Policy Bulletin No. 1993-04 (Part 3 pp.27

Policy Bulletin No. 1993-04

(Part 3 pp. 27 - 37)

Section 21.8 Workers' Compensation Leave - June 23, 1993

[For faster downloading, this bulletin is broken down here into three parts.]

TABLE OF CONTENTS (Part 3)

MANDATORY ALTERNATE DUTY PROGRAM
AGENCY ALTERNATE DUTY POLICIES
ATTACHMENTS
A. Roles and Responsibilities
B. Program Provisions
C. The State Insurance Fund Intake Form
D. State Insurance Fund District Offices
E. Estimated Physical Capabilities Form

RECORD KEEPING (Continued)

Time records must be maintained throughout an employee's absence since leave is credited to the employee as if he/she were in full pay status (up to nine cumulative months). See Earning of Leave Accruals for further information.

Additional information that needs to be kept with an employee's time records includes restored leave accruals (kept separately) and the date when leave credits are restored if the restoration brings the employee over the allowable maximum. Employees have one year from return to work or restoration of leave credits, whichever occurs later, to reduce leave credits below the maximum, and employees continue to earn leave credits throughout this period. If the employee chooses not to charge credits, a record of that choice should be maintained also.

The Workers' Compensation Board and State Insurance Fund do not maintain records of benefit enhancements provided to State employees. It is advisable to retain records on each workers' compensation case for six years after an employee retires or, if an employee transfers to another agency, to make them available to that agency. The new agency needs the information in these records to ensure that an employee receives only the benefits to which he/she is entitled if the case is reopened.

MANDATORY ALTERNATE DUTY PROGRAM

In the interest of returning employees who have sustained workers' compensation disabilities to duty as soon as possible and in recognition of the fact that the statutory wage replacement benefit may be reduced in proportion to the employee's reduced percentage of disability and that the supplemental payment will stop, the State and PEF have negotiated a Mandatory Alternate Duty Policy in connection with the workers' compensation benefits provided in the 1991-95 agreement. The Mandatory Alternate Duty Policy is effective on July 1, 1993, the effective date of the Medical Evaluation Program.

The Mandatory Alternate Duty Policy is designed to assist employees in returning to work prior to resumption of full job duties and to enable agency management to utilize the capabilities of these employees who would otherwise be unable to return to duty until some future time. In connection with this policy, the term "mandatory" means that (a) an employee who meets the eligibility criteria and requests a mandatory alternate duty assignment must be offered a mandatory alternate duty assignment or the employee must be compensated as provided below, and, (b) that an employee who...

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... meets the eligibility criteria can be ordered by management to return to work a mandatory alternate duty assignment.

Eligibility

The Mandatory Alternate Duty Policy applies to every employee who is eligible for benefits under the workers' compensation article of the negotiated agreement and who has not submitted a written request to the employer requesting not to be covered by the Medical Evaluation Program. In addition, to qualify for participation in the Mandatory Alternate Duty Program, an employee must meet the following criteria:

be classified as partially disabled at 50% or less (moderate or mild disability) by the State Insurance Fund; and
have a prognosis of full recovery (defined as the ability to perform the full duties of the job in which the employee was injured) within 45 calendar days (defined as 45 calendar days prior to the date of full recovery given by the examining physician);

These medical findings may occur in the course of an examination by an SIF consulting physician, or by the employee's attending physician, or in connection with a management-ordered medical evaluation as described on page 20.

There are no limitations on the number of times an employee can be given a mandatory alternate duty assignment either at employee request or management direction. However, each 45-calendar day period must be discrete; that is, the employee must be absent and must meet the eligibility criteria at the time each request is made. For example, an employee may have had an accident and requested and received a mandatory alternate duty assignment at the time he/she initially returned to work. Now, several months later, the employee is again absent due to surgery to correct a problem caused by the accident and is requesting mandatory alternate duty prior to return to full duties. As long as the employee meets the eligibility criteria, as evidenced by medical documentation satisfactory to management, he/she is again eligible for a mandatory alternate duty assignment.

