HomeMy WebLinkAbout01/21/2000 City of Sebastian, Florida
1225 Main Street [] Sebastian~ Florida 32958
Telephone {561) 589-5330 [] Fax {561} 589-5570
City Council Information Letter
January 21,2000
Permit Process - Community Project with Rotary Club of
Sebastian
Please be advised that arrangements officially began to secure the
necessary permit from the State of Florida Department of Environmental
Protection (DEP) to improve city owned property located along Indian River
Drive (per Gene Rauth's presentation during your January 12th meeting). As
such, this process will be coordinated by both the City Manager's Office and
Engineering Department, as Mr. Rauth will provide logistical assistance
accordingly. In addition, arrangements have begun to procure $20,000 from
Indian River County's Florida Boating Improvement Program (FBIP) grant
allocation to finance this activity. In the coming weeks, action will be
required by City Council to formally accept and appropriate funds, as well as
program this initiative into the community's Capital Improvement Program.
Open House - Fir~/EMS Station #8
Please find the attached letter as delivered by Douglas Wright, Director,
Indian River County Department of Emergency Services relative to last
week's update for the open house ceremony for the enhanced
Fire/Emergency Medical Service (EMS) station at Barber Street. A function
has been therefore scheduled to take place Sunday, February 6th, from 1:00
p.m. to 4:00 p.m. at the station. As such, citizens who anxiously awaited the
expansion can join the celebration, as tours will be conducted on the
premises. I plan to attend (perhaps I will ride my bicycle as I do not reside
very far away). Feel free to join us if your schedule permits.
City Council Information Letter
January 21, 2000
Page2
Workers' Compensation Policy
Please find the attached Worker's Compensation Policy as compiled and
delivered via the efforts of the Human Resources Department. I thought it
would be nice for you to review the document, as the policy has been
significantly revised to reflect current standards in the indusW. As such, the
document will become and integral component of the Personnel Procedures
Manual (as previously reported, a work in progress).
Enclosures:
Letter from Indian River County Department of Emergency Services
Workers' Compensation Policy
Indian River County.
Board of County Commissioners
Department of Emergency Services
1840 25th Street, Veto Beach, Florida 32960
January 14, 2000
Mr. Terrence R. Moore
City Manager
City of Sebastian
1225 Main Street
Sebastian, Florida 32958
RE: Open House - Fire/EMS Station #8
Dear Mr. Moore:
The Indian River County Board of County Commissioners and the Department of Emergency
Services are pleased to inform you, the Sebastian City Council and the citizens in the area, that the
renovation of Fire/EMS Station #8 has been completed.
At 8:00AM on January 3, 2000, a fully equipped new ambulance and two paramedic personnel were
placed into service providing an EMS Advanced Life Support (ALS) level of service 24 hours a day
from this station location.
An OPEN HOUSE function is planned for Station #8 on Sunday, February 6, 2000, from 1:00PM
to 4:00PM, so that members of the Council, community organizations, and the community as a
whole can visit and tour the facility. The ambulance, fire engine, fire pumper, hazardous material
trailer, tanker, and special operations vehicle will be on display, along with the equipment on board
each vehicle. The Department will also provide refreshments during the OPEN HOUSE.
I know that everyone in the community is extremely proud to see the station and the additional level
of EMS ALS service become a reality.
S~cerely, ~ .
Douglas M(_~Vright, CEM
Director
Department of Emergency Services
Division of Division of Division of Division of
Emergency Medical Animal Control Fire Services Emergency Management
Services 567-8000 562.2028 567-8000
567-8000 Ext. 446 Ext. 444
Ext. 217
SUNCOM 224-1444
FAX (561) 567-9323
City of Sebastian
1225 MAIN STREET g SEBASTIAN, FLORIDA 32958
TELEPHONE (561) 589-5330 g FAX (561) 589-5570
DATE:
TO:
FROM:
SUBJECT:
January 20, 2000
Ten'enceM~::~re 'I / ~-~// /__
Workers' Compensation and Ught Duty Policy
The City of Sebastian is committed to providing a work environment that is safe and injury free but,
occasionally accidents will happen. When an employee is injured at work as a result of an accident
or exposure, our pdmary concern is for their health and welfare. As such, a review of ~
circumstances surrounding the injury is essential if the City is to promote employee safety by
identifying unsafe practices and conditions. Therefore, all employees will adhere to the following
Policies and Procedures unless otherwise specif~,d by applicable bargaining unit agreements.
