Roles and Areas of Responsibilities

LETRICE WAITE-MOORE is one of two Department Benefits Specialists. Letrice can be reached at 642-1127 or letrice@berkeley.edu. Letrice’s duties include:

• counseling Cal Dining employees from introduction through termination for all UC sponsored benefits
• counseling all RSSP employees who are considering any type of leave or reduced time and managing related compensation (pay) issues
• coordinating the reporting of work-related injuries and illnesses
• coordinating Workers’ Compensation and disability claims processing
• performing Workers’ Compensation adjustments and processing pay and personnel actions for related cases
• coordinating family and medical leaves covered by FMLA, determining eligibility and tracking usage

DEE PALACIOS is our second Department Benefits Specialists. Dee can be reached at 642-3211 or deepals@berkeley.edu. Dee’s duties include:

• counseling all employees (except Cal Dining) from introduction through termination for all UC sponsored benefits except when employees are on leave (refer them to Letrice.

ELYSSE PAIGE is a Human Resources Analyst and the RSSP’s Americans with Disabilities Act (ADA) expert. Elysse can be reached at 643-6701 or epaige@berkeley.edu. She specializes in disability management including:

• clarifying medical restrictions and counseling managers and employees on reasonable accommodation
• assessing job duties and reviewing job descriptions and PEM forms for essential functions
• preparing modified work plans
• policy and contract issues related to all leaves of absence (including military, jury duty, personal, etc.), medical issues, and medical separations
• monitoring the progress of employees who are on medical leave
• assisting employees in recovery from injury and illness
• facilitating return to work
• fitness for duty
• tracking Workers’ Compensation costs, minimizing liability, and identifying trends
• conducting case management meetings with directors, assistant directors, and associate directors.

EMPLOYEE'S responsibilities include:

• submitting timely requests for medical leaves (and extensions) directly to supervisors
• providing supervisors with timely medical documentation related to medical leaves
• providing supervisors with timely medical documentation when health care provider has prescribed work restrictions and discussing accommodations with the supervisor
• contacting Letrice Waite-Moore for benefits counseling to prepare for a medical leave
• contacting Letrice Waite-Moore to request disability claim forms

AS A SUPERVISOR your responsibilities include:

• requiring employees to provide timely medical documentation for medical leaves
• discussing requests for medical leaves (and extensions) with the employee as well as Elysse Paige-Moore and documenting your decision
• conducting the Interactive Process with employees who require accommodation by asking for the employee’s suggestions for accommodation and documenting these suggestions; reviewing job functions, qualifications, and suggestions for accommodation with Elysse
• referring the employee to Letrice Waite for benefits counseling to prepare for a medical leave
• referring the employee Letrice Waite to request disability claim forms or making the request on the employee’s behalf when necessary
• providing Elysse Paige-Moore with timely medical documentation related to medical leaves
• providing Letrice Waite-Moore with timely information including timesheets related to medical leaves
• requiring employees to provide timely medical documentation for work restrictions and accommodations
• discussing work restrictions and accommodations with the employee, Elysse Paige-Moore, and your assistant director or director and documenting your decisions

How to Handle Workers’ Compensation Inquiries

The following email was distributed through the RSSP-ALL-STAFF mailing list on July 2, 2002.

Date: Tue, 02 Jul 2002 12:38:42 -0700
To: rssp-all-staff@uclink4.berkeley.edu
From: "Elysse R. Paige"
Subject: Reminder re: calls from Workers' Compensation (ORS)

Hi everyone,

I am writing to remind you to follow the guidelines outlined below if you are contacted by our Workers' Compensation claims administrator Octagon Risk Services (ORS). Recently, there were several occasions when claims administrators contacted supervisors to discuss accommodations and employment status. These calls should have been directed to me (Elysse Paige). The supervisors provided inaccurate information which I later had to correct. This information had an impact on employees' status and in some instances created overpayments. In other cases statements were made that left the impression that we were not following contracts, policies, statutes, and laws. Although ORS is periodically reminded of the protocol to follow when making contacts concerning RSSP employees, like us, they do experience staff turnover and reassignment from time to time. And sometimes of course, things simply fall through the cracks. Here are some general guidelines for responding to their inquiries.

1. If an employee has been injured at work and a Workers' Compensation claim has been filed, you will be contacted as part of their investigation. Your conversations with them should be limited to answering any appropriate questions they may have concerning the accident that caused the employee's injury. If you begin to feel uncomfortable with the nature or the tone of their inquiries, refer the inquirer to me immediately. Also keep in mind that they are taking notes on your responses and that you may be accountable for your statements, so...avoid hearsay, rumors, etc. When in doubt run it by me. Please report in as objective a fashion as possible. Be honest and be fair.

