Worker's Compensation
Worker Compensation Guide for Thompson School District
- Filing a Claim
- Designated Providers
- Safety Policy & Rules
- Medical Information
- Important Timelines
- Time Loss
- Returning to Work & Modified Duty
- Worker Compensation Contact Information
Filing a Claim
If you are injured at work, here are the next steps:
- In an emergency, seek medical care at the nearest hospital. An appointment must be scheduled within 24 hours of an ER visit with one of the designated providers listed on Designated Provider tab.
- Fill out a First Report of Injury. Click here to access the form.
- Notify your supervisor.
- Email the form to Denise.Absalom@tsd.org.
- In non-emergency situations, select one of the designated providers from the list and make an appointment to be seen.
- If you have scheduled an appointment during work hours, use the ANNUAL LEAVE code to record your absence in your department's absence management system(Absence Management or TC Plus).
All injuries, no matter how minor, should be reported immediately, but they can be reported up to 10 days after the date of the injury.
Designated Providers
In the event of a work-related injury or illness, employee can seek
medical treatment at one of the following providers.
Banner Occupational Health-Loveland
1703 E 18th St. Bldg 4 Loveland CO 80538
Ph. 970.820.4580
M-F 7:30 am-6:00 pm
Banner Occupational Health-Fort Colllins
3617 S. College Ave. Suite C Fort Collins, CO 80525
Ph. 970.821.3500
M-F 8:00 am-4:00 pm
Concentra Health
620 S. Lemay Ave. Fort Collins, CO 80524
Ph. 970.221.5811
M-F 8:00 am-6:00 pm
*Telemedicine & Transportation available
MBI-Loveland
(formerly WorkWell)
1608 Topaz Dr. Loveland, CO 80537
Ph. 970.593.0125
M-F 8:00 am-5:00 pm
*Telemedicine & Transportation Available **Spanish-speaking services
** on site X-ray available
MBI-Fort Colllins
1600 Specht Pt. Dr. Fort Collins, CO 80525
Ph. 970.672.5100
M-F 8:00 am-5:00 pm
UC HEALTH
221 E. 29th St. Loveland, CO 80538
Ph. 970.619.6824
M-F 8:00 am-5:00 pm
McKee Medical Center-Emergencies or after hour care
2000 Boise Ave. Loveland, CO 80538
Ph 970.820.4640
***if the injury is a life or limb-threatening emergency, call 911 or go to the nearest ER. Follow-up care must be scheduled within 24 hrs of an ER visit
Safety Policy & Rules
The Board of Education believes that safety education and accident prevention are essential to everyone involved with our schools and should be integrated into every aspect of our work activity. All employees of the district are responsible for maintaining a safe and healthy workplace and for ensuring that safety precautions and practices are followed. To safely perform your job, you must familiarize yourself with the safety rules specific to your position and participate in all safety training provided by your department.
1. Perform all tasks with safety as the top priority. Your specific job may have additional safety rules that your supervisor will discuss with you. If you are uncertain of how to safely perform a task, stop and ask your supervisor before continuing.
2. When lifting, use your legs, not your back. Ask for help if needed.
3. Use appropriate equipment for the task, e.g., do not use chairs or tables as ladders; use handrails when going up or down steps.
4. Don’t jump from heights; use the proper equipment or technique to return to surface level.
5. Wear personal protective devices, i.e., ear plugs, safety glasses, rubber gloves, etc., as needed or required by the job. Wear appropriate footwear for the job and appropriate to weather conditions.
6. Observe all traffic and motor vehicle regulations; use seat belts when driving a district vehicle or driving a personal vehicle on district business.
7. Do not use your cellular phone while driving during your work day. The work day is the period of time for which the district is paying you, for example, if you are required to drive to and from district meetings, to multiple locations to perform work, etc.
8. Do not engage in horseplay or other acts that may compromise the safety and well-being of you, your co-workers, students, or the public.
9. Use, possession, or sale of alcohol or unlawful drugs on the job is prohibited.
10. Immediately report any unsafe working conditions or safety problems to your supervisor. Until action is taken be sure that the area or condition is restricted and that cautionary devices, i.e., cones, temporary fencing, floor signs, etc., are in place so that others are not affected or injured.