Definitions:
A. Accident:
Unexpected/undesirable event occurring unintentionally.
COBRA (Consolidated Omnibus Budget Recor~liation Act of 1985): This is the continuation
of cun-ent group health plans offered to terminated, retired, or full-time employees reduced
to uncovered part-time employees' and/or their dependants'. This insurance coverage is paid
for by the individual. For other provisions, contact Human Resources.
Covered Claim: Valid Workem' Compensation claim approved by both the Department of
Human Resources and the Worker's Compensation Insurance Carder.
Disability:. Disabted state or condition which permanently or temporarily restricts or disables
persons from doing their normal daily work routine.
Eligible Employees: Employees normally on the City of Sebastian payroll (part-time
employee, full-time employee, temporary part-time employee, etc.).
Exposure: Direct contact with body fluids on open cuts, breaks in the sldn, or mucous
membrane such as the mouth or eyes.
Insurance Fraud: An employee who engages in misrepreeentation, falsehcod, or fraudulent
statements and claims to gain workers' compensation benefits.
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Ught Duty ('Temporary Reassignment): This is sedentary work while rehabilitating from an
injury or illness, prior to reaching maximum medical improvement.
Nonpaid Employees: Any position not normally on the City of Sebastian payroll (volunteers,
etc.). These positions are covered for medical expenses only.
Off-Duty Injury:. A disability, illness, or injury that takes place while employees are off duty or
occurring outside the scope of their employment.
On-Duty Injury: Accident occurring during employment resulting in a physical wound,
distress, disability, infection, or death by accident.
Willful acts: A disabil~ that is a result of the employee's willful intent to cause self-injury or
to injure others. (Not compensable under Worker's Compensation).
Intoxication: Injuries that are the result of an employee's intoxication of alcohol or by an
impairment o[the employee's faculties by use of non-prescription drugs. (Not compensable
under WorkeYs Compensation).
Portal to PortaJ: Injudes incurred while traveling to or from work, unless the employee was'
actively engaged in work duties at the time. (Not compensable under Worker's.
Compensation).
Recreational Activities: Injuries sustained during participation in an employer-sponsored
recreational activity where participation was required by the employer.
Violation of Safety Rules: Injudes sustained as a result of an employee's intentional failure
to use safety devices or obey safety rules that were mandated by the employer..
Compensation may be reduced by 25% in these situations.
Mental or Nervous Injuries: Mental or nervous injures resulting only from stress, fright, or
excitement, or arising out of depression from being absent from work. (Not compensable
under Worker's Compensation).
Managed Care: A program in place whereby the employee must choose from the managed
care organization's list of care providers.
Safety Programs: Employer developed safety training programs.
Temporary Reassignment Emplo*~ tanpor~ly unable to perform the essential functions
of their regular position due to a medical condition or injury who may be temporarily
reassigned to a position for which they can perform the essential job function.
Workers' Compensation Procedure:
Any employee who is injured at work and requires immediate emergency medical assistance
will receive all ne(es,san/medical care from the nearest hospital or medical facility. If
continuing medical care is required, employees will use a City-approved Workers'
Compensation Physician. The Department of Human Resources will provide all necessary
referrals to the employee.
Employees will receive benefits and compensation as outlined in Flodda State Statute,
Chapter 440.
Employees' are responsible for nol~fying their immediate supe~sor/manager of all work
related injuries or exposures at the time of the incident no matter how minor the incident may
seem and they may need to show that the injury arose out of and in the course of their
employment.
