(a) Administration. The director of risk management is authorized and directed to develop and distribute necessary administrative directives for the fair and efficient administration of the injured employees’ wage supplementation plan. Department directors shall authorize wage supplementation for their employees in accordance with the administrative directives. Determinations and decisions made by department directors are final, conclusive, and binding on all parties.
(b) Eligibility.
(1) A permanent employee who, as the result of an injury sustained in the course of employment with the city, is being paid weekly workers’ compensation payments, or would be paid workers’ compensation payments if the disability continued for a period of more than seven days, may receive payments, as injured employee wage supplementation, separate and distinct from and in addition to the weekly workers’ compensation payments. An injured employee must complete an “Initiation of Wage Supplementation Form” provided by the city before being granted partial or full-day injury leave. An injured employee has 60 days from the receipt of the “Initiation of Wage Supplementation Form” to make any final election to accept or reject wage supplementation.
(2) To be eligible for wage supplementation payments, an injured employee who lives within the city’s certified worker’s compensation network service area must choose a treating physician who is a member of the network. An injured employee who lives outside the city’s certified worker’s compensation network service area has the right to treatment by a physician of the employee’s choice under Section 408.022 of the Workers’ Compensation Act, as amended, and treatment by a physician outside of the network will not disqualify that employee from receiving wage supplementation payments.
(c) Amount. The employee may receive full wage supplementation for the first seven days of time lost from the employee’s position. After seven days, the wage supplementation will be in an amount that is approximately equal to the difference between any workers’ compensation payments and the employee’s regular pay.
(d) Discontinuation. In no event may wage supplementation to any employee be continued:
(1) after a compromise settlement agreement or an agreed judgment has been effected;
(2) after weekly indemnity workers’ compensation payments have ceased;
(3) after 52 weeks of payments for each occurrence of an injury for which an employee received, or was eligible to receive, wage supplementation payments on or after October 1, 2003;
(4) after an impairment rating has been assessed; or
(5) whenever the employee owes the city reimbursement for overpaid wage supplementation.
(e) Medical statement required. Wage supplementation must be supported by appropriate medical statements from a treating physician, whether partial or full-day leave is granted. A request for an extension of wage supplementation beyond four weeks must be accompanied by a current medical narrative or report.
(f) Grounds for denial and termination. Wage supplementation benefits may not be paid to any injured employee who:
(1) is assigned a preventable classification for the cause of the injury;
(2) engages in any work, whether for pay or as a volunteer, while off work due to an injury for which the employee is requesting or receiving wage supplementation;
(3) after being injured, terminates employment or is involuntarily terminated from employment for any reason;
(4) fails or refuses to comply with the instructions or advice of a treating physician or other physician performing an independent medical examination for the city regarding treatment of the injured condition;
(5) fails to act in a manner that is conductive to or consistent with being off work convalescing from a job-related injury;
(6) refuses to perform limited, partial, or part-time duty when authorized by a treating physician or other physician performing an independent medical examination for the city;
(7) refuses to accept or perform a different job with the city that, in the opinion of a treating physician or other physician performing an independent medical examination for the city, is within the employee’s physical capacity and for which the employee is qualified or will be trained;
(8) refuses to submit to any independent medical examination or treatment required by the city in accordance with workers’ compensation laws;
(9) refuses to return to regular duty after being released for regular duty by a treating physician or other physician performing an independent medical examination for the city;
(10) is injured as the result of:
(A) the breaking of rules, regulations, or laws by the employee; or
(B) the gross negligence of the employee.
(11) fails to use city or department-mandated safety equipment or follow city or department-mandated safety procedures when the injury was sustained;
(12) fails to report the injury within 24 hours after its occurrence, unless the employee can show good cause for the delay;
(13) fails to keep the employee’s immediate supervisor and workers’ compensation representative informed, on a monthly basis and in accordance with departmental procedure, of medical examinations and treatments and related dates, future medical treatments, status regarding return to limited and full duty, and changes in the employee’s ability to work;
(14) submits a workers’ compensation claim that is denied; or
(15) sustains an injury while participating in any sports activity, regardless of whether the activity was organized or unorganized or sanctioned or unsanctioned by the department.
(g) Use of vacation and sick leave. An employee who is denied, has refused, or has exhausted wage supplementation while receiving workers’ compensation payments may take accrued sick leave or vacation leave, but only in an amount necessary to make up the difference between workers’ compensation payments and the employee’s regular rate of pay.
(h) Leave without pay. An employee who has used all of the employee’s accrued sick leave and wage supplementation payments, while still off work and receiving workers’ compensation payments, may be granted leave of absence without pay in accordance with Section 34-28 of this chapter. (Ord. Nos. 24873; 24930; 25389; 25630; 28024; 29480)