2. If ORS requests a site visit, refer them directly to me. I will call you back to coordinate the visit at a time that is convenient to you.

3. Any inquiries concerning accommodations, return to work, time lost from work, job descriptions, work history, employment status, etc. should be referred directly to me.

If you need immediate assistance concerning a contact from ORS and I am not available to assist you, please contact Letrice Waite at 642-1179. She is my back-up in this situation.

Elysse R. Paige
Human Resources Analyst
Medical Management Program
Housing and Dining Services
(510) 643-6701

Overview of Accommodations and Leaves of Absence

The Berkeley campus’ standards for managing accommodations and medical leaves continue to change. We have more laws to comply with and we are seeing more grievances and complaints. We are being required to keep more detailed documentation and to emphasize interactive communication between the supervisor and employee.

HR Analyst Elysse Paige-Moore helps supervisors make the best decisions and stay in compliance with all the regulations, policies, and contracts. Each month, Elysse schedules separate Disability Management Meetings with the Assistant Directors, Associate Directors, and Directors of Cal Dining, Housing Facilities Operations and Services, and the Early Childhood Education Program to review outstanding cases of temporary accommodation and current leaves of absence. The purpose of these meetings is to check in on the status of these cases, create and maintain standards, and develop strategies for managing the cases while efficiently maintaining operations.

As a Human Resources disability management specialist, Elysse’s primary focus is to work with supervisors and help them address their disability-related questions. She also monitors any other type of leave including military, jury duty, personal leave, etc. She will work with you to 1) apply best practices while realistically addressing operational needs and 2) achieve positive outcomes. Based on your particular case she will follow up with other campus specialists and ORS to seek clarification of policy, obtain doctor’s notes, and determine the employee’s status re: recovery, return to work, whether disability claims have been approved, and possible retirement and medical separation options.

Benefits Specialist Letrice Waite-Moore provides benefits counseling to employees who are on leave or reduced schedules, requests disability claim forms for them and helps them with disability planning. She will go over special programs such as FMLA, CFRA, CPDA, and Catastrophic Leave Sharing with them. She will also remind them that they need to discuss and request approval for their leaves with their supervisor and turn in doctor’s note. Letrice also calculates wages due employees and helps you to process Workers’ Compensation claims. Note: Continue to contact Dee Palacios for regular benefits counseling and assistance for new hires, normal benefits changes, open enrollment, and benefits problems.

Please keep in mind that you should never 1) speak directly with an employee’s doctor, even if the doctor calls you, 2) call a doctor’s office (even if the employee asks you to, or 3) ask employees for their diagnosis. Doctor’s notes should only include the actual medical restrictions, the period covered by the note, and the date of the next appointment. Be sure to discuss all employees’ requests for accommodation or leave of absence with Elysse at 643-6701, epaige@berkeley.edu, or fax 643-9839.

When an employee requests accommodation or a leave of absence it is important that you take the following factors into consideration:

• You must conduct and document the Interactive Process.
• Avoid doing informal accommodations for more than a few days and always put a note in the file documenting this agreement
• Is the restriction/accommodation temporary or permanent?
• Employees do not have an automatic right to medical leave just because doctors has taken them off work or they a receiving disability checks. Employees’ rights to leave are determined by reviewing State and Federal statutes, University contracts and policies, and PPSM.
• Has the employee provided you with proper documentation?

There are other times when you will want to consult with Elysse such as when:

• You have concerns about an employee’s own health or safety at work
• You are concerned that an employee’s accommodation or leave of absence may be impacting co-workers
• An employee begins missing a lot of time from work and is attributing the time-off to his/her own or a family member’s illness or health condition
• You begin to see a pattern of absenteeism that is being attributed to illness
• An employee requests time off to take a family member to a series of medical appointments or advises you of a family member’s serious health condition
• An employee needs treatment for or complains of pain related to an old injury.

The key to successfully managing accommodations and leaves is to document, document, document!

• Doctor’s notes
• Conversations
• Phone calls and phone messages
• Interactive Processes
• Agreements
• Actions
• The status/designation of accommodations and leaves.

Accommodation and Leave of Absence Checklist

Below are the steps to follow when an employee requests or raises the topic of medical restrictions, accommodation, or any type of leave of absence:

1. Listen to the employees’ requests then, tell them that you will need a doctor’s note. If the employee is requesting a leave of absence, you will also want the employee to write a request (except if the employee is requesting a leave for a Workers’ Compensation injury). Do not agree to/approve anything at this point.
   