Failure of the employee to nctJfy their supen~sor of such occurrence may prohibit the
employee from receiving Workers' Compeflsation benefits.
The employee will complete their portion of the City's Supervisor/Employee Report
of Injun/Form (HR # 99-001) whether tyeatment is necessary or not. The employee.
will then fonvard the report to their immediate supervisor. The immediate supervisor
will complete their section of the report and forward it to the Human Resources
Representative.
The supervisor will complete the employee's section of the Supervisor/Employee
Report of Injury Form when the employee is unable to do so as a result of the
injun//exposure. When the employee is able, he or she will review the report and
make any additional comments or changes that are necessary, then sign and date
the report.
It is the responsibility of the employee to provide to the Human Resources
Representative all doctors' certification or medical treab,ent forms. The employee
will bdng bhem to the Department of Human Resources or, if the employee is unable
to do so as a result of the injun//exposure, they should contact their home
department. The employee's immediate supervisor or designee will collect the
medical cerlificafionfforms and deiiver them to the Department of Human Resources
Representative for processing within 24 hours of the injury/exposure.
It is the responsibility of the employee to request and receive a doctor's certification
form on all medical treatments, follow-up visits or rehabilitation san/ices and deliver
them to the Human Resources Representative pdor to scheduling or attending any
additional follow-up visits or therapy treatments.
The City of Sebastian and/or its Worker's Compensation Carrier reserve the right to
have employees absent from work and disabled periodically evaluated by a cander-
approved physician other than the Worker's Compensation Physician treating the
employee.
Immediately after a work-related accident or exposure occurs, the supervisor's responsibility
is to ensure that the injured employee receives all required first aid or emergency medical
treatment at an approved physician's office, health clinic, or hospital emergency facility.
For employees' requiring medical treatment, the supervisor will call the medical
facility to inform them that a City employee is en route to their location and give a
brief explanation of the injuries, the supervisor wifl then call the Worker's
Compensation Carder (1-800-574-8183) to obtain authorization for treatment. The
Worker's Compensation Carder phone number is also located on the back of the
Supervisor/Employee Report of Injury Form (HR # 99-001).
if the injury/exposure is not an emergency, the supervisor is required to call the
Worker's Compensation Carrier at (1- 800-574-8183) to receive authorization for
treatment and have the employee take this information to the attending facility.
The supewisor is to forward their completed original Supervisor/Employee Report of
Injury Form (HR# 99-001) to the Human Resources Representative responsible for
the administration of Workers' Compensation Claims within twenty-four (24) hours
of the injury/exposure.
The supervisor is responsible for reporting all accidents or illness no matter how
minor the incident may seem on the Supervisor/Employee Report of Injury Form (HR
# 99-001) and forward the original to the Human Resources Representative.
For injuries incurred by motor vehicle related accidents, the supervisor will call the
City of Sebastian Police Department Communications Center (589-5233) to report
rite incident, request emergency semk es if necessary, request that a crash report be
made, and obtain the crash report number from the dispatcher. The crash report
number is to be pdnted in the upper right-hand comer of the Supervisor/Employee
Report of Injury Form (HR # 99-001).
The supervisor will complete the employee's section of the Supervisor/Employee
Report of Injury Form if the employee is unable due to the seriousness of the
injury/exposure.
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At the start of an employee's absence, the employee's home department will prepare
and submit the employee's payroll work sheet to the Finance Department. It will list
the day of the injury as a worker's compensation absence at the bottom of the form
under 'other.' The employee's home department will continue to provide to the
Finance Department the employee's payroll work sheet for the duration that the
employee is absent from work.
The City will pay for any regular work time lost by the employee on the day of such
incident.
The Human Resources Representative will have the responsibility for receiving all
appropriate forms from the supervisorknanager and employee. The HR Representative will
then coordinate the following:
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1. Ail injuries (employees and citizens) including injuries resulting in death are reported
within twenty-four (24) hours to the City's Worker's Compensation Carder.
