Medical

Medical Emergency – Need of Emergency Room and/or Emergency Transportation:

• The injured worker reports the injury to  the supervisor immediately. If the supervisor is not available, report to the manager on/ duty. Self-directed treatment is subject to adjuster approval, can be denied, and could lead to out-of-pocket expenses for the injured worker.
• The injured worker should go to the nearest emergency facility. For off campus emergency transportation call, (305) 348-5911.
• Be sure to inform the emergency medical facility that the injury is work related.
• The Injured worker must submit the FIU Injury Report Online.
• Sign on to Panther Soft.
• Click on Health & Safety Tile on the Home Page. For details on how to submit a report, check out our How-To-Guide.

Contact the FIU Workers’ Compensation Specialist at (305) 348-2181 or workerscomp@fiu.edu to schedule any medical treatment. Do not seek any medical care unless you have been authorized by our approved managed care network provider, AmeriSys, (800) 455-2079.

Seeking medical treatment for Non-Medical Emergency:

• The injured worker reports the injury to the supervisor immediately. If the supervisor is not available, report to the manager on/ duty. Self-directed treatment is subject to adjuster approval, can be denied, and could lead to out-of-pocket expenses for the injured worker.
• The Injured worker must submit the FIU Injury Report Online.
• Sign on to Panther Soft.
• Click on Health & Safety Tile on the Home Page. For details on how to submit a report, check out our How-To-Guide.
• The FIU Workers’ Compensation Specialist files the Workers’ Compensation claim with AmeriSys.
• During working hours, if the Workers’ Compensation Specialist is not available, the injured worker and/or supervisor may contact AmeriSys, at (800) 455-2079 or contact the Human Resources Service Center at (305) 348-2181 for additional assistance.
• After hours or weekends, the injured worker and/or supervisor may file the claim directly with AmeriSys.

Not Seeking Medical Treatment:

• The injured worker reports the injury to the supervisor immediately.
• The Injured worker completes the FIU Injury Report Online.
• Sign on to Panther Soft.
• Click on Health & Safety Tile on the Home Page. For details on how to submit a report, check out our How-To-Guide.
• The FIU Workers’ Compensation Specialist files the Workers’ Compensation claim with AmeriSys.
• If the injured worker decided to seek medical treatment, after the claim was filed with AmeriSys, he/she may call directly to our medical provider AmeriSys at (800) 455-2079 and notify Workers’ Compensation Specialist at workerscomp@fiu.edu or call (305) 348-2181.

After Injury

Medical Treatment Process:

• The authorized medical provider coordinates the initial treatment.
• A copy of the medical treatment form (DWC-25) must be provided immediately to the Workers’ Compensation Specialist within 24 hours after the doctor’s appointment.
• A Workers’ Compensation Notification Letter is sent to the supervisor and injured worker after each medical appointment, providing updated information on work status and/or any follow-up medical appointments.
• The injured worker’s supervisor reviews the restrictions and makes the decision on if the department is able to make the accommodations. The supervisor completes and returns the Workers’ Compensation Notification Letter to the Workers’ Compensation Specialist who forwards the letter to the approved managed care network provider and adjuster for their information.
• The injured worker will continue this process until he/she reaches the Maximum Medical Improvement, or, until no further medical treatment is required.
• If the injured worker needs to go to an emergency room and is already receiving medical treatment, contact AmeriSys at (800) 455-2079, to be authorized to receive treatment at the ER.

Out of Work: Loss Time

If the department is unable to accommodate the injured worker’s restriction, or the physician placed the injured worker off work the following will apply:

• The workers’ compensation wages loss benefits starts the eighth day that the injured worker is unable to work.  The first 40  hours of missed work will be paid under the Workers’ Compensation Administrative Leave, which may also be used intermittently when visiting an authorized Managed Care Network Physician.
• After the first 40  hours, if the injured worker continues to be out of work, two-thirds of the pre-injury wages are paid by the State Workers’ Compensation wage replacement benefits.  The remaining one-third may be paid by using your available personal leave (sick, annual, or compensatory).  This combination allows the injured worker to receive a full bi-weekly paycheck.
• Temporary employees do not receive the first 40  hours of Workers’ Compensation Administrative Leave.  On the eighth day, the temporary employee will be eligible to receive the two-thirds of the pre-injury wages paid by the State Workers’ Compensation wage replacement benefits.  If the temporary employee continues to be out of work for 21 consecutive days, they will get paid retroactively for the first eight days.

Medical Bills:

• Medical bills need to be billed and sent directly to AmeriSys.  The Workers’ Compensation Specialist assists the injured worker in case they receive any medical bill.
• The injured worker provides a copy of the medical bill to the Workers’ Compensation Specialist.
• The Workers’ Compensation Specialist provides billing information to the injured worker for future billing, if requested.
• The Workers’ Compensation Specialist sends an email to the injured worker to advise that the bill has been mailed to AmeriSys and medical facility for payment.

Return-To-Work Program

• This is a coordination between the injured worker’s department and the Workers’ Compensation Specialist.  If further assistance is necessary, then Employee & Labor Relations (ELR), the Department of Access, Compliance, and Equal Opportunity (ACE) and/or Benefits Administration will be involved to assist the department to determine if the injured worker’s restrictions can be accommodated.
• The Workers’ Compensation Specialist receives the Medical Treatment/Status Report (DWC-25) from the physician’s office, AmeriSys, and/or the injured worker after each medical appointment providing the employee’s medical update and restrictions.
• The Workers’ Compensation Specialist sends the Workers’ Compensation Notification Letter to the injured worker’s supervisor(s) and the injured worker via email to advise that employee has been released to return to work on modified/light duty. This memo provides any restrictions identified by the physician and also information on the next scheduled doctor’s appointment and/or any prescribed treatment for the employee.  The supervisor is asked to reply to the email within one to two days of receipt indicating if the department is able to accommodate the work restrictions/ limitations.
• Within 24 hours of supervisor’s response, the Workers’ Compensation Specialist notifies the case manager and adjuster via email if the department is able to accommodate restrictions.  If the department is unable to accommodate restrictions, the Workers’ Compensation Specialist notifies ELR and ACE, if necessary.

For more information, please refer to the Return to Work Program Guidelines.