UNIVERSITY OF PITTSBURGH POLICY 07-06-02
SECTION: Employee Support
SUBJECT: Workers' Compensation
EFFECTIVE DATE: February 1, 2012 Revised
This policy establishes the responsibility of the University, as defined by the Pennsylvania
Workers' Compensation Act (PA WC Act), to compensate employees for injuries sustained,
or exposure to an occupational disease hazard during the course of employment.
This policy also establishes guidelines for modified duty work for employees who are
receiving Workers’ Compensation lost wage replacement so they may perform productive
work within the functional limitations imposed by a work injury or illness.
In compliance with the provisions of the PA WC Act, the University is permitted to self-insure
its workers’ compensation liabilities.
Therefore, the University retains a third-party claims administrator (TPA) to administer WC
payments as defined by the PA WC Act and as managed through the University’s Office of
Risk Management, Insurance & Workers’ Compensation (ORMI).
Faculty, staff, and certain student employees who believe they have sustained a work-related
injury, illness, or disease which prevents them from performing their regular assigned duties,
may be eligible for partial wage loss and reasonable, necessary and related medical services
Volunteers are not eligible for Workers' Compensation. Students who are performing functions
to fulfill a financial aid obligation or to fulfill educational objectives may not be considered
employees for the purposes of Workers’ Compensation.
It is the responsibility of the Office of Risk Management, Insurance & Workers' Compensation
(ORMI) to oversee the University’s administration and management of the Workers’
Compensation program in accordance with state regulations. ORMI consults with the Office
of General Counsel on claims as appropriate and delegates claims administration to a third-
party claims administrator (TPA). The University’s Workers’ Compensation program’s
primary goals are the resolution of claims and the safe and timely return of employees to
Reporting an Injury
Employees or their supervisor must report any illness, injury, or disease that is believed to
have arisen from the performance of one’s job duties to the TPA and their supervisor
immediately. Failure to report the injury immediately may jeopardize the Workers'
Detailed directions for reporting a potential work injury or illness are located at
http://www.cfo.pitt.edu/wc/index.html. See Procedure 07-06-02, Workers’ Compensation.
For medical payments to be considered by the TPA, non-emergency treatment must be
obtained through the providers listed on the University’s Health Care Provider Panel – Form C.
http://www.cfo.pitt.edu/wc/campmed.html. Initial medical care for a medical emergency may
be obtained at the nearest emergency medical facility. The employee must treat with a
panel provider for 90 days from the date of the first panel provider visit.
The University has a Panel list for each campus. Employees may choose a provider from
any Panel list. If an employee opts to change providers, they must notify the TPA within
five (5) days. Reasonable, related, and necessary medical costs will be paid subject to
review by the TPA in accordance with the PA WC Act.
Employees’ Rights and Responsibilities under the PA WC Act are available on Employee
Acknowledgement of Rights & Duties – Form D at http://www.cfo.pitt.edu/wc/index.html.
Lost Time Wage Payments
Pursuant to state law and TPA claim acceptance, a waiting period is applicable before lost
time wage replacement is available. You must be disabled more than seven (7) calendar
days (including weekends) before WC payments for disability are payable. Lost time wage
payments are payable on the eighth (8th) day after injury. Once you have been off work
fourteen (14) days, you receive retroactive payment for the first seven (7) days. Please
consult with the Office of Human Resources for guidance on use of benefit days, such as
sick, vacation, FMLA, etc., to cover any unpaid Workers’ Compensation during this waiting
If an employee returns to work at wages less than the time of injury average weekly wage,
partial wage replacement may be continued as dictated by state law and administered through
Return to Work
The ORMI and TPA will work closely with the employee’s Department as needed to assist
with the return to work process, at full, modified or alternative work. In cases where the
employee is unable to return to his/her time of injury job, the availability of modified duty
work is usually considered temporary in nature, and is geared toward the successful return
to full duty responsibilities. When necessary, the University may assign modified duty work
within or outside of the department or school to which the injured worker is regularly
assigned, based upon a review of transferable skills, education, training, work experience,
and applicable collective bargaining agreements.
The employee is responsible for maintaining contact with their department supervisor,
especially regarding any change in medical status or restrictions, following a medical
appointment related to their work injury/illness. In the event the employee is released to
work at anything less than his/her pre-injury job demands, it is the Department’s responsibility
to consider the availability of modified duty work given the injured worker’s specific restrictions,
job functions, and potential temporary accommodations.
Procedure 07-06-02, Workers' Compensation