Minnesota Department of Transportation

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MnDOT Policies

Workers’ Compensation Injury Reporting and Return-to-Work

MnDOT Policy #WF012
Effective: September 11, 2020

View/print signed policy (PDF)

Workers' Compensation Injury Reporting and Return-to-Work Procedures

Please go to the MnDOT Org Chart to find specific contact information: Org Chart.

Responsible Senior Officer: Deputy Commissioner/Chief Administrative Officer
Policy Owner: Director, Office of Administration
Policy Contact: Workers' Compensation Program Manager

Policy statement

Employees are required to report all work-related injuries or illnesses immediately and not later than 24 hours after the injury or illness.

When appropriate and in accordance with laws, rules, regulations, and collective bargaining agreements/plans, a qualified employee may be placed into another job or job assignment. Each return-to-work situation must receive careful review on a case-by-case basis and must take into consideration the varying factors of the injury and work place needs.

Reason for policy

For employees who are returning to work from a non-work-related injury or illness, see the MnDOT Return-to Work Policy.

Applicability

All MnDOT employees must comply with MnDOT policies.

Key stakeholders affected by this policy include:

  • All employees
  • Managers/Supervisors
  • Office of Human Resources
  • Office of Equity and Diversity
  • Workers’ Compensation Coordinators
  • MnDOT Office of Administration

Definitions

Designee

For the purpose of reporting a work-related injury or illness, the individual selected to act on behalf of the supervisor when the supervisor is absent.

MnDOT Report of Work Ability for Work Injuries

A form to be completed by a healthcare provider on behalf of an employee with a work-related injury.

Significant Injury or Illness

A work-related injury or illness that results in death, medical treatment beyond first aid, loss of consciousness,
days away from work, restricted work, or transfer to another job.

Treating Healthcare Provider

For state employees entitled to workers' compensation treatment, a physician, chiropractor, osteopathic physician, podiatrist, or dentist directing and coordinating the course of medical care to the employee.

Responsibilities

Employees

  • Report and provide injury or illness information to supervisor (this is not done through eSAFE).
  • Enter injury information electronically into eSAFE. If eSAFE is unavailable, complete paper forms located
    under the Resources Tab of the agency Workers’ Compensation iHUB page and submit to the Workers’
    Compensation Coordinator.
  • Promptly provide a completed MnDOT Report of Work Ability for Work Injuries received from the
    treating health care provider to the Workers' Compensation Coordinator.
  • Actively participate in the return-to-work process.

Managers/Supervisors (or Designee)

  • Complete and submit all agency claims investigation information immediately, but not later than 24
    hours, after the injury or illness.
  • Enter injury information electronically into eSAFE. If eSAFE is unavailable, complete paper forms located
    under the Resources Tab of the agency Workers’ Compensation iHUB page and submit to the Workers’
    Compensation Coordinator.
  • Maintain regular contact with the employee.
  • Actively participate in the return-to-work process.

Workers' Compensation Coordinators

  • Coordinate with the Minnesota Department of Administration - Risk Management Division (RMD) to
    facilitate the management of a claim from initial filing to final closing.
  • Facilitate the return-to-work process for injuries or illnesses involving temporary and/or permanent
    work restrictions.
  • Work with the Office of Human Resources and Office of Equity and Diversity to evaluate the need for
    reasonable accommodation, where applicable.

Office of Human Resources

  • Collaborate with and advise the Workers' Compensation Coordinator and Office of Equity and Diversity
    regarding:
    • FMLA qualifying leave
    • Job opportunities within the agency when permanent restrictions are determined
    • Leave of absence and separation

Office of Equity and Diversity

  • Collaborate with and advise the Workers’ Compensation Coordinator and Office of Human Resources
    regarding reasonable accommodation, where applicable.

Office of Administration, Workers' Compensation Manager

  • Serve as MnDOT's internal consultant to offices/districts regarding specific workers' compensation
    claims and case management.
  • Develop, conduct and coordinate training, and provide information regarding the claims process to
    office/district Workers' Compensation Coordinators, safety administrators, managers, supervisors and
    employees.
  • Act as the primary point of contact for Minnesota Department of Administration - Risk Management
    Division (RMD) and the Department of Labor and Industry Workers' Compensation Division when a
    significant injury occurs.

Office Directors/District Engineers

  • Be familiar with this policy

Policy Owner (Director, Office of Administration)

  • Review policy every two years, or sooner as necessary, to ensure policy remains up-to-date.
  • Ensure procedures, form, and training associated with the policy remain current.
  • Work with Policy Coordinator to revise policy and/or confirm its accuracy.
  • Communicate policy revisions, reviews, and retirements to stakeholders.

Resources and related information

Agency Injury Website

Forms required for every incident receiving medical attention:

Processes, Procedures, and Instructions

Resources

History and updates

Adopted

March 19, 2015

Superseded

  • Policy 98-2, Workers' Compensation Return-to-Work
    • Effective April 7, 1998
  • Policy 3.28, Workers' Compensation Return-to-Work
    • Effective September 18, 2008

Revised

  • First Revision: August 14, 2018
  • Second Revision: March 12, 2019
  • Third Revision: September 11, 20202 (renumbered #WF012 from #HR012)

Policy Review

This policy's next scheduled review is due September 2022.