   
2. Review the doctor’s note and fax it to Elysse at 643-9839. Call her at 643-6701 if you need help interpreting the doctor’s note.
   
   
3. Conduct the Interactive Process (IP). State law mandates that we ask employees whether they have any suggestions for how they could be accommodated (even if the employee is requesting a leave). Document the employees’ suggestions (if any) and tell them you will be getting back to them.
   
   
4. Review the restrictions and your IP discussion with your Assistant/Associate Director, Director, or other department/unit head. Discuss your ideas for accommodation as well and determine whether the employee can perform the essential job functions and accommodation is possible. Refer to page 7, Reasonable Accommodation. You are not required to implement the employees’ suggestions; you are required to consider them in good faith.
   
   
5. Call Elysse at 643-6701 to discuss your decision. She will help you to designate the status of the accommodation (i.e. temporary or permanent, scope, duration) or leave (i.e. FMLA, approved/denied, personal) and advise you on next steps such as writing a Transitional Work Agreement (TWA), placing the employee on leave and designating leave status, denying the request, monitoring, etc.
   
   
6. Send Elysse a brief email at epaige@berkeley.edu summarizing the IP and including the following:
   • date and time
   • names of those present
   • employee’s suggestions
   • your decision
   • period for which you will accommodate (if applicable)
   • reason you cannot accommodate (if applicable)
   
   
   
7. If the employee will be going on leave or working a reduced schedule, advise the employee to contact Letrice at 642-1179 for counseling.
   
   
8. Check-in to make sure the employee is complying with the accommodation and ask if there are any problems. Continue to evaluate the accommodation independently and contact Elysse if you run into challenges.
   
   
9. Track the duration of accommodations and leaves. Make sure employees bring you updated notes after each doctor’s visit then, do the IP again. Do not continue accommodations or leaves without documentation.

Reasonable Accommodation

These procedures supplement relevant personnel policies and collective bargaining agreements, and should be read in conjunction with those provisions. The procedures apply for employees covered by the Americans with Disabilities Act (ADA) and/or Sections 503/504 of the 1973 Rehabilitation Act.

When an employee becomes unable to perform the essential, assigned duties of the currently-held position as a result of a covered disability, the Berkeley campus is committed to providing services to assist the employee, including efforts at reasonable accommodation. The campus will explore reasonable accommodation options when an employee requests accommodation or indicates a need for accommodation due to a covered disability. Accommodation options will be considered in discussions with the employee.

1. Supervisor notified that employee needs accommodation: Unless the disability or the need for accommodation is obvious, it is the responsibility of the employee to inform the supervisor that an accommodation is needed in order to perform the essential job functions, or to receive equal benefits and privileges of employment. When the disability or the need for accommodation is obvious, the supervisor should consult with Elysse Paige-Moore before inquiring as to whether the employee perceives a need for accommodation. This must be done carefully to avoid an improper inquiry about the employee’s possible disability. If there is any question concerning the nature of the limitation or an accommodation being considered, contact Elysse at 643-6701. She will consult with the Rehabilitation Counselor at University Health Services.
   
   
2. Conduct interactive process: Upon receipt of information about the need for accommodation from the employee, the supervisor should conduct the State of California mandated Interactive Process by asking the employee for suggestions for accommodation and documenting these suggestions. The next step is to review job functions and qualifications for the held position with Elysse.
   
   
3. Make accommodation agreement: Consistent with departmental practices, the supervisor and Elysse may agree to an accommodation for essential functions, and to accommodation for or elimination of non-essential functions. Such agreement should be documented.
   
   A job function is essential if any of the following apply:
   • Performance of the function is an essential reason for the job existing
   • A limited number of employees are capable of performing the function
   • The function is highly specialized, requiring unique expertise or abilities.

   You can find more information on how to determine whether a function is essential in the Classification section of the ‘Guide’.

   
   
4. Explore other options: If the disability precludes the employee from performing essential job functions, Elysse in consultation with the supervisor, the Rehabilitation Counselor, the employee, and other offices as necessary, will undertake the following actions, as appropriate:
   1. Evaluate the employee’s functional abilities and limitations
   2. Analyze the job requirements
   3. Explore options available for an accommodation, including but not limited to:
      • making existing facilities used by employees readily accessible to and usable by the disabled employee
      • restructuring the job
      • granting a leave of absence
      • modifying work schedules
      • acquiring or modifying equipment or devices
      • providing qualified readers or interpreters
      • reviewing current vacancies within the department
      • requesting the opportunity for Trial Employment as a reasonable accommodation, as set forth in relevant personnel policies or collective bargaining agreements.
      • requesting the opportunity for Transfer Search as set forth in relevant personnel policies or collective bargaining agreements
   4. Determine the most effective accommodations, take into consideration the employee’s expressed preferences
   5. Evaluate whether the employee can perform the job safely
   
