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Home / Insurance & Managing Risk / Report an Incident / Workers' Compensation

Workers' Compensation

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The University of Pennsylvania’s Workers’ Compensation Program provides medical and/or wage loss benefits to employees who suffer an injury or illness in the course and scope of their employment.

If you are a faculty or staff member of the university, including part-time, temporary, academic, and nonacademic employees, you are covered by workers’ compensation.

Please note that NRSA Postdocs, Pre-Doctoral Trainees, Medical Students, Visiting Scholars, and those employed by a Temporary Agency are not considered to be employees of the university and are not covered by the university’s workers’ compensation program.


Reporting a Claim

Employees are required to report all work-related accidents and illnesses immediately to their supervisor, even if they do not require medical treatment.

The supervisor, along with the employee, is to report the claim to Broadspire. There are two (2) ways to report a claim:

OPTION 1: Phone

  • Report Claim over the phone by calling Broadspire at (888) 808-1440.
  • You will need your Penn ID number.
  • You will receive a claim number instantly, which you can give to your providers.


OPTION 2: Claims Reporting Form

  • Complete Claims reporting form
  • Send a copy of the completed claims reporting form to Broadspire via fax to (800) 245-9927, or email upennwc@choosebroadspire.com.
  • Bring your temporary prescription ID card to the pharmacy to receive prescriptions.
    • Your SSN is your temporary claim number until a claim number is assigned.

 

Medical Treatment for Work-Related Injury and/or Illness

  • During the first 90 days of treatment, employees MUST seek medical treatment from a panel provider.
  • Discovery Labs panel
  • New Bolton Center panel
  • Morris Arboretum panel

If an employee wishes to change healthcare providers during the initial 90-day period, they may do so, provided the visit is to another panel healthcare provider. Failure to treat with a panel provider for the first 90 days could result in non-payment of medical bills.

After the first 90-day period of treatment, an employee may choose to:

  • continue treatment from the posted physician or specialist to whom the employee was referred.
  • seek treatment from another duly licensed healthcare provider, provided that the employee notifies their claims adjuster within five (5) days of the first visit to the non-panel healthcare provider.


Workers’ Compensation Waiting Period

  • According to Pennsylvania law, lost wage benefits are paid after the first seven (7) calendar days of lost time. The employee’s sick time should be used to cover the waiting period.
  • If the lost time from work exceeds fourteen (14) calendar days, benefits go retroactive to day one, and the sick days will be credited back to the employee’s sick accrued sick leave.
  • The Departmental Payroll Administrator is responsible for notifying the Workers’ Compensation Manager that an employee is out of work and needs to be placed on a Workers’ Compensation Leave of Absence in Workday.


Benefits Continuation

  • While an employee is on Workers’ Compensation Leave, there is no accrual of Sick Leave or Paid Time Off.
  • During the initial thirty (30) days an employee is on Workers’ Compensation leave:
    • The employee’s benefits are continued. Deductions that would normally be taken from the employee’s paycheck instead accumulate in a suspense account.
    • The employee must contact the Human Resource Benefits Department within this thirty-day period to make arrangements for continuation of benefits, and to pay the employee’s share of the cost.
  • This healthcare benefit cost is typically equivalent to the share normally deducted from the employee’s paycheck.
  • Any amount accumulated in the suspense account during the first thirty (30) days must also be paid by the employee.
  • After the first thirty (30) days and up to the end of the first twelve (12) months from the date the employee initially began his/her Workers’ Compensation leave:
    • The employee’s benefits are continued, providing the employee has contacted the Benefits Department during the initial thirty-day period to arrange for the continuation of benefits.
    • Deductions that would normally be taken from the employee’s paycheck are instead billed directly to the employee.
    • The employee will continue to earn service credit for those benefits that are dependent upon the length of service.
    • Individuals may continue making payments to their tax-deferred annuity plan on an after-tax basis.
    • If the employee makes no arrangement to continue benefits or stops paying the employee’s share, all benefits will be terminated immediately.
    • Please note that it can take up to 90 days for an employee to receive an invoice for their health benefits, so please plan accordingly.
  • Employees who are out of the workplace due to a work-related injury or illness may be required to concurrently use benefits under the Family Medical Leave policy. Please see Penn Human Resources Policy No: 631, Family and Medical Leave, for further information.
  • This document provides a basic overview of benefits continuation as related to Workers’ Compensation leaves of absence. All specific questions relating to benefits availability while on a Workers’ Compensation leave of absence should be referred to the Benefits Department of the Division of Human Resources.
  • Unionized University staff are excluded from this section of the policy and should refer to the terms and conditions of the appropriate collective


Workers’ Compensation/Long Term Disability

  • Once an employee is out of work for six (6) months, they may apply for Long Term Disability. They will not receive wage loss benefits from LTD, but this will protect their medical benefits. Employees interested in applying for Long Term Disability can do so through the Benefits Department of the Division of Human Resources.


Position Retention for Employees on Workers’ Compensation Leave

  • When an employee is worker’s compensation leave, the department is required to hold the employee’s position for six (6) months. If the employee is out of work for more than (6) months, the department may submit a request to Human Resources to fill the employee’s position.
  • Unionized University staff are excluded from this section of the policy and should refer to the terms and conditions of the appropriate collective bargaining agreement.


Return to Work

  • Upon returning from a Workers’ Compensation leave, the employee must present the appropriate medical evaluation form to his/her supervisor and/or payroll manager.
  • In the case of an employee being permitted to return to work with restrictions, the department will make every effort to accommodate any physical limitations placed on the employee by the treating physician.
  • All specific questions relating to whether an employee has fulfilled the requirements to return to work should be directed to the Office of Risk Management and Insurance.
  • If the employee’s Workers’ Compensation leave was for more than fourteen (14) calendar days, the employee is then eligible to have any Sick Leave and Paid Time Off used during the initial “waiting period” reinstated.
  • The Departmental Payroll Administrator is responsible for notifying the WC Manager that the employee has returned to work, and if applicable, confirming the type/amount of hours owed to the employee. The WC Manager will return the employee from Workers’ Compensation Leave of Absence in WorkDay and make any necessary adjustments to the employee’s paid time off accruals.
  • It is the employee’s responsibility to contact the Human Resource Benefits Department upon return to work to ensure that benefits for which the employee may be eligible are reinstated.

 

Questions about Workers’ Compensation?
Phone: 215.573.9552 or 215.898.1338

 

For more information

Visit the Office of Risk Management & Insurance

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