Home Table of Contents

016.14.1-302. Workers' Compensation

AR ADC 016.14.1-302Arkansas Administrative Code

West's Arkansas Administrative Code
Title 016. Department of Human Services
Division 14. Office of Finance and Administration
Rule 1. DHS Administrative Procedures Manual
Part III. Payables
Ark. Admin. Code 016.14.1-302
016.14.1-302. Workers' Compensation
Currentness
I. PURPOSE: The Department of Human Services (DHS) Workers' Compensation procedure is established pursuant to the Arkansas Workers' Compensation Act, Ark. Code Ann. 21-5-601 et seq., 21-4-201 et seq., and DHS Administrative Policy No. 1064, Department of Human Services Financial Authority, to provide equitable and consistent methods for review and processing of Workers' Compensation claims filed by DHS employees. This procedure provides guidance for the Workers' Compensation process from the first report of injury through leave buy-back.
II. SCOPE: Procedures apply to all classified and unclassified DHS employees. All DHS divisions and offices shall follow these procedures to assure equitable and consistent treatment of employees involved in the Workers' Compensation process.
III. PROCEDURES: Response to Work Related Injury
A. The employee immediately reports injury to supervisor.
B. Supervisor:
1. Renders first aid as needed
2. Ensures that transportation is available for the injured employee to a physician or hospital emergency room
3. Procures ambulance service if needed
4. Places employee on leave
IV. PROCEDURES: Forms
A. The employee completes the front of Workers' Compensation Commission (WCC) Form N, Employee's Notice of Injury, at the time of injury or as soon as possible thereafter, and signs and dates it.
B. The supervisor detaches the bottom portion of WCC Form N and gives it to the employee.
C. The supervisor completes and signs WCC Form 1, First Report of Injury or Illness and the “Information Requested” form as soon as possible after being notified of injury.
D. The supervisor completes and obtains employee's signature on Authorization for Release of Information form.
E. All forms in Section IV.A. through D. above are to be mailed within five days of the report of injury to the Public Employee Claims Division (PECD) at:
Public Employee Claims
1123 South University Avenue
Suite 217 - University Tower Building
Little Rock, Arkansas 72204
F. The supervisor obtains the employee's signature on the Department of Human Services Wage Reconciliation form. The original is maintained in the employee's personnel file at the work unit. One copy is given to the employee; one copy is mailed to:
Arkansas Department of Human Services
Division of Administrative Services
General Operations Section, Payroll Unit
P.O. Box 1437, Slot 3520
Little Rock, Arkansas 72203-1437
G. If WCC Form 1 (Section IV.C. above) did not reflect that the injured employee returned to work, the supervisor completes WCC Form E. Employer's Supplemental Report and forwards it to the PECD (address above) immediately after the employee returns to work.
H. If WCC Form 1 did not reflect lost time and the employee is later unable to work. Form E is utilized to indicate the date disability was incurred. Form E is submitted to the PECD in duplicate.
I. The supervisor notifies the Division of Administrative Services (DAS), Office of Human Resources, Slot 3300, via DHS Request for Personnel Action Form DHS-1161 of the day the injured employee returns to work, only if the employee has been on leave without pay status.
* J. WCC Form W will be requested by the Workers' Compensation agent handling the claim at the Arkansas Workers' Compensation Commission if the claimant receives less than maximum benefits. The form must be forwarded to the DAS Payroll Unit for completion.
V. PROCEDURES: Wage Reconciliation
A. The PECD notifies the Payroll Unit when compensation due to time lost is awarded, by sending the Payroll Unit copies of the vouchers indicating payment of such compensation.
B. The Payroll Unit processes a payroll/personnel document to decrease the employee's gross wages for the current pay period by the amount of the Workers' Compensation warrant received so that the combined total of employee's wages and Workers' Compensation does not exceed normal gross pay.
VI. PROCEDURES: Leave Reconciliation
A. Employees who are absent from work due to occupational injury or illness and who are entitled to Workers' Compensation benefits may, upon proper application, utilize accrued sick leave as a supplement to Workers' Compensation benefits. Benefits from both sources may equal, but not exceed, the employee's normal rate of pay at the time of the injury or the onset of illness. Such option, when exercised, reduces the employee's accrued sick leave on a proportional basis.
Note 1: An employee who is unable to work because of injury must be placed in some form of leave status, i.e., sick, annual, or leave without pay. The supervisor is responsible for initiating the employee's leave slips after five days absence unless the employee is on leave without pay.
* Note 2: WCC forms included in Appendix A are for informational purposes only. Official WCC forms are to be requested from the DAS Office of Human Resources.
Note 3: Supervisor, as used in this text, is defined as the responsible person (supervisor, manager, administrator, or director) to whom the accident is reported.
B. Absence due to occupational injury is charged in the following order:
1. Earned sick leave
2. FLSA compensatory time
3. Offset time
4. Earned annual leave
5. Earned holiday
6. Leave without pay
* Exception: Injured employees may choose to utilize leave without pay throughout absence due to injury to conserve paid leave. Any employee on leave of absence without pay does not earn leave time. Employees must also submit any insurance premiums being deducted from their pay warrants or have insurance coverage canceled. DHS continues to pay the state matching share for health insurance as long as employees are insured and draw Workers' Compensation.
C. When an employee suffers an occupational injury and is unable to work, the employee should be placed in the appropriate leave status. If leave without pay is utilized, the DAS Office of Human Resources should be notified immediately via Form DHS-1161.
D. Each time a payment for wages is received from Workers' Compensation, paid leave taken is re-established up to the amount of the check from Workers' Compensation. Leave is re-established in the reverse order of the manner it was utilized.
Note: Because of the number of variables in reconciling leave and wages, each Workers' Compensation claim is different. The steps above are guidelines.
* 1. Questions concerning filing or processing Workers' Compensation claims should be referred to the DAS Office of Human Resources.
* 2. Questions concerning Workers' Compensation deductions from salary should be referred to the DAS Payroll Unit.

Credits

Eff. Dec. 15, 1995.
Current with amendments received through May 15, 2024. Some sections may be more current, see credit for details.
Ark. Admin. Code 016.14.1-302, AR ADC 016.14.1-302
End of Document