   
   
5. The department evaluates the reasonableness of the suggested accommodation(s) by assessing its effectiveness in enabling the employee to perform the essential functions of the job. This review of reasonableness includes an assessment of cost and the operational needs of the department. The items listed below provide guidelines for this review, and should be considered as appropriate:
   • number of persons employed in the unit and the department
   • number, type, and locations of the units within the department
   • type of operation, including the composition, structure, and functions of its workforce, its geographic separateness, and the administrative or fiscal relationship of the department to the campus
   • impact of the accommodation on the operation of the department, including the impact on the ability of other employees to perform their duties and the impact on the department’s ability to conduct business
   • nature and cost of the accommodation
   • overall financial resources of the campus
   • effect on expenses and resources, or other impact of the accommodation on business operations
   
   
   
6. Elysse will discuss the possible accommodation with the supervisor, the Rehabilitation Counselor and the employee. If determined by the department to be reasonable, the accommodation will be implemented; if not, Elysse will work with the affected parties to determine how next to proceed.
   
   
7. Any accommodation adopted should be reviewed as necessary with the employee by Elysse and the supervisor.

Information on Family and Medical Leave Requests

Below are guidelines to follow when an employee requests a family or medical leave. The guidelines must be used in conjunction with University policies, PPSM, and applicable contracts. Remember policies related to this type of leaves change frequently and each case should be reviewed carefully. In addition to referring to this document, we recommend that you consult with Human Resources Senior Analyst Elysse Paige-Moore before making any final commitments.

Three Types of Leave:

1. Family and Medical Leave Act (FMLA). This is a federal law that provides up to 12 weeks of leave to University employees who have worked 12 months and at least 1,250 hours prior to the requested leave.
   
   
2. California Family Rights Act (CFRA). This is a state law that provides up to an additional 12 weeks of leave, which is deemed by the University as supplemental family and medical leave. Application varies depending on PPSM or contract.
   
   
3. California Pregnancy Disability Act (CPDA). This is a state law that provides female employees up to four months of pregnancy disability leave.
   
   

Under FMLA and CFRA, entitlement leaves are for a serious health condition of an employee or an employee’s parent, spouse, or child; or for the birth, adoption, or placement of a child in the employee’s foster care.

Note: For maternity leaves, the total of the FMLA, CFRA, and CPDA cannot exceed seven months in the same leave year. Family and medical leave records must be kept for three years in the home department.

Pay

Family care and medical leave (FMLA) is normally unpaid leave; however, the University and the employee may request or be required to substitute paid leave (e.g., accrued vacation, sick leave, or extended sick leave) for all or a portion of the unpaid leave in accordance with policies and collective bargaining agreements.

Benefits

Family care and medical leave (FMLA) benefits are maintained as if the employee is working. CFRA benefits are maintained if the employee is on pay status using accrued time. For CPDA, the employee’s medical insurance may be maintained for up to 6 months. It is the responsibility of the employee to maintain their benefits while on a leave without pay.

Family and Medical Leave Requests

When an employee requests a leave that might be covered by FMLA, or if the employee makes you aware of the employee’s own or a family member’s health condition which may qualify for FMLA coverage you are required to:

• verbally inform the employee of possible FMLA rights and arrange to provide the employee with FMLA information by contacting their Human Resources Benefits Specialist (HRBS) Letrice Waite-Moore
• notify the HRBS immediately
• advise the employee to speak to the HRBS regarding benefits
• forward doctor’s note and a copy of the employee’s most recent job description to Elysse Paige-Moore
• consult with Elysse before denying a leave (the employee might be eligible for other types of leave).

The HRBS will provide to the employee:

• a copy of Rights and Obligations of the FMLA of 1993,
• a FMLA checklist
• a Family Care and Medical Leave of Absence Request form,
• a Family Care and Medical Leave Certification form and a copy of the job description, and
• a Request to Continue Benefits During Leave Without Pay (if applicable).

Completion of the Forms

The employee completes the designated area on the Family Care and Medical Leave of Absence Request and the Family Care and Medical Leave Certification forms. The employee should present the certification form and a copy of the job description to the health care provider. The employee should return the completed forms to Letrice within 14 business days.

The employee is responsible for completing and forwarding the Request to Continue Benefits During Leave Without Pay form to Letrice.