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Employee Requests for Mandatory Alternate Duty

An employee meeting these eligibility criteria may request his/her agency to develop an alternate duty assignment. Such request can be submitted at any time between the date of full recovery specified in the medical documentation and 65 calendar days prior to that date. However, in no instance may the mandatory alternate duty assignment begin earlier than 45 calendar days prior to the date of full recovery provided by the examining physician. For any such employee who meets the eligibility criteria set forth above, as determined on the basis of medical documentation satisfactory to management, the appointing authority is required to take one of the following actions:

provide the employee with a mandatory alternate duty assignment for up to 45 calendar days which takes into account the employee's physical limitations; OR
where a mandatory alternate duty assignment cannot be provided, arrange for the employee to receive a supplemental payment that will provide the employee, when
added to the SIP payment, with 60 per cent of his/her gross income as of the date of accident. This supplement is payable for the period the mandatory alternate duty assignment would have been expected to last, not to exceed 45 calendar days. All requests for payment of a supplement under these circumstances must be submitted to and approved by the Governor's Office of Employee Relations. Please telephone your GOER representative to initiate this supplemental payment process.

Management-Directed Mandatory Alternate Duty Assignments

Whether or not an employee who meets the eligibility criteria requests an alternate duty assignment, agency management may direct the employee to return to work on an alternate duty basis. Such mandatory alternate duty assignment shall be for up to 45 calendar days initially and shall take into account the employee's physical limitations. Usually a management directed assignment will be based on an evaluation through the Medical Evaluation Network, but may be based on any acceptable medical documentation as noted above.

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Assignment to Mandatory Alternate Duty

The employee who accepts a mandatory alternate duty assignment is returned to the payroll and is entitled to receive his/her regular salary for the period of the mandatory alternate duty assignment. Eligibility for added salary factors is the same as for an employee performing full duties. In addition, time spent in a mandatory alternate duty assignment counts as time served for the purpose of completing an employee's probationary period. Employees working a mandatory alternate duty assignment are in full pay status and are eligible to earn bi-weekly leave accruals, observe holidays, earn holiday pay or holiday leave for work on a holiday, earn floating holidays, and otherwise be treated for attendance and leave purposes as any other employee at work performing his/her regular duties.

Where an employee declines a mandatory alternate duty assignment, the employee will be continued on workers' compensation disability leave with percentage supplement and will be referred to the SIF for an appropriate benefit determination. Employees who neither request nor are ordered to return to work continue on workers' compensation disability leave with percentage supplement receiving wage replacement benefits from the SIF in accordance with the Workers' Compensation Law. Employees in either of these situations are ineligible for a supplement because they are 50% or less disabled.

Medical Documentation

Medical documentation submitted to support an employee's participation in the Mandatory Alternate Duty program must be satisfactory to management. This documentation should contain the following information: a statement that the employee is 50% or less disabled, an estimated date of full recovery that is within 65 calendar days of the date of the medical examination, and a statement of the physical limitations which need to be taken into consideration in developing the employee's mandatory alternate duty assignment. This documentation may be provided by an SIF or other State-selected physician or by the employee's attending physician or by a combination of information from these sources.

When the documentation is provided through the Medical Evaluation Program, the physicians will be completing the limitations/capabilities form for all eligible employees and submitting it to the agency for their review in establishing alternate duty assignments.

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Confidentiality

All medical documentation should be treated confidentially and great care should be exercised to protect employees against the indiscriminate dissemination or use of the medical information it contains. However, appropriate agency staff are entitled to have access to the medical information related to an employee's physical limitations to the extent it is necessary (1) to evaluate the employee's ability to participate in the Mandatory Alternate Duty Program and (2) to develop an appropriate assignment.

Disability Rating

The first eligibility criterion for a mandatory alternate duty assignment is having a disability rating of 50 percent or less. The SIF consulting physicians will generally indicate that an employee is totally, marked, moderately or mildly disabled. The moderate and mild disability categories meet the criterion of being 50 percent or less disabled. If the agency has any questions about the disability rating, the SIF should be contacted immediately. The physicians in the Medical Evaluation Network will indicate whether or not the employee is 50 per cent or less disabled in the report following the examination. In the case of an attending physician's report or a management-ordered medical evaluation report other than an SIF report, if the physician's report indicates a partial disability, the SIF should be contacted immediately for their interpretation of the disability rating. If they advise that the medical report is to be interpreted as rating the employee as mildly or moderately disabled, the employee will meet the eligibility criterion of being 50% or less disabled for the Mandatory Alternate Duty Program.

