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There are claim forms for each type of loss depending on which coverage is called for. If a workplace injury has occurred, a Workers' Compensation First Report of Injury form is needed. If at anytime you have questions about which form to use, please give us a call and we will help you. The loss forms are found online at our Forms section.
The First Report of Injury can be submitted online in our Forms section. We encourage you to report any serious claim directly to us at 800-649-7915. Serious claims are usually ones involving serious injuries or death or claims that involve catastrophic loss of property.
You should report the claim as soon as you are aware of the incident. We encourage you to file the claim and allow for our investigation prior to paying any bills. Once you have received notice of a claim, it is important that you report that claim to our office immediately.
Permanency is a term used in conjunction with a Workers' Compensation claim. If a municipal employee is injured while performing his or her duties, and that injury is deemed by a treating physician to have caused permanent partial impairment, then the employee is entitled to collect permanency benefits under the Workers' Compensation system.
The amount of those benefits depends on the severity of the permanent impairment. A permanent impairment to an individual does not necessarily mean that the person is unable to perform all or any of his or her normal work duties or function normally in his or her daily living activities. It does mean that, according to a physician, the individual, because of a work related injury, is not completely the same physically as he or she was prior to the injury.
If an employee is injured on the job and that injury causes lost time from work, the employee may be entitled to recoup part of his or her lost wages through Workers' Compensation coverage.
Injured workers are entitled to receive 66 2/3% of their average weekly wage as benefits for lost time from work due to a work related injury. Wage information is provided to the claims representative by the municipality employing the injured worker. Wages 12 weeks prior to the date of the injury, not including the week of the injury, are used to calculate the benefit amount the worker is entitled to receive. The average of the 12 weeks' wages is determined and 66 2/3% of the average is paid to the injured employee as temporary total disability benefits (TTD). As an example, if the average weekly wage is $500.00 multiplied by 66 2/3%, the employee is entitled to receive $333.34 in TTD benefits. These benefits are tax-free and the injured worker may also be entitled to additional weekly benefits based on the number of dependent children that the worker can claim. We make no deductions for things such as health insurance or other contributory benefits. The employee must resolve that with his or her employer.
Workers' Compensation coverage is designed to protect employees of organizations against injuries that arise in the course of performing their daily work duties for their employers. Typically, elected officials are not considered employees of a municipality as they report to the taxpayers of a municipality and are not directed by anyone who is an employee of a municipality. Since they are not considered employees, elected officials are not covered under Workers' Compensation.
However, if an elected official is collecting a salary and is listed on the municipal payroll as collecting a salary, then he or she may be eligible to receive benefits under the Workers' Compensation system. An examply of this would be a municipal clerk or treasurer who is elected by the taxpayers, but is paid a salary by a municipality.
By law, an employer has to file a First Report of Injury Form with the State of Vermont Department of Labor and Industry within 72 hours of being notified of an on the job injury. If this time frame is not met, the employer is subject to fines of up to $100.00 per violation.
You also have reporting and recording requirements under VOSHA. Filing the First Report of Injury Form does not exempt your municipality from the VOSHA requirements. The one most often overlooked is the responsibility to notify VOSHA about the worst accidents. If an accident results in one or more employee deaths or the hospitalization of three or more employees, the employer has to notify VOSHA by phone or in writing within eight hours.
Subrogation is a term used when PACIF attempts to recover damages from a party that is responsible for causing a loss to one of our members. If PACIF reimburses a muncipality for damages as a result of a claim, and our investigation of that claim reveals that another party (someone other than the municipality) is responsible for those damages, we will pursue reimbursement for those damages from the responsible party. If PACIF is successful in our subrogation attempt we will then reimburse the municipality for any deductible amount paid for the specific claim.