2. Copies of all forms will be forwarded to the Cib/s Worker's Compensation Carrier.
If the injured/exposed employee received medical treatment, the Human Resources
Representative will collect the odginal medical treatment documents from the
employee and forward a copy to the City's Worker's Compensation Carder.
If the employee is unable to deliver the medical treatment documents to Human
Resources, it will be the employee's immediate supervisor's responsibility to obtain
the documents from the employee and deliver them to the Human Resource
Reprase,-~e within twenty-four (24) hours of the occurrence. A copy will then be
sent to the employee.
If the employee has been referred by the attending physician to receive additional,
specialized, rehabilitative, or follow-up treatment, the Human Resources
Representative in conjunction wffh the Worker's Compensation Carder will provide
the employee with a list of care providers for them to select from.
The Human Resources Representative will schedule the appointments for the
employee through the Worker's Compensation Carder and notify both the employee
and the employee's home department of the scheduled appointment(s).
The Human Resource Representatives will contact the employee's home department
and inform the supervisor/manager/department head of the employee's work status.
If the employee needs to change a scheduled appointment he/she must notify the
Human Resources Representative of the change and the date of the rescheduled
appoii~iant.'
The employee must submit a Doctor's Retum to Work Form to the Human Resource
Representative pdor to reporting for work to their home department. The Return to Work
Form should indicate If the employee has had any restrictions placed on them by the doctor.
It should specify if the employee will retum to regular full duty or light duty work and the
effective date of return.
Based on the attending physician's statement, If the employee has been placed on
light duty status the Human Resource Director under direction of the City Manager
and in conjunction with the employee's immediate Department Head/Designee will
determine where the employee will report for work to accommodate the employee.
Management may confer with the attending physician and the Worker's
Compensation Carder If necessa~/for clarification.
If the emplo~e has been placed on Light Duty status by the attending physician, the
employee must abide bythe light DutyAssignment and Restrictions. This temporary
assignment does not have to be in the same position or classification pdor to the
injury/exposure. Dudng this temporary assignment the employee will receive their
regular rate of pay. However, should the employee refuse to accept the light duty
assignment he or she may be disqualified from receiving wage benefits under
Florida's Worker's Compensation Law.
Under the guidelines of the Worker's Comper~sation Carrier, to receive wage bener~s the
employee must submit a doctor's note of certification identifying the date of the injury and
the anticipated date of return to work. This cedificate must be fonvarded to the Human
Resources Representative for processing.
The City will pay the employee for any regular work time lost on the day of
injury/exposure.
The City will compensate the employee with their regular hourly rate of pay for the
first seven (7) consecutive work days of absence due to the injury/exposure.
If the employee is absent from work for seven (7) consecutive work days after the
injup//exposure ('including date of incident), than the Worker's Compensation Carder
will be responsible for issuing a check for the employee's work related absence.
The ~Uma-r~ Resource Representative will coordinate payment with the Worker's
Compensation Carrier to insure that a check is issued to the employee for the first
sevan~7) consecutive work days the employee was absent from work provided the
employee is absent for a minimum of twenty-one (21) consecutive work days or.
more. The Human Resources Representative will notify the employee that they will
be receiving a check from the Worker's Compensation Cartier.
When the employee receives the check from the Workers' Compensation Carrier and
it is made payable to the employee, he or she will notify the Human Resource
Representative that they have received the check. The employee will then endorse
the check and tum it into the Finance Department. Failure to rum the endorsed
check into the Finance Department will result in the employee's next payroll check
being docked for the amount of the check that was received from the Workers'
Compensation Carrier. ff the employee is totally disabled as a result of the illness or
injury and cannot return to work, any monies due the employee in the form of leave
pay outs would be reduced by the outstanding balance owed to the City before
payment to the employee is mede.