If the employee disputes the disability rating, the case will be referred to the Workers' Compensation Board for a final determination and the employee will remain absent receiving benefits from the SIF as determined appropriate.

Prognosis

The second eligibility criterion is having a prognosis of full recovery within 45 calendar days of the first day a mandatory alternate duty assignment will begin. Generally, medical documentation that indicates a recovery date within 65 calendar days of the date of the medical examination would be considered acceptable although in no case is the employee eligible to be...

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... returned to duty on a mandatory basis sooner than 45 calendar days from the indicated full recovery date.

Limitations/Capabilities

Once management has acceptable medical documentation indicating the employee's eligibility for mandatory alternate duty, it is necessary to obtain medical information concerning the employee's limitations so that an appropriate assignment can be designed. SIP physicians, both consultants and those doing examinations under the Medical Evaluation Program, are being requested to provide this information at the time of their evaluation so their initial reports should meet management's needs in most cases. If an employee presents documentation from his/her personal physician that does not contain sufficient information, management should contact that physician to obtain additional information since that would generally be the most expedient route to obtain the needed information. The attached Physical Capabilities Form (Attachment E) can be used, as can any existing agency form, to make such a request of an attending physician.

The issue of medical documentation is not reviewable under Article 34 of the Agreement. Employees have the right, however, pursuant to the Workers' Compensation Law, to challenge the determination of level of disability as it impacts on the statutory wage replacement benefits they receive. Decisions of the Workers' Compensation Board are binding on the parties.

Development of Mandatory Alternate Duty Assignments

A mandatory alternate duty assignment, to constitute a valid offer, must be reflective of the employee's physical limitations and may involve performance of some duties of the employee's regular position, or some duties of another existing position or a composite of tasks from several positions. Through a review of past workers' compensation experience, agencies may be able to develop an inventory of potential alternate duty assignments or tasks. However, agencies are expected to make every effort to tailor any mandatory alternate duty assignment to the individual employee's specific limitations as well as his/her capabilities.

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An offer of a mandatory alternate duty assignment to an employee should include the following:

description of proposed alternate duties
location of assignment
work hours and workweek
supervisor
starting date (no earlier than 45 calendar days prior to the anticipated date of full recovery) and ending date (the anticipated date of full recovery)

The specifications in the offer will be based on the medical documentation accepted by management. Since an assignment may be for as long as 45 calendar days, management may design an assignment that changes over time. For example, an assignment may begin with training for a week or two and then progress to an assignment that is less sedentary for a second period of time, and finally to more physical tasks at the end of the period immediately prior to return to full duties. Assignments such as this should be explained to the employee when initially offered. In addition, management may find it necessary, occasionally, to offer an employee an assignment defined only for the beginning of the mandatory alternate duty period in order to return him/her to work as quickly as possible. For example, if an employee was eligible for a mandatory alternate duty assignment for four weeks, management could offer the employee an assignment that was defined for two weeks with the understanding that the next two weeks of the assignment would be developed and discussed with the employee prior to expiration of the first two week period.

If an eligible employee believes that some element of the proposed mandatory alternate duty assignment constitutes a personal hardship, he/she may express the claim of hardship to the appropriate agency official who has been designated to fill this role. Such claim of hardship will be considered by the agency official and responded to in writing with a copy to PEF prior to the proposed beginning date of the mandatory alternate duty assignment or as soon thereto as possible. This response shall be considered dispositive of the matter.

As stipulated in the agreement, management has the authority to make mandatory alternate duty assignments to tasks that can be performed by the employee which may not necessarily fall within the employee's regular salary grade, title series or job duties and such assignments are not considered violations of either Article 17 of the agreement or Section 61.2 of the Civil Service Law.

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Additionally, when developing an assignment, management is not restricted to the employee's former work location, work schedule, or workweek and such conditions of the assignment are not considered violations of Article 32. However, once a mandatory alternate duty assignment is specified for the entire period required and has begun, the provisions of Article 32 cover the employee while he/she is working in the assignment.

Notwithstanding this broad latitude to develop assignments, agencies may find that identifying alternate duties as close to the employee's regular duties as possible, given the person's physical limitations, are the most successful assignments and are most helpful in preparing the employee to return to his/her regular duties at the end of the assignment. Agencies may also find that identifying assignments that are similar to the employee's regular job in terms of location, shift and pass days also provide a level of normalcy that improves the employee's prognosis for successful completion of the assignment and return to regular duty at the end of the assignment.