The purpose of providing safety rules is to increase employee awareness of safety, acknowledge the importance of safety in the workplace, recognize the vital role that the employee plays in creating a safe work environment, and reduce the risk of personal injury. If you are injured on the job, report the injury to your supervisor immediately(within 24 hours), complete the Employee’s First Report of Injury Form, and fax it to the Benefits & Risk Management Office. The form is available on the district website, from your supervisor, or the Benefits & Risk Management Office.
Per the Colorado Revised Statute 8-42-112, failure to obey safety rules will result in a 50% reduction of worker's compensation disability benefits, “where injury results from employee’s willful failure to obey any reasonable rule adopted by the employer for the safety of the employee.”
Medical Information
If medical treatment is necessary, it must be obtained from one of the designated providers. Emergency or after-hours care can be provided by McKee Medical Center or another emergency medical facility; however, follow-up care must be directed by a physician from Banner Occupational Health Services, Concentra Occupational Health, MBI or UC Health Occupational Health. You must see a designated physician within 24 hours upon leaving the ER.
You are encouraged to work with your employer to find the best time to schedule your appointments.
If you miss time from work due to appointments, that time must be entered into the Absence Management system, TC Plus, or your department's absence reporting system using the Annual Leave code.
Please see the Colorado Department of Labor and Employment for further information regarding switching designated providers after the initial visit.
Important Timelines
When a worker gets injured, it is important to follow certain timelines. These timelines include seeking medical attention, informing the employer about the injury, or contesting a denial. The State of Colorado Injured Workers Guide provides detailed information on these timelines, which must be adhered to. To access the guide, please click on this link to be directed to the State of Colorado website.
Time Loss
If you are losing time from work because of your injury, you may be entitled to either Temporary Total or Temporary Partial Disability benefits. Pinnacol Assurance will not pay lost wage benefits until an injured worker has missed three shifts from work (24 hours). This 24-hour threshold may be consecutive or intermittent. Employees will use available Annual Leave for the first 24 hours of missed work due to injury or doctor's appointments. If an employee does not have available Annual Leave then this time will be docked. Absences, which are authorized by the designated physician, that follow these first three days will be paid at 66-2/3% of gross wages and will be paid directly to you by Pinnacol. The district will dock those absences from your paycheck.
If the employee loses more than 14 days of work, workers’ compensation will also cover the initial 3-day waiting period.
Employees are encouraged to schedule appointments and treatment outside of the workday, in order not to lose pay. The district will track the injured employee’s lost time and doctor visits in order to accurately report compensable absences to Pinnacol for payment to the injured employee. At the end of each month, a time loss sheet will be sent to the injured worker. If there are missed times due to appointments, this is where that time will be tracked. A time-loss memo will be sent to the injured worker so they can also track their time.
All absences must be reported in Absence Management, TC Plus, or the injured worker's department's absence reporting system using the Annual Leave code.
Returning to Work & Modified Duty
If your doctor has given you permission to return to work but with certain restrictions, such as not being able to lift more than 20 pounds, your employer may offer you modified duty that fits your abilities. However, if you are unable to perform the modified duties due to your injury, you should contact your doctor right away. If you refuse an offer of modified duty or take yourself off work, you may lose your lost wage benefits. In case your employer is unable to accommodate your restrictions and bring you back to work, you should contact your adjuster. You may be entitled to Temporary Total Disability (TTD) benefits.
Worker Compensation Contact Information
Denise Absalom
Risk Management Specialist
970.613.5003
denise.absalom@tsd.org
Dorothy Barnhart
Risk Manager
970.613.5006
dorothy.barnhart@tsd.org
Pinnacol Assurance
303.361.4000
www.pinnacol.com
Worker Compensation Forms
1st Injury Report
If you are injured at work, here are the next steps:
- In an emergency, seek medical care at the nearest hospital. An appointment must be scheduled within 24 hours of an ER visit with one of the designated providers listed on Designated Provider tab.
- Fill out a First Report of Injury. Click here to access the form.
- Notify your supervisor.
- Email the form to Denise.Absalom@tsd.org.
- In non-emergency situations, select one of the designated providers from the list and make an appointment to be seen.
- If you have scheduled an appointment during work hours, use the ANNUAL LEAVE code to record your absence in your department's absence management system(Absence Management or TC Plus).