If the employee is absent for more than seven (7) consecutive work days, all
additional checks issued by the Worker's Compensation Carrier will be made payable
to the employee arad mailed directJy to them. The employees rate of pay at this time
will be reduced to 2/3 rds the employee's normal weekly gross wage. Once the
employee's salary has been reduced to 2/3 rds pay the City will supplement the
employee's salary by paying the remaining 1/3 rd gross salary minus all normal
deduddons. If the deductions exceed the remaining 1/3 rd gross salary, the Finance
Department will bill the employes for those additional expenditures. This will
continue for the next 83 consecutive work days should the employee be absent for
that length of time. This will help keep the employee whole during their time of
rehabilitation. After nine{y (90) consecuave work days of an employee's absence the
City will stop payment of the 1/3 pay and the City's Long Term Disability Carrier will
then supplement that portion of the employee's pay. These limits will be determined
by the Long Term Disability Carder and may be different from what the City was
supplementing.
7. All annual and sick leave accrual rates will continue dudng this pedod of disability.
8. If an employee had a planned vacation pdor to the injury/exposure while in either a
part-time/full-time disabled status, then annual or compensatory leave must be used,
and the employee will not be carded under Worker's Compensation. Pdor to granting
annual or compensatory leave the employee must obtain written authorization from
their treating physician stating that they are capable of going on annual leave that it
will not hamper their rehabilitation, and that they have not reached maximum medical
improvement to refum to wedc The employee will then turn the written authorization
into the Human Resources Representative. The Human Resources Director will then
confer with both the employees' Department Head and City Manager as to whether
or not to approve the leave request. The Employer maintains the dght to have the
employee evaluated by a physician of the City's choice pdor to making the decision
to approve or disapprove the leave request.
The disabili~ Pr~:jram includes a rehabilitation clause which may be approved to let
employees return to work on a partial disability basis.
The City will make reasonable accommodations for an employee able to return tO
work within a 24-month pedod. Those employees able to return to work may be
reclassified to another position in the City if their pdor position has been filled. The
employee may be offered a vacated position, at the pay grade of that position, if they
meet the job skills required to perform the essential functions of the position.
Dudng any part of the 24-month pedod in which the employee will be rehabilitating and not
working the corrent insurance benefits provided by the City of Sebastian to the employee will
remain in force.
1. Health insurance 3. Dental Insurance
2. Life insurance 4. Vision Insurance
Note:
Employees will be responsible for paying their portio~ of the health, dental, vision and life
insurance premium cun'ently deducted from their paychecks for dependent coverage. Failure
to make these payments will result in employees losing their dependent coverage for health,
dental, vision, or life insurance benefits.
Any additional payments the employee has deducted from their paycheck toward outside
insurance companies, union dues, credit union payments, etc., will be the sole responsibility
of the employee.
Employees absent and on Workers' Compensation will be subject to the same rules as those
governing sick leave.
1. Upon returning to work the employee must report to the Department of Human
Resources pdor to reporting to their appropriate department for assignment. A
Return to Work Form signed by the treating physician must be submitted to the
Human Resource Representative. The physician statement will identify any
limitations that may be placed on the employee. If so, the Department of Human
Resources will notify the appropriate Deparlment Head of those limitations.
Human Resources will implement the following Workem' Compensation procedure:
During new emPlOYee orientation, an Employse Benefits Representative will:
ac
Advise attending employees of their dghts under Florida's Workers'
Compensation Law and the proper reporting procedures to follow should
they sustain an injury while at work.
Distribute a copy of the Worker's Compensation/Light Duty Policy to each
attending employee to read and sign.
C;
Instruct new employees to submit the signed information form to their
immediate supen~sor. The immediate supervisor will sign and date the form,
keep a copy for the new employ~' department file, and send the original
signed form to the Department of Human Resources.
Human Resources will review all forms for completeness and accuracy. The forms
will then be placed in the employ-"-~-=s' personnel file.
All attorney correspondence will be filed in the applicable employees' file in the
Human Resources Department.
