Workers Compensation Policy

Applies to: The following policy applies to all Eligible Individuals, as defined by the policy.

1. Workers Compensation Policy

Issued: 05/03/2022
Last Revised: N/A
Last Reviewed: N/A

2. Policy Purpose

USC is committed to maintaining a safe work environment for faculty, staff, student workers (including post-doctoral and graduate student workers), and volunteers (“Eligible Individual(s)”). The University follows an established Workers’ Compensation policy explained below.

The USC Workers’ Compensation program is a California state-mandated program that provides benefits to Eligible Individuals who suffer from work-related illness or injuries resulting from employment. Workers’ compensation benefits are designed to provide Eligible Individuals with the medical treatment needed to recover from work-related injuries or illness, partially replace the wages lost while recovering and help Eligible Individuals return to work. This coverage is provided at no cost to the ill or injured Eligible Individual. If an Eligible Individual becomes ill or is injured outside of California, they may be covered by other state-mandated programs outside of the state of California.

Workers’ Compensation benefits may include compensation for medical costs, Temporary Disability, Permanent Disability, Supplemental Job Displacement Benefits (“SJDB”), or Death Benefits. It is essential that Eligible Individuals report work-related illnesses, injuries, or accidents within 24 hours to be compliant with this policy and so that the university can evaluate any prevention options that might mitigate future incidents.

Non-Retaliation or Discrimination Notice

USC will not take adverse employment action against an Eligible Individual who reports an illness or injury or files a claim under this policy.

If an Eligible Individual believes an adverse employment action has been or is being taken for exercising rights under this policy, the Eligible Individual should contact the USC Office of Professionalism and Ethics, the Office for Equity, Equal Opportunity, and Title IX, and/or the Office of Culture, Ethics, and Compliance.

3. Scope and Application

Workers’ Compensation is a state-mandated program for Eligible Individuals who become ill or injured in the Course and Scope of their Employment and/or volunteering for the university. Eligible Individuals may be qualified for the program on the first day of employment or once they have begun volunteering for the university. Contractors and temporary agency staff are not covered under USC’s Workers’ Compensation program.

For an illness or injury to be considered work-related, the incident has to arise out of and occur during the Course and Scope of Employment/volunteering. Illnesses or injuries that happen in remote and/or virtual environments may be covered if certain requirements are met. Work-related illnesses or injuries include both physical and mental illnesses or injuries.

Workers’ Compensation benefits do not extend to all activities in the workplace or to off-duty recreational activities.

USC’s Third-Party Administrator (“TPA”) confirms Eligible Individual eligibility, reviews and investigates claims, and ensures the application of USC’s Workers’ Compensation Policy.

4. Definitions

Refer to the grid below for definitions of terms specific to this this Workers’ Compensation program.

TERMDEFINITION
(Reasonable) Accommodations / AccommodateAccommodations are designed to facilitate the Eligible Individual’s safe and timely transition back to work. For the purposes of this policy, the ADA requires an employer to provide reasonable accommodations to qualified Eligible Individuals with disabilities unless doing so would cause undue hardship. Generally, an accommodation is any change that enables a qualified Eligible Individual with a disability to perform the essential functions of a job, including modifications or adjustments to the work environment, or to the manner or circumstances under which a position is customarily performed.
Course of Employment“Course of Employment” refers to the time, place, and circumstances under which an illness or injury occurred. An illness or injury occurs within the Course of Employment when it occurs (1) within the period of employment or volunteering, (2) at a place where the Eligible Individual reasonably may be in the performance of their duties, and (3) while the Eligible Individual is fulfilling the duties or, in most cases, if acting at the direction of their supervisor.
Death BenefitsDeath Benefits are payments to surviving qualified dependents (e.g., spouse, child) if the Eligible Individual dies from a job illness or injury. The amount is set by California state law and depends on the number of the Eligible Individual’s financial dependents. A burial allowance is also provided. If an Eligible Individual’s financial dependents are outside of California, the Death Benefits may be covered by other state mandated Workers’ Compensation programs.
Eligible Individual(s)Eligible Individuals of the University include: employees, student workers, and volunteers of the University of Southern California.
Injury and Illness Prevention Program (“IIPP”)IIPP is a policy that outlines safety responsibilities and requirements to support illness and injury prevention, maintain a safe and healthful workplace, and ensure Eligible Individual and institutional compliance with relevant environmental health and safety regulations. IIPP is a California state requirement (CA Labor Code 6401.7)
USC Medical Provider Network (“USC MPN”)The USC MPN is California Department of Industrial Relation’s-approved group plan of healthcare providers, with knowledge in general areas of medicine, who provide medical treatment to USC Eligible Individuals who have become ill or been injured while working /volunteering.After initial treatment, the Eligible Individual must continue treatment through the USC MPN.
Permanent Disability Permanent Disability is any lasting disability from an Eligible Individual’s work illness or injury that affects the Eligible Individual’s ability to earn a living. If an illness or injury results in Permanent Disability, determined by a Treating Physician or other medical examiner, an Eligible Individual is entitled to Permanent Disability benefits, even if they can go back to work. Permanent Disability benefits may include payments for an Eligible Individual whose illness or injury occurs through the course of their employment. Total disability benefits, a form of Permanent Disability, are payments to an Eligible Individual who is considered permanently and completely unable to work.
Predesignation / PredesignateCalifornia law allows Eligible Individuals to designate in advance (“Predesignate”) a personal medical doctor (“MD”) or Doctor of Osteopathic Medicine (“DO”) to treat them
Scope of Employment  An illness or injury occurs within the “Scope of Employment” when the Eligible Individual’s actions at the time of the illness or injury is intended, in whole or in part, to further the employer’s interests and that the actions were actually or were presumed to be at the direction of the employer or potentially foreseen by the employer.
SupervisorA Supervisor includes staff Supervisor, Deans of Faculty, Department Chairs, and volunteer contacts.
Temporary Total Disability / Temporary Partial DisabilityTemporary Total Disability / Temporary Partial Disability benefits are payments given to an Eligible Individual, as designated by a Treating Physician or other medical examiner, if they lose wages because the illness or injury prevents them from doing their usual and customary job while recovering.
Treating PhysicianA Treating Physician is a physician within the USC MPN, or the Predesignated provider. 
Workers’ Compensation ClaimA Workers’ Compensation Claim is initiated when an ill or injured Eligible Individual completes a Workers’ Compensation Claim Form (DWC-1) & Notice of Potential Eligibility (CA) and reports to the TPA.

