Workers' Compensation Insurance

Definition
Any employee who becomes incapable of performing his / her essential job functions as the result of an injury or illness incurred within the scope of the county’s employment shall be deemed to be on workers' comp leave until:
  • He / she is able to resume his / her essential job functions on his / her regular work schedule
  • When approval is granted, by the county, to return to his / her regular work schedule on a restricted duty basis, as defined by the attending physician, resuming performance of all of the essential duties required in the employee’s position with reasonable accommodation
  • When the employee is separated from county employment
Statutory Benefits
An employee on leave, whether full-time or part-time leave, shall receive the statutory benefits available under the Workers' Compensation Act of Colorado, C.R.S. 8-40-101, et. seq., and pursuant to Gunnison County personnel policies.

Modified Schedule or Restricted Duty
While recovering from an on-the-job injury, an employee may return to work on a temporary basis with a modified work schedule and / or with restricted duties as the case may allow. Gunnison County reserves the right to limit or deny return to work on a modified schedule or restricted duty.

Policy Regarding FMLA
The Family and Medical Leave Act is a separate federal act, but will run concurrently with any eligible on-the-job injury leave. See Section 9-4 of the personnel policies for further information regarding Family and Medical Leave policies.
   
Statutory Exceptions
Benefits may be reduced by 50% in the following situations:
  • Where an injury is caused by the willful failure of the employee to use safety devices provided by the employer.
  • Where injury results from the employee’s willful failure to obey any reasonable rule adopted by the employer for the safety of the employee. (Reference department policies for safety rules.)
  • Where injury results from intoxication of the employee from drugs or alcohol.
Notification/Reporting for Workers' Compensation
In the event of an on-the-job injury, an employee should notify his / her supervisor immediately or by no later than the end of the shift on which the injury occurs. The employee must complete an Employee's Report of Incident form, the designated provider form, and an Authorization for Release of Medical Information form for submission to his / her supervisor within four workdays from the time of the incident. If the employee is unable to complete the form, it may be completed by a family member or a representative.
   
Medical Examinations & Treatments
If an injury requires immediate emergency treatment, the nearest hospital emergency room should be utilized. Upon release from emergency treatment, the employee must seek follow-up medical care from a county-designated provider. Injuries not constituting an emergency, but requiring a physician's care, shall be treated by a county-designated medical service provider.

Failure to comply with utilization of a county-designated provider may result in a denial of payment for medical expenses through the county workers' compensation insurance carrier. Each new employee receives a list of designated medical providers and a list can be obtained from the human resources office at any time or from the county website.
   
Denial by the Workers' Compensation Insurance Carrier
An employee may be denied compensation for a workers' comp claim if it is determined by the county's workers' compensation carrier that the injury / illness is not job-related. If the injury / illness is finally deemed non-compensable under Gunnison County's workers' compensation policy, compensation will cease on the date the claim is denied.

In this event, unless the finding is overturned on appeal, the amount of compensation made to the employee by the county and the county's workers' compensation insurance carrier with regard to the denied claim, will be deducted from the employee's paycheck and / or accrued sick and vacation leave balances or, if these balances are not sufficient, deducted as leave without pay.
   
Reporting Medical Status
During leave for a workers' comp injury or illness, employees must keep their supervisor informed of their medical status in regard to their ability to return to work. The county reserves the right to request periodic reports regarding the employee's medical status from the designated medical provider.
   
Separation
A workers' comp claim does not preclude an employee from being separated from employment pursuant to another personnel policy.