When notified that an employee is absent on disability or Workers' Compensation, the
Finance Department will:
Check the payroll against the Human Resources Disability List verifying that the
employee is absent from work and carried on Workers' Compensation:
That employees reportedly absent and on Workers Compensation are on the
Human Resources Disability List.
That the employee names that are on the Human Resources Disability List
are properly posted on the payroll work sheet.
Finance will notify Human Resources, via memo/telephone, of an employee's name
who appears on the Human Resources Disability List and not on the payroll work
sheet.
Finance will compare the employee's payroll work sheet with the time posted against
the Workers' Compensation List. If the affected employee does not appear on the
Human Resources Disability I.Jst, Payroll will:
Notify the employee's department head via telephone and memo, of the
discrepancy.
Inform the employee's deparlme~ head that the time will be changed to sick,
annual or compensatory leave on the payroll work sheet until Human
Resources authorizes a change in status.
c. Send a copy of the discrepancy memo to Human Resources.
Reassionment Due to Iniurv or Illness (Uoht Duty1:
Employees who are temporarily unable to perform the essential functions of their position
due to a medical condition or injury may be temporarily reassigned to a position for which
they can perform the essential job function. Any such temporary reassignment will be at the
direction of and in the sole discretion of the City Manager or Designee.
Nothing contained within this policy will create any contractual term or condition of
employment whatsoever nor is it binding on the City Manager or the City of Sebastian.
The provisions contained within this policy will not be construed in a manner inconsistent with
the binding provisions of any collective bargaining agreement in effect between a collective
Bargaining Unit and the City.
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No decisions made concerning a temporary reassignment will be cause for any appeal by
an employee under the City of Sebastian's Policies and Procedures. *,
Employees seeking temporary reassignments must first provide medical certification from
the treating physician acceptable to the City Manager, documenting the need for the
reassignment and detailing the essential job functions the employee seeking reassignment
can safely perform. The City Manager may request a second opinion by a medical care
provider of the City Manager's choosing. If the second opinion is in conflict with that of the
original treating physician's opinion then a third evaluation will be scheduled. The City.
Manager will request a third opinion and this will be relied upon regarding all issues relating
to the request for temporary reassignment.
A decision ~ to grant a temporary _re~s__~ignment (light duty) as well as the duration and
nature of any temporary reassignment will be determined pursuant to the following
provisions:
Light Duty is defined as sedentary work status while rehabilitating from an injury or
illness, prior to reaching maximum medical improvement.
Employees may be placed on temporary reassignments not to exceed one hundred
and twenty (120) consecutive work days in any continuous forty-eight (48) month
pedod. Employees receiving such benefits and who, in the opinion of the City
Managa', is unfit to return to regular work duty at the end of the 120-day time period
may, at the discretion of the City Manager receive such benef~s for an additional
pedod, not to exceed sixty (60) days. A request must be made in writing by the
employee addressed to the City Manager supported with documentation from the
treating physician for the additional sixty (60) day request.
At any tJme dudng absence from work due to a work-related injury, the employee may
be required, by request of the City Manager or the Worker's Compensation Carrier,
to submit to a physical examination within ffEeen (15) days after receiving notice of
such request. Failure to submit to the examination at the specified time, without
reason, will cause all Workers' Compensation benefits to be terminated.
If an employee is absent from work while on light duty, and the absence is a result
of the work related injury, upon retuming to work the next day the employee must
submit a doctor's note to the Human Resources Representative specif~ng that the
absence was due to the work related injury. Failure to submit a doctor's note for that
absence will result in the employee being charged their own leave time such as sick,
compensatory or annual leave. If the employee has no accrued leave, they will be
carried in a no-pay status.
To be eligible for temporary reassignment, employees must, be qualEied to perform
the essential functions of the position to which they may be assigned.
Employess may be temporarily reassigned to any position in the City at the sole
discretJon of the City Manager or designee. The City Manager will not create, add,
or vam~e a position to affect any temporary reassignment.
Employees will be compensated at their current rate of pay dudng this temporary
reassignment.
