Reporting an Injury

Workers' Compensation

UTHealth maintains Workers’ Compensation Insurance (“WCI”) through UT System as part of a self-administered/self-insurance plan.  This plan provides necessary and reasonable medical coverage and income benefits payments to employees who sustain injuries or occupational disease while in the course and scope of employment.  Some of the employee benefits are:  Disability income, medical expense reimbursement, and rehabilitation services.

UTHealth as the employer has a duty of care to you the employee to:  provide a safe place to work, provide competent fellow employees, provide safe tools and equipment, warn employees of inherent dangers and make and enforce rules for the safety of all employees.

UTHealth employees have a duty to:  Report your injury to your supervisor within 7 days from the date of the injury or from the date you knew your injury or illness was related to your job. You are required to see a medical provider if you miss time from work even if you use your own sick time. You must obtain a Work Status Report which must be given to your supervisor and faxed to Risk Management and Insurance (713-500-8111) so that you may return to work and you are required to keep in contact with your supervisor each time you seek treatment from your medical provider or miss time from work

Workers’ Compensation by the Numbers

The numbers surrounding WCI shows how broad and important a program it is. The premium charged to UTHealth by UT System is determined by the following:

50%-Loss history (3 years); capped at $100,000 per claim, 30% -Payroll (3 years) and 20%-Claim Frequency (3 years).


In FY 2010, UT System’s WCI program covered more employees than at any time in its history, 104,467.  Claims (lost time and medical only) and benefit expenditures (medical and indemnity) were one of the lowest in the last ten years. The average cost per covered employee for FY 2010 is $66, a $4 increase from FY 2009. The UT System premium rate has remained flat at $0.11 since FY 2009. In comparison, the State Office of Risk Management (SORM) rates for higher education institutions have increased by 3% to $0.35 for FY 2010.

The numbers show that UTHealth is doing very well.  The total number of injury reports received by Risk Management & Insurance has continued to decrease.  This is due to a combined effort of all employees.

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UT Health has WCI because it cares about its employees, but you must do your part by following the guidelines.
   
To learn more about WCI please follow this link to the Safety, Health, Environment and Risk Management website:  http://www.uthouston.edu/safety/risk-management-and-insurance/ or call the UTHealth WCI Representative, Sondra Faul, 713-500-8127, Sondra.k.faul@uth.tmc.edu.  You can also find information in the HOOP policy #100  (http://www.uthouston.edu/hoop/policy.htm?id=1448048).


Workers' Compensation Insurance and Injury Reporting

Workers’ Compensation is a program that provides medical and income benefits to employees injured during the course and scope of employment.  UTHealth provides these benefits on behalf of all employees including faculty, staff, and residents.  If you or an employee you supervise has an on-the-job injury medical care should be found through the IMO  Network unless it’s an emergency.  When necessary medical attention is provided please complete Supervisor's First Report of Injury (pdf).  Students are covered under their personal insurance, however RMI would like any injured students to complete Supervisor's First Report of Injury (pdf).  Reporting work related injuries and illness insures proper accident investigation and possible development of mitigation strategies to reduce accident recidivism.

STEPS TO BE TAKEN IN EVENT OF A NEEDLESTICK / BLOODBORNE PATHOGEN EXPOSURE  (pdf)

Workers’ Compensation by Classification 
Information for Injured Employees (weblink)
Information for Supervisor/Department of an Injured Employee (weblink)
Information for UT System Medical Foundation Residents (weblink)
Information for Students (weblink)

Workers' Compensation IMO Med-Select Health Care Network
Notice to UT Health Employees Concerning New Network
WCI Network Acknowledgement Form  (Española)
WCI Notice of Network Requirements (Española)
WCI Network Employee Handbook (Española)
Provider Search and Network Service Areas 
Workers’ Compensation Benefits HealthCare Network FAQ

Workers’ Compensation Forms
Supervisor's First Report of Injury (pdf) 
Prescription Card (pdf)
Request for Paid Leave (pdf) 
Employees Rights & Responsibilities (pdf)
Flowchart with steps for when an incident occurs 
(pdf) 
Division of Workers' Compensation Work Status Report (DWC73) (pdf)  
Employee Request for Reimbursement of Medical Expenses (pdf)

Worker’s Compensation Links
Common Workers’ Compensation Definitions (weblink)
Frequently Asked Questions (FAQ) for Workers’ Compensation  (weblink)
Workers’ Compensation Fact Sheets from the Texas Department of Insurance (weblink)

Workers' Compensation Coverage for Out-of-State or Out-of-Country Employees

Most UT Health Science Center at Houston employees receive Texas-specific Workers' Compensation insurance coverage through the UT System self-administered plan. Health science center faculty or staff stationed out of state or in another country may require coverage under a separate workers' compensation policy since some states or countries do not accept the self-administered plan.

Examples:

Out-of-State Employee 
One whose permanent home and work address is located in another state or nation, whether the office is newly set-up or has been in existence for a long time. 
An employee hired in Texas for a new office in Washington, D.C., for example, where that person will live.

In-State Employee — One who travels outside of Texas for a limited assignment, but keeps Texas as a home base and intends to return to Texas — even if an out-of-state residence is set up temporarily.

Risk Management and Insurance must be alerted if someone in your department falls within out-of-state or out-of-country categories — as detailed above, so the health science center can provide the correct insurance coverage for our employees. Please contact Sondra Faul, (713) 500-8127, with information about any employees who may fall into an out-of-state or out-of-country category.