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General Description
Policy Provisions
Performance Evaluation
Subject Experts
Faculty and Staff Benefits--Worker's Compensation

Document Number: HR--125 Revision #: 1.0
Document Owner: Executive VP Date Last Updated: 08/17/2012
Primary Author: Director of Human Resources Status: Approved
Date Originally Created: 01/12/2012

General Description

Information about worker's compensation relative to HR policy.


Delineation of policy.


All faculty, staff, students, and administrators

Responsibility: Human Resources

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Relevant Knowledge: In order to comply with this policy you should know:
Federal statutes
Current University policy

Terms and Definitions: Additional training

Corrective Action

Loss of privilege

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Policy Provisions

Worker's Compensation

Cumberland University is in compliance with all known Tennessee Workers' Compensation Laws. The Compensation Laws of Tennessee protect all University employees. The benefit applies to accidental injuries and occupational diseases which arise out of and in the course and scope of employment. Participation in voluntary activities, recreational or otherwise, is not considered to be within the course of employment.

1. Any disease or injury that may qualify as employment-related must be reported immediately to the Director of Human Resources.

2. The Director of Human Resources will complete The Tennessee First Report of Work Injury (Form C-20) as required by the Workers' Compensation Division of the Department of Labor & Workforce Development and Occupational Safety and Health Administration (OSHA). Cumberland University maintains a copy of the First Report on site to be available to Tennessee Occupational Safety and Health Administration (TOSHA) representatives.

3. In compliance with The Tennessee Workers' Compensation Law, T.C.A. Section 50-6-204, the Director of Human Resources will, in addition to completing the First Report, offer the injured employee a panel of three physicians to select from. If the injury is a back injury, the panel will be expanded to 4, one of whom will be a chiropractor with treatment limited to 12 chiropractic visits. The panel will consist of three clinics/physicians and one chiropractor, in accordance with Tennessee Workers' Compensation Law. The panel list is posted on the HR Board located outside the Office of Human Resources and on the Physical Plant Board located in the Physical Plant Office.

4. The injured employee must submit to examination by the clinic/physician acceptable to Cumberland University at all reasonable times if requested to do so by the Director of Human Resources, but the employee shall have the right to have their own physician present at the examination, in which case the employee shall be liable to their own physician for such physician's services. The employee will be entitled to have a second opinion on the issue of surgery, impairment, and a diagnosis from the same panel.

5. If the injured employee refuses to comply with any reasonable request for examination or to accept the medical or specialized medical services which Cumberland University has furnished, as required under provisions of this law, the injured employee's right to compensation will be suspended and no compensation shall be due and payable while the employee continues such refusal.

6. Prescription drugs prescribed for the employee by the panel physician must be purchased at an approved pharmacy. The Director of Human Resources will inform the employee of the location of an approved pharmacy and give verbal approval. Generally, the employee pays the pharmacy when the prescription is filled. Copies of invoices and/or receipts for prescription services must be turned in to the Director of Human Resources within two (2) working days of filling the prescription.

7. The employee must have a doctor's statement for time out from work. Employees should provide any documentation given to them or information regarding treatment of their work related injury to the Director of Human Resources within two (2) working days after each physician visit.

8. The employee will be allowed to return to work only if he/she provides a doctor?s statement of release. If the employee has restrictions of any type, a detailed description of work restrictions from the physician will be required prior to returning. If an employee is to be placed on restrictions, Cumberland University will try to provide the type of work that would comply with the restrictions. If Cumberland University is unable to meet those guidelines, the employee could be required to remain on his/her own with a loss of work time and pay. If the University can meet the guidelines but the light-duty position pays a lesser amount of compensation, the employee may be entitled to „temporary partial disability“ benefits by the Workers' Compensation Carrier. These payments are figured at 66 2/3 % of the decrease in wages, subject to the maximum and minimum workers' compensation rates in effect on the day the employee was injured.

9. Employees of Cumberland University should see the Director of Human Resources if they have questions concerning the Workers' Compensation Benefit and/or to obtain the name, address, and phone number of the University's current Workers' Compensation Insurance Carrier.


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Performance Evaluation
Performance Metrics: Compliance with standard policy and procedure
Compliance with federal mandate

Consequences: Further training
Loss of privileges

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Subject Experts
The following may be consulted for additional information.
Director of Human Resources

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