Management is expected to accommodate the employee as much as possible and exercise sound judgment and consistency in the development of mandatory alternate duty assignments. Once management has received satisfactory medical documentation establishing an employee's eligibility and physical limitations, it is incumbent upon them to establish and offer the mandatory alternate duty assignment as soon as practicable and consistent with the employee's first date of eligibility for the assignment. Agency management will discuss, clarify and review the proposed mandatory alternate duty assignment with the employee and will discuss any changes in that assignment that become necessary during the course of the assignment prior to the change taking place. It is not the intent of this policy, however, to in any way entitle an affected employee to negotiate his/her mandatory alternate duty assignment with agency management.

The provisions of this Program including, for example, the nature of alternate duty assignments and the review of personal hardship situations, are appropriate subjects for labor/management discussions.

Expiration of Mandatory Alternate Duty Assignments

When an employee's mandatory alternate duty assignment expires, the employee will be found able to perform the full duties of his/her regular position in most cases and will return to full...

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...duty. If not sufficiently recovered, however, the employee either is placed on workers' compensation disability leave with percentage supplement or leave without pay, depending on the length of absence, and is covered by the workers' compensation statute (receiving a wage replacement benefit reflective of the employee's level of disability), or, may request a discretionary extension of the mandatory alternate duty assignment. The employee is no longer eligible for a supplemental payment if his/her disability level is at 50% or less. (Refer to "Extension of Mandatory Alternate Duty Assignments" below.)

Management has the right, whenever necessary, to request an employee to submit additional medical documentation during the course of a mandatory alternate duty assignment to verify on-going eligibility for the Program. An employee determined to be recovered, based on this medical evidence, before the anticipated recovery date should be directed to return to full duty and an employee whose condition worsens may be returned to leave status (See "Termination of Mandatory Alternate Duty Assignments" below.) The most common situation will be a change in the date of return to full duties. Generally a prognosis of return to regular duties that is originally given two to three months in advance could change by a few days or even a week or so. In this case, management should consider extension of the mandatory alternate duty assignment as described below.

Nothing in this policy diminishes management's right to have the employee examined by a physician selected by management as a condition of allowing the employee to return to full duties. In other words, the fact that there was an initial prognosis accepted by management of ability to perform the full duties of the employee's regular job on a specific date does not make return to full duty at the end of the mandatory alternate duty assignment on that date automatic.

Extension of Mandatory Alternate Duty Assignments

There will be cases where employees who qualified for and participated in the Mandatory Alternate Duty Program and whose mandatory alternate duty assignment has expired do not fully recover within the specified period. Since their alternate duty assignments automatically expire, these employees may request and management may elect to continue the assignments on a discretionary basis beyond the established ending date.

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One common occurrence will be a change in the date of return to full duties by a few days or a week or so based on more current medical information. Agencies are encouraged to continue employees on alternate duty whose date of return to full duties changes in this manner rather than returning an employee to leave status only to reinstate him/her from leave within a very short period of time.

Any extensions are subject to the terms and conditions of this program, are solely at management discretion and must be supported by the submission of additional medical documentation satisfactory to management. Extensions will be granted only for very limited time periods, for example in single payroll period blocks, and only when supported by satisfactory medical documentation.

Termination of Mandatory Alternate Duty Assignments

A mandatory alternate duty assignment may be terminated prior to its expiration if it is determined, based on medical documentation satisfactory to management, that the employee is able to return to full duties earlier than the original prognosis had indicated. When the agency has medical documentation indicating full recovery, the employee should be ordered to return to full duties immediately. If the employee disputes management's finding of full recovery, the employee will be placed on leave without pay and the case will be referred to the SIP for an appropriate benefit determination. If the employee appeals the findings of the SIP, the claim will be resolved by the Workers' Compensation Board whose decision is binding on the parties.

In exceptional cases, management may determine that a mandatory alternate duty assignment in progress is not successful. In that instance, management may elect to modify the mandatory alternate duty assignment to improve the prospects for success. Such changes should be discussed with the employee prior to being implemented. Alternatively, management may rescind the mandatory alternate duty assignment, in which case management is required to provide the employee with a supplement that brings the employee to 60 per cent of gross pay as of the date of the accident. Such supplement will not be paid beyond the point the mandatory alternate duty assignment would have expired. As previously stated, telephone your GOER representative to initiate the payment of a supplement under these circumstances.