When an employee is placed on Light Duty by the treating physician, a Return to
Work Form will be hand carried by the employee, directly to the Department of
Human Resources prior to returning to work. Human Resources will then advise the
employee where to report for their Light Duty assignment. During this time of Light
Duty assignment civilian attire will be worn.
NOTE: -.
For those employees assigned to the UnIformed Division of the Police
Department, civilian attire will be worn while on a Light Duty assignment,
unless the employee obtains written approval from the City Manager or
designee granting permission to wear the police uniform, ff the request is
granted, a copy of the approval will be sent to the Human Resources
Representative for inclusion in their personnel file.
Weapons wom with civilian attire will be carded so that they are concealed
and not visible to the public.
Police Officer's who are on Light Duty and assigned a take home City Police
Vehicle will be required to drive their pemonai vehicle to and from work dudng
the time they are in a Light Duty status.
All light duty work assignments will be based upon an 8-hour, 5-day work schedule,
without exceptions. Employees will be entitled to a 30-minute paid lunch period.
The Director of Human Resources under direction of the City Manager will review
assignment priorities for light duty personnel within the City, and make the
assignment accordingly.
I0
11.
If a transfer is required from the employees current assignment, the Director of
Human Resources will contact the Department Head of the receiving department
where the employee is to be temporarily reassigned, to determine the reporting time
and location of the new assignment.
12.
When transfer of a light duty employee is made from one department to another
department the receiving depatment will handle the employee's attendance records
and supen/ise the employee's activities during their tenure in the new department.
If discipline is administered during this time of reassignment, it will be the receiving
department's responsibility.
13.
When an employee is returned to regular full work duty status, the Retum to Work
Form will be hand carried to the Department of Human Resources prior to returning
to the employee's originating department. All emolovees returning to work from
rehabilitatino on Worker's Comoensation or a light duty reassignment MIJ~;T
cleared to return to work bv the Deeartmant of Human Resources.
14.
TheDepa!.tment of Human Resources will notify the appropriate Department Head
of the employee's change in work status.
Off-Duty In_Juries:
Employees injured while not at work are covered by provisions of their individual health care
insurance plan.
Employees may receive medical care from any authorized physician, hospital, or medical
facility as specified by the individual employee's health care plan.
Employees missing work due to an injury that occurred not at work will contact their
Supervisor, Departma3t Head, or the Depalment of Human Resources as soon as possibie
and advised them of their situation. The employee will continue to update their supervisor
on their medical status.
Employees missing work may be required to provide a doctor's Return to Work Authorization
Form before retuming to work.
Employees may use accn.,ed annual, compensatory or sick leave during this period of
disability.
Sick Leave Pool members may request the use of pool time per City Policies and
Procedures.
Employees exhausting all available time may be placed in a no-pay status or be considered
for termination. This decision is at the sole discretion of the City Manager or designee.
CITY OF SEBASTIAN
WORKER'S COMPENSATION and LIGHT DUTY POLICY
RECEIPT
This will acknowledge my receipt of the City of Sebastian's Worker's Compensation and Light Duty
Policy. I have read this Policy and understand its contents. I will contact my supervisor or the
Department of Human Resources for clarification if at any time in the furore I do not understand any
portion of this Policy. I agree to be respons~le for obtaining any revisions and/or updates to the
policy and for deletion of any obsolete material therein.
I reco~tmi?e that this policy is not a contractual agreement and that none of its provisions constitute
contractual terms or.conditions of employment. I also recognize that the City Manager may alter,
supplement, delete 0f amend any portion of this policy at any time at his sole discretion.
My signature attests to the fact that I have read this Policy. I am familiar with its contents, and that
I will act accordingly.
Employee Signature
Name (Printed) and PCN
Date
This receipt must be returned to your SupervisortDepattment Head within 10 calendar days from the
date that you receive this policy. Supervisors/Department Heads will then forward the original
receipts to the Human Resources Bureau as they are received.
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