All injuries, no matter how minor, should be reported immediately, but they can be reported up to 10 days after the date of the injury.
Supervisor Report
To help with cost containment we are required to have a supervisor's report on file for each injured employee that sought medical care for their injury. Email the completed report to Denise.Absalom@tsd.org
Click here to access the report
Time loss
Workers' Compensation Time Loss Information After evaluating the impact to staff following the significant change to the policy for wage loss recovery, due to a work-related injury, the following policy revisions have been reviewed and adopted by the BOE. The change to allow limited use of paid leave applies to claims that occur on or after June 20, 2013.
The reason for the revision was to ease the effect of three unpaid days or in some cases, the less than 66- 2/3% recovery of wages for the employee, by allowing the limited use of available paid leave for the first three days of work-injury related absence and to backfill lost wages up to the maximum benefit of 66-2/3%.
The BOE adopted the proposed language: visit the district website for the complete policy–GBGD. Additional information on workers’ compensation can be found in the Workers’ Compensation Brochure, also on the website. The employee will use available paid leave to cover the first three days of unpaid, work-related injury leave.
Under the Workers’ Compensation Statute, workers’ compensation benefits do not begin until after a three day waiting period has been met. Temporary disability benefits are paid at the rate of 66-2/3% of the employee’s average weekly wage up to a maximum benefit set by the legislature. If the employee loses more than 14 days of work, workers’ compensation will then also cover the initial 3 day waiting period.
If work related absences are considered compensable under Colorado Revised Statute 8-42-103, the employee will be credited back that portion of the employee’s paid leave.
If the average daily wage rate for employees who work less than 260 days and are paid over 12months, is less than 66-2/3% of regular wages, the employee shall be permitted to use available paid leave time to total up to 66-2/3% of actual loss wages during contract or assigned work days.
However, under no circumstances shall an employee be allowed to receive more than an amount equal to their weekly wage when combining workers’ compensation benefits and district paid leave benefits.
Key factors regarding loss wages due to a work related injury:
1. All absences, including those for doctor's visits or physical therapy, etc. must be reported through Absence Management, TC Plus or your department's absence reporting process to ensure accurate payment of wages and determination of future benefits for loss time under workers’ compensation statute.
2. The first three days of absence following the date of injury* (whether consecutive or intermittent) will be covered by the employee’s available paid leave; if the employee doesn’t have available paid leave these days will be unpaid. 3. Absences, which are authorized by the designated physician, that follows these first three days will be paid at 66-2/3% of gross wages and will be paid directly to you by Pinnacol. The district will dock those absences from your paycheck.
4. You may request additional use of your own available leave, if the designated physician releases you to return to regular duty without restriction or if you have signed and returned a modified duty letter.
5. If the designated physician releases you to return to work with restrictions or to modified duty, contact the Risk Management Specialist (613-5003) immediately following the doctor's visit, who will work with you and your supervisor to ensure that modified work is available and that you will be able to return to work right away.
6. You may request additional use of available leave only when the modified duty paperwork has been completed, indicating you have received the offer of modified duty. The reason for this process is to establish that the employer is knowledgeable about the employee's restrictions, modifies the position to accommodate those restrictions and the employee is involved in the process and acknowledges the offer to return to work.
7. If adjustments to your Thompson wages do not cover insurance premiums or Section 125 deductions, Payroll will contact you directly regarding payment.
*Absences on the date of injury are paid according to requirements of the Fair Labor Standards Act.
Worker's Compensation Tracking Absence Form
Absences related to the treatment of workers’ compensation claims are paid in accordance with C.R.S. § 8-42-102, 103 and Board Policy GBGD. All absences, including those for doctor's visits, physical therapy, surgery, doctor authorized time off from work, etc. must be reported through AESOP,TC Plus or your department’s absence reporting method. This form may also be used as a reference for the * Mileage Reimbursement Form provided by Pinnacol Assurance. To minimize the effect an absence has on student learning, work load, and to avoid a reduction in pay due to a dock in wages, injured employees are encouraged to schedule medical care appointments outside of regular work hours, whenever possible.
Contact Us
If you need assistance with any of the above information, please contact a member of the Risk Management Team.