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AGENCY ALTERNATE DUTY POLICIES

This Mandatory Alternate Duty Program, developed in connection with the negotiation of benefits covering occupational disabilities of PEF-represented employees injured on or after July 1, 1993, does not negate existing agency discretionary alternate/light duty policies that may be available for disabled employees recovering from both occupational and ordinary disabilities. Any such agency policies continue to be available for employees not eligible for this Mandatory Alternate Duty Program. Agencies interested in establishing alternate duty programs in addition to this Program should contact their Governor's Office of Employee Relations representative for guidance.

ATTACHMENTS

Attachment A - ROLES AND RESPONSIBILITIES

AGENCY	LEAVE PROGRAM	SUPPLEMENTAL PAY PROGRAM
Appointing Authority	Determines reportability of incident based on Workers' Comp. Law criteria. Makes independent determination of eligibility for Workers' Compensation Leave. Processes PR75s to provide employee with paid leave. Maintains records of leave granted. Monitors six-month benefit entitlement. Restores leave credits. May terminate employee under Section 71 CSL. Files required forms with the Workers' Compensation Board.	Determines reportability of incident based on Workers' Comp. Law criteria. Provides salary continuation benefits to employees based on determination of ligibility by the SIF. Maintains contact with OSC, SIF, employee and supervisor regarding employee's continued eligibility for benefits, payroll status, and leave credits used, recredited and restored. Maintains accurate records. Monitors nine-month benefit entitlement. Files and/or provides information for forms required by OSC, and the Workers' Compensation Board. May terminate employee under Section 71 CSL.
State Insurance Fund (SIF)	Pays Workers' Comp. Law benefits. Determines compensability. May controvert claim.	Pays Workers' Comp. Law benefits. Determines compensability. May controvert claim. Maintains liaison with agency and OSC.
Workers' Compensation Board (WCB)	Hears, judges merits of, and issues determinations on workers' compensation cases. Resolves controversies. Directs SIF to pay benefits to the employee or New York State as appropriate.	No Change.
Office of the State Comptroller (OSC)	Processes PR75s submitted by agency. Issues social security refunds and amended wage statements.	Administers supplemental payment system, including calculating amount of supplemental payment. Maintains liaison with agencies and SIF. Processes forms submitted by agency and resolves overpayments. Issues social security refunds and amended wage statements.
Department of Civil Service	Administers Attendance Rules provisions as modified by negotiated agreements.	Administers Attendance Rules provisions as modified by negotiated agreements. Acts as liaison between SIF, OSC and agencies. Maintains database on workers' compensation experience.

Attachment A - ROLES AND RESPONSIBILITIES - [Continued]

STATUTORY PROGRAM	C-82 MANAGED CARE PROGRAM	PS&T MEDICAL EVALUATION PROGRAM
Determines reportability of incident based on Workers' Comp. Law criteria. Files and/or provides information for forms required by OSC and WCB. Maintains accurate records. Monitors twelve-month benefit entitlement. Prorates restoral of credits. Maintains contact with SIF employee and supervisor regarding employee's continued eligibility for benefits and leave status. Develops alternate duties for employees eligible for the Mandatory Alternate Duty Program. May terminate employee under Section 71 CSL.	Determines reportability of incident based on Workers' Comp. Law criteria. Makes independent determination of eligibility for workers' compensation leave. Verifies employee's choice of benefit. Processes PR75s to provide emplyee with paid leave. Maintains records of leave granted. Monitors six-month benefit entitlement. Restores leave credits. Requests medical evaluations as indicated. Develops alternate duties for employee eligible for limited duty. May terminate employee under Section 71 CSL. Files required forms with Workers' Compensation Board.	Determines reportability of incident based on Workers' Comp. Law criteria. Verifies employee's choice of benefit. Maintains accurate records. Monitors nine-month benefit entitlement. Files and/or provides information for forms required by OSC and WCB. Maintains contact with SIF, employee and supervisor regarding employee's continued eligibility for benefits, supplemental pay and leave status. Requests medical evaluations as indicated. Develops alternate duties for employees eligible for the Mandatory Alternate Duty Program. May terminate employee under Section 71 CSL.
Pays Workers' Comp. Law benefits. Determines compensability. May controvert claim. Maintains liaison with agency.	Pays Workers' Comp. Law benefits. Determines compensability. May controvert claim. Maintains liaison with agency. Schedules medical evaluations as requested.	Pays Workers' Comp. Law benefits. Determines compensability. May controvert claim. Maintains liaison with agency and OSC. Schedules medical evaluations as requested.
No Change.	No Change.	No Change.
Processes PR75s submitted by agency. Issues social security refunds and amended wage statements.	Processes PR75s submitted by agency. Issues social security refunds and amended wage statements.	Administers supplemental payment process including calculating amount of supplemental payment. Maintains liaison with agencies and SIF. Processes forms submitted by agencies. Issues social security refunds and amended wage statements.
Administers Attendance Rules provisions as modified by negotiated agreements. Acts as liaison between SIF, OSC and agencies. Maintains database on workers' compensation experience.	Administers Attendance Rules provisions as modified by negotiated agreements.	Administers Attendance Rules provisions as modified by negotiated agreements. Acts as liaison between SIF, OSC and agencies. Maintains database on workers' compensation experience.