Recording FMLA Leave (using sick leave, vacation or leave without pay)

We will continue to use our method for recording time. There are leave codes available for you and Letrice to use to designate the leave covered by FMLA. (e.g., FML - without pay; FMS - sick leave; FMV- vacation). Please refer to your Payroll Manual for detailed instructions.

Note: Federal regulations prohibit denying a leave if FMLA forms are not used by the employee or the health provider. The forms serve as a tools to facilitate the processing of leave requests that might be related to FMLA. If for some reason the employee does not use the Family Care and Medical Leave of Absence Request form, Letrice or Elysse will complete the form after conferring with the employee regarding the information in the shaded area, and upon receipt of the health provider’s input. The Family Care and Medical Certification and Family Care and Medical Leave Return Certification forms may be substituted with letters from the health provider as long as the necessary information is stated

Medical Leaves of Absences and Accommodations: FAQs

The responses below include some general information. Keep in mind that policies and contracts may need to be consulted and that each situation could have unique circumstances.

1. How does a disability affect a performance track in progress?

If an employee is out on disability, and has been notified of the performance track, this process will continue upon return to work. The disability leave doesn’t change the performance track in any way unless the employee returns with limited ability to perform essential functions of the job. If the performance track is related to attendance issues, the supervisor should differentiate between intermittent unscheduled absences that have contributed to the problem and planned approved leaves of absence which may be FMLA approved leave or disability related.

2. Do I have to grant medical leave if a physician states that the employee must be off of work for a long time?

If the employee is eligible for FMLA and his condition qualifies for FMLA leave, the department must grant it. PPSM and contract vary on maximum allowable length of leave. Contact Elysse Paige-Moore for assistance.

If the manager believes that the employee does not qualify for a medical leave, the manager must work with Elysse to determine the next steps.

3. Who decides whether I can accommodate restrictions? What if I can’t make an accommodation (because it’s too expensive, I don’t have anyone to do the employee’s regular work, etc.)?

The manager decides whether to accommodate restrictions in consultation the director/assistant director and Elysse. If the manager is questioning whether the employee can be accommodated, Elysse will do an analysis to explore all options and what impact these options would have on the unit and the department. If the department has no funds to accommodate the employee, other funding sources must be considered. The University is considered “one funding source” and therefore all attempts should be made to consider sources outside of the department.

4. When can I medically separate an employee?

When you and Elysse have exhausted all possible accommodations and the employee still cannot perform essential assigned functions, a medical separation may be an appropriate action. Elysse will submit a request to review the employee’s status to campus OHR and Vocational Rehabilitation.

5. What is a "work hardening" program, who does it, and can I force an employee to do it?

In this program an employee is slowly conditioned to go back to work. The employee’s work is simulated in a program outside of the work site until the doctor feels the employee is ready to go back to work and perform the tasks on the job. An employee may enter this type of program on the recommendation of his physician. If you believe that an employee might benefit from work hardening, discuss your ideas with Elysse.

6. What if I can accommodate but not at the same classification? Should the job be reclassified?

An accommodation doesn’t guarantee that an employee remains at the same classification level. However, under FMLA and the Transitional Work Program the employee’s pay must remain the same. Temporary accommodations related to FMLA and the Return to Modified Work Program can last from 30 to 180 days. An employee has the option to refuse a permanent offer of accommodation. This may lead to a medical separation.

7. Does the employee have the right to refuse accommodation if he doesn’t like it, or if he can’t change his hours of work as required?

If the employee is on approved FMLA leave that was initiated by the employee, we cannot force the employee to accept modified work. If the employee is not eligible for FMLA leave, the employee doesn’t have the right to refuse accommodation which meets functional limitations specified by the health care provider. The employee does not have the right to refuse work and continue to receive benefits. An employee has the option to refuse a permanent offer of accommodation. This may lead to a medical separation.

8. How long can an employee stay out on a Workers’ Compensation leave?

The leave period will vary depending on the seriousness of the injury and the doctor’s prescriptions, and can continue until the employee’s condition is declared permanent and stationery.

9. What does permanent and stationary mean?

It means that the employee’s medical condition has stabilized and is not expected to get significantly better or worse over time.

10. What is the difference between Workers’ Compensation and University Paid (Liberty Mutual) Disability?

Workers’ Compensation disability is provided for medically certified industrial injuries; that is any injury, illness, or disease that results from work or working conditions and which occurs during the employee’s service to the University.

University paid disability (UPD) which is often coupled with employee paid disability (EPD) pays benefits if an employee cannot come to work because of a medically certified temporarily disabling illness or injury that is not work related, and that requires the employee to be under a doctor’s direct and continuous care. The current University disability carrier is Liberty Mutual