5. Policy Details 

Types of Workers’ Compensation Claims

Specific Injury/Illness

An Eligible Individual could get injured by a specific one-time occurrence through the course of their employment. Examples of one-time occurrences include an Eligible Individual hurting their knee in a fall or getting burned by a chemical that splashes on their skin.

Continuous Trauma

Illnesses or injuries caused by repeated exposures at work. Examples of repeated exposure include an injured wrist from using vibrating tools or keyboarding or additional repeated body movements.

Workplace Crimes

Examples of illness or injuries arising from workplace crimes include getting hurt in a robbery or other acts of violence.

6. Procedures

Please refer to Procedure for Workers’ Compensation Policy for additional information

7. Forms

The following supporting documents and forms are applicable to USC’s Workers’ Compensation Program:

Workers’ Compensation Claim Form (DWC-1) & Notice of Potential Eligibility

Procedure for Workers’ Compensation Policy

Predesignation of Personal Physician

Manager’s Incident Report Form

Workers’ Comp/Disability Leave Checklist

Covered Employee Notification of Rights

Facts about Workers’ Compensation

Volunteer’s Injury or Illness Report

Declination of Workers’ Compensation Benefits and Medical Treatment

Employers Report of Occupational Injury or Illness (First Report of Injury – 5020)

8. Responsibilities

Refer to the grid below for a list of the units or individual who are responsible for aspects of this policy and their associated major responsibilities.

 POSITION or OFFICERESPONSIBILITIES
University of Southern California Office of Workers Compensation and Disability A. Maintains and updates the Workers’ Compensation policy, website, training, and associated resourcesB. Partners with HR Administration to maintain and distribute Workers’ Compensation informational materials for new and existing employees
C. Supports the Eligible Individual with the process of initiating a claim, overall process guidance, and answering questions or concerns
D. Partners with the Workers’ Compensation Third-Party Administrator to ensure employer obligations of the claims process are met
E. Maintains compliance with the regulations and laws for the State of California and other states, including all posting and notification requirements
Third-Party Administrator (“TPA”)A. Administers the Workers’ Compensation Operational services (such as claims processing and benefit management)
B. Handles all of the claim management of Workers’ Compensation cases from notification to approval/denial
C. Maintains all of the medical supporting documentation that support the Workers’ Compensation claims
University of Southern California Office of Institutional Accessibility and ADA Compliance A. Partners with the HR Partner (“HRP”) when the Eligible Individual’s department isn’t able to easily fulfill a request for Accommodations. Manages the complex Return to Work process with assistance from the Office of USC Workers’ Compensation and Disability
University of Southern California Departmental Human Resources Partner (“HRP”) A. Ensures the Eligible Individual has the appropriate forms and information for understanding their Workers’ Compensation and (if needed) disability benefits. Manages the Return-to-Work process with assistance from the USC Office of Workers’ Compensation and Disability

9. Related Information

Anthem Provider’s Website

California Department of Industrial Relations Division of Workers’ Compensation

California Department of Fair Employment and Housing

California Division of Workers’ Compensation’s (DWC) 22 district offices

California’s Employment Development Department – Workers’ Compensation FAQs

California Executive Order N-62-20 (COVID-19 and Workers’ Compensation Guidelines)

California Injury and Illness Program

California Labor Code for Volunteers (Sec. 3363.5)

California Labor Code for Permanent Disability (Sec. 4663)

California Local EDD Offices

California Labor Code (Sec. 3200)

USC Leave Checklist

10. Contacts

Please direct any questions regarding this policy to:

OFFICEPHONEEMAIL
USC HR Service Center(213) 821-8100uschr@usc.edu 
USC Office of Workers Compensation and Disability(213) 821-8100workerscompdisability@usc.edu
USC Environmental Health & Safety Department(323) 442-2200EHS@usc.edu
Broadspire (TPA as of 2021)(800) 495-2315https://myclaim.choosebroadspire.com/
USC Office of Professionalism and Ethics(213) 740-2500 or(800) 348-7454www.mycompliancereport.com, and enter UOSC as the access code.
Office of Culture, Ethics, and Compliance(213) 740-2500 or(800) 348-7454www.mycompliancereport.com, and enter UOSC as the access code.

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