Attachment B - Program Provisions

WORKERS' COMPENSATION OUTLINE OF BENEFITS

BENEFIT	EMPLOYEE GROUPS COVERED	WAITING PERIOD	BASIC PROVISIONS
NYS Workers' Compensation Law	All employees	-7 calendar days for wage replacement: after 14 calendar days retroactive to first day of disability.	- Medical expenses -Wage replacement 2/3 avg. wkly. salary up to: $340 max 7/1/90 $350 max 7/1/91 $400 max 7/1/92
Leave Program	Security Services & Security Supervisors (accidents prior to 4/15/93)	None	- 6 months leave with full pay without charge to credits with benefit continuation - Use of credits after 6 months - SL 1/2 pay or IPP - LWOP -Section 71 coverage
Leave Program	ASU, ISU, OSU, DMNA,PS&T,RRSU (accidents prior to 4/11/86) M/C (accidents prior to 9/1/86)	- 10 workdays per year/per accident -Provisions for waiver -Advance of sick leave if credits are exhausted
Supplemental Pay Program	ASU, ISU, OSU, DMNA, RRSU (accidents on or after 4/1/86 and prior to 7/1/92) M/C (accidents on or after 9/1/86 and prior to 7/1/92) PS&T (accidents on or after 4/1/86 and prior to 7/1/93)	Same as WC Law	- 9 months leave with net pay without charge to credits with benefit continuation - Use of credits - SL at 1/2 pay or IPP - LWOP -Section 71 coverage
Statutory Program	ASU,ISU,OSU,DMNA, RRSU (accidents on or after 7/1/92)	Same as WC Law	- 12 months leave without pay with benefit continuation -Section 71 coverage plus -Mandatory Alternate Duty for employees found to be 50% or less disabled and within 45 days of full recovery Out-of-title work allowed

WORKERS' COMPENSATION OUTLINE OF BENEFITS - [Continued]

BENEFIT	EMPLOYEE GROUPS COVERED	WAITING PERIOD	BASIC PROVISIONS
Council 82 Managed Care Program	Security Services and Security Supervisors (accident on or after 4/15/93)	Same as WC Law or	Choice of WC Law Benefit only or
Council 82 Managed Care Program		None	Managed Care Program including - Leave Program plus - Mandatory Medical Evaluation plus - Mandatory Limited Duty for employees 50% or less disabled No out of title work allowed.
PS&T Medical Evaluation Program	PS&T (accidents on or after 7/1/93)	Same as WC Law	Choice of WC Law benefit only or Medical Evaluation Program including: - 9 months leave with 60% gross pay without charge to credits with benefit continuation for disability greater than 50% - LWOP - Section 71 coverage plus - Mandatory Medical Evaluation plus - Mandatory Alternate Duty for employees found to be 50% or less disabled and within 45 days of full recovery. Out-of-title work allowed
M/C Interim Benefit	M/C (accidents on or after 7/1/92)	None	- Leave with full pay with charge to credits from first day of disability - Use of all credits - Sick leave 1/2 pay or IPP - LWOP - Section 71 coverage

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