed during the waiting period. However, the injured employee may choose one of the following options during the required waiting period:
Option 1. Elect to take sick or vacation leave during the required 7 day waiting period and then be placed on Leave Without Pay due to Workers' Compensation and begin drawing the Workers' compensation weekly benefits.
Option 2. Elect to be placed on Leave Without pay due to workers' Compensation for the required 7 day waiting period and then begin drawing the workers' compensation weekly benefits.
NOTE: In either option above if the injury results in disability for more than 21 days, the workers' compensation weekly benefit shall be allowed from the date of disability.
Salary Continuation Benefits
Employees of the Department of Correction whose position at the time of a compensable injury requires certification by the Criminal Justice Training and Standards Act as State Correctional Officers and State Probation and Parole Officers will receive full salary continuation (injury leave) if the injury requires any absences from work for up to two years from the date of incapacity.
In addition, effective July 1, 1996, any employee of the Department of Correction who is injured by a direct and deliberate act of an offender/inmate supervised by the Department will also receive full salary continuation (injury leave) for related absences from work for up to two years. Some examples of "direct and deliberate acts" would be:
- a nurse was attempting to take an inmate's blood pressure when, without warning, the inmate struck the nurse with an object; or
- a secretary was sitting at a desk drafting a letter when an irate inmate came down the hall and kicked the secretary; or
- a medical records clerk was filing medical charts when an inmate came into the office and punched the clerk in the face.
In the preceding (3) examples, the employees are entitled to full salary continuation using the same procedures as those used for the injured Criminal Justice Certified State Correctional Officers and State Probation and Parole Officers.
First Notice of Loss (FNOL)
DOC uses a web based application called First Notice of Loss (FNOL). The FNOL is only done when an employee seeks outside medical treatment.
1. Immediately give written notice, by completing the DOC-WC-4 "Employee's Initial Report of Injury", of an accident or injury to his/her supervisor as soon as possible after the accident occurs;
2. Accept medical treatment provided by the employer/CorVel to treat the injury;
3. Follow the prescribed treatment to affect a cure for the injury;
NOTE: Refusal may bar the employee from further compensation until such refusal is resolved;
4. Provide his/her supervisor with any medical restrictions;
NOTE: Refusal to comply with work restrictions may bar the employee from further compensation. Employees without restrictions shall return to the regular work schedule.5. Provide his/her supervisor with an out of work medical excuse every 30 days, if needed. The supervisor will forward a copy of the medical excuse to the Benefits Section.
6. Contact supervisor weekly while out of work.
Work Location Responsibilities
Workers' Comp Flowchart
1. Provide the employee a form DOC-WC-4 "Employee's Initial Report of Injury" for completion.
2. Division of Prisons - Refer employee to Unit Nurse or person rendering first aid (person rendering first aid must complete the back of the DOC-WC-4).
3. If the employee requires outside medical treatment, refer to a physician list in the PPO Network provided by CorVel (Medical Authorization Form). It it is an emergency, the employee may seek immediate medical attention at the closest medical facility.
4. Complete the First Notice of Loss (FNOL) using CorVel's Website www.caremc.com within 24 hours of notification of the injury. Please see Corvel FNOL Tutorial Handbook (DOC version).
5. Submit the completed DOC-WC-4 and witness statements to the Workers' Compensation Office in DOC Personnel.
6. Submit Request for Injury Leave & Injury Absence Approval to the Workers' Compensation Office in DOC Personnel.
Workers' Comp Office Responsibilities
1. Retrieve FNOL submitted by work locations and review for accuracy.
2. Contact work locations if corrections need to be made.
3. Submit FNOL to CorVel via Website for processing.Medical Treatment / Prescriptions
Employees shall seek medical treatment from a physician listed in the PPO Network. If it is an emergency, the injured employee may seek immediate medical treatment from the nearest medical facility and then notify the Benefits Section of medical attention outside the PPO Network. Medical treatment from sources other than the PPO Network, except in emergency situations, without prior approval of CorVel may result in the denial of part or all of the employee's claim.
To locate a Physician closest to you, go to www.caremc.com, then click on Provider Look-Up and follow the prompts.
CorVel has a pharmacy network to fill prescriptions for employees that have been injured on the job.
Payment of Medical Bills
CorVel is responsible for the payment of all medical bills. If you have questions regarding the status of unpaid medical bills, please contact CorVel at 1-866-441-4153. Any member of this team can assist you.
Transitional Return to Work Program (TRTWP)
The purpose of the TRTWP is to provide transitional work to employees of the Department of Correction (DOC) that are restricted from doing their normal job duties due to a compensable job related injury. The TRTWP provides employees the opportunity to return to suitable, productive work while continuing to recover from the job related injuries. The DOC believes that offering transitional work to employees during the recovery period is an important part of the healing process.
In the event of death resulting from an injury arising out of and in course of an employee's employment, compensation is paid to the surviving spouse and/or dependents for 500 weeks or until the child reaches their eighteenth (18) birthday, whichever is longer. There is a $10,000 allowance for funeral expenses.
After Hours Contact For CorVel
In the event of a fatality or catastrophic injury after hours or on weekends, CorVel should be contacted immediately. The phone number is 1-866-441-4153.
THE NORTH CAROLINA DEPARTMENT OF
CORRECTION DOES NOT DISCRIMINATE ON THE BASIS
OF RACE, COLOR, SEX, RELIGION, NATIONAL ORIGIN, AGE, OR DISABILITY.
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