workers’ compensation temporary disability benefits and uc benefits
pay and benefits while on approved medical leave
If I am not working, am I entitled to benefits and who do I contact about these benefits?
While you are away from work on approved medical leave and recovering from your injury or illness, you will receive temporary disability (td) payments from sedgwick cms.
Temporary disability partially replaces lost wages. it is always less than 100% of your regular earnings. the amount of the td benefit depends on your average weekly earnings at the time you were injured and the maximums established by law. For most employees, td pays about 2/3 of their gross earnings.
How will I be paid while I am out of work due to disability?
if your claim is accepted by sedgwick:
- sedgwick will send you a disability check (td) every two weeks.
- you can use your sick leave (option a) or sick and vacation leave (option b) to supplement the td check up to 100% of your regular earnings. Because td is partially replacing your lost wages, you don’t need to use as much sick or vacation leave as you normally would. the amount you use will depend on the amount you receive in td. complete the sick leave/vacation leave authorization form, which is sent to you by dms.
- if your sick leave, or your sick leave and vacation leave is exhausted and you are still disabled, You may be eligible for extended sick leave benefits that will supplement your TD checks up to 80% of your salary plus shift differential for up to twenty-six (26) weeks. to be eligible for esl, you must have chosen option a or option b on the sick/vacation leave authorization form.
here is the formula: esl = (.80)*(regular income) – td
for example:
if you normally earn $3,000 a month and sedgwick pays you $2,000 in td for that month, then the university will calculate the extended sick leave due to you as follows:
80% of regular revenue = (0.80)*(3,000) = $2,400 paid by sedgwick = $2,000 owed = $2,400 – $2,000 = $400
for that month, you will receive $2000 in td from sedgwick and $400 in esl from the university. therefore, your total income will be $2,400, which is 80% of your regular income of $3,000.
- If your extended sick leave benefits run out and you are still disabled, call the ucpath center at (855) 982-7284. you may be eligible for uc supplemental disability benefits through liberty mutual to supplement your td check, and you may be eligible to have the university’s contingency fund pay the full cost of your health insurance premium. you should also contact the payroll office to make arrangements to pay your dental and vision insurance premiums.
- td payments end when you return to work or your medical condition stabilizes (for example, it is determined which is permanent and stationary)
if your claim is delayed by sedgwick cms:
- call the ucpath center at (855) 982-7284.
- you may be eligible to receive supplemental disability payments from uc through liberty mutual until sedgwick cms makes a decision on your claim.
if your claim is denied by sedgwick cms:
- Call the ucpath center at (855) 982-7284.
- You may be eligible for uc supplemental disability through liberty mutual.
For more detailed information, see ppsm 44 (pdf), your collective bargaining agreement, or the dms workers’ compensation payroll process website.
how will i get paid if i’m disabled part time?
You may be entitled to temporary partial disability (tpd) payments from sedgwick cms. if so, this will pay for a portion of your lost wages while working a part-time schedule:
- the university will pay you for the time you work.
- if you qualify, sedgwick will pay you tpd benefits.
- sick or sick leave and vacation, can supplement the above up to 100%.
- subsequently extended sick leave can supplement the above up to 80%.
- subsequently disability supplement uc can complement the above. call benefits & financial planning office at (415) 476-1400 to see if you are eligible.
For more detailed information, see ppsm 44 (pdf), your collective bargaining agreement, or the dms workers’ compensation payroll process website.
how do i fill out my time sheet?
You fill out your time sheet, indicating the hours you worked and any sick or vacation leave used outside of the time you were off due to your injury.
then each month your department’s payroll processor will reconcile your timesheet, based on workers’ compensation payments made by sedgwick cms.
if your claim has been accepted by sedgwick, and you elected to use both sick leave and vacation leave to supplement workers’ compensation payments made by sedgwick, you may begin using your vacation leave hours once your sick leave hours are exhausted.
if sedgwick has delayed your claim, you are automatically not allowed to use your vacation leave. you must get approval from your department.
if sedgwick has denied your claim, please follow your department’s normal procedures.
Do I use sick leave to attend medical visits?
You fill out your time sheet as you normally would, using sick leave hours for time missed to keep medical appointments. td is paid during periods of time when you are medically unable to work, and attendance at a medical appointment does not constitute a medical exclusion from work.
Do I use sick leave for the three-day waiting period?
yes. temporary disability is generally not paid for the first three days of disability.
You must use your sick leave. if you do not have enough sick leave to cover the full three days, and if you are eligible for extended sick leave, then the extended sick leave will apply to the remainder of the three days and pay you at 80% of your regular earnings, even if temporary disability is not being paid.
Will I still accrue sick and vacation leave while I’m out of work?
while using sick and/or vacation leave to supplement temporary disability payments:
- You continue to earn sick and vacation leave at your usual rate.
- Earnings are credited to you immediately, and you can use them as soon as you earn them.
- yes you leave university without returning to work:
- vacation leave accrued in this period is paid to you.
- sick leave accrued in this period is not paid to you.
while using extended sick leave to supplement temporary disability payments:
- You continue to accrue sick and vacation leave at your regular rate.
- Accruals are credited to you when you return to work and you can use them after you return to work.
- if you leave the university without returning to work:
- vacation accrued in this period are paid to you.
- sick leave accumulated in this period they are not paid.
after extended sick leave is exhausted, while you are on unpaid leave and still receiving temporary disability payments:
- You continue to accrue sick and vacation leave at your regular rate.
- Accruals are credited to you when you return to work and you can use them after you return to work.
- if you leave the university without returning to work:
- vacation leave accrued in this period is not paid to you.
- accrued sick leave in this period he has not been paid.
how will having a temporary disability affect my retirement service credit?
While you use sick and/or vacation leave to supplement temporary disability payments, you continue to earn retirement service credit at your regular rate.
While you use extended sick leave to supplement temporary disability payments, you earn a retirement service credit at 80% of your regular rate.
After extended sick leave is exhausted, while on unpaid leave, you will not earn retirement service credit.
How will my medical, dental and vision insurance premiums be paid?
while sick and/or vacation leave supplements sedgwick td checks, all contributions to your medical, dental and vision insurance premiums continue as usual.
While extended sick leave supplements Sedgwick’s TD checks, all contributions to your medical, dental, and vision insurance premiums continue as usual.
However, after twenty-six (26) weeks of extended sick leave is exhausted, your department will place you on unpaid leave and alternative arrangements must be made to ensure that your premiums continue to be paid. health insurance. if you continue to be an employee of the university, continue to be disabled, and continue to receive workers’ compensation temporary disability benefits from sedgwick cms, then:
- Medical premium:
- The university will continue to pay its contribution to your medical premium. In addition, the university will begin paying for that part of your medical premium that you used to pay through deductions from your paycheck. In other words, the university will start paying the full cost of your health insurance premium.
- Dental Premium:
- You must call the payroll office and arrange to pay the full cost of your dental premium, if you want insurance coverage to continue.
- Optical Premium:
- You must call the payroll office and arrange to pay the full cost of your optical premium, if you want insurance coverage to continue.
what is the contingency fund?
The contingency fund is the fund the university uses to pay its portion of your medical premium after extended sick leave is exhausted.
the contingency fund is administered by the office of the president of the uc. every month your department writes a memorandum on the benefits & amp; financial planning department, who contact the president’s office and request that their medical premium be paid for another month.
If you have questions about the contingency fund, please contact the benefits department at (510) 987-0900.
who should I contact about my insurance premiums and retirement service credit?
Contact the benefits department at (510) 987-0900.