On the Job Injuries & Workers Compensation Benefits

1. How do I File a Claim?
2. How is my pay determined while on OJI ?
3. What about light duty while on OJI?
4. What about my benefits while on OJI?
   Supplementing Pay by Using Vacation Weeks During OJI

How do I file a claim? 

1.  How do I file a claim for an on the job (OJI) injury?

• If your injury does not require immediate attention you should proceed to Inflight Administration at Terminal 4 and fill out the necessary paperwork with a benefits coordinator.  If your injury requires immediate attention at the US Airways Clinic or the Hospital then you should tell the caregiver that you were injured on the job.   You should be given a “pink form”, entitled Worker’s and Physician’s Report, to complete and sign. By signing this form you were applying for Worker’s Compensation.

 2.  Now what happens?

• The hospital or doctor sends the original of the form to the Industrial Commission (ICA), a copy to the employer and a copy to the insurance company that wrote the policy for the company. US Airways has chosen Hartford as the insurance provider for Worker’s Compensation claims. If this “pink form” was not filled out at the time of the doctor or emergency room visit, another form, entitled “Worker’s Report of Injury”, can be completed and filed with the ICA. This form can be sent to you upon request.  Please be aware that the Insurance Company is looking for the Doctors documentation and confirmation of an On the Job Injury. Your claim is officially filed upon receipt of one of these forms. Without a signed claim form the insurance carrier is not legally responsible required to take action on your injury claim.  If you are not notified of the receipt of your claim within two weeks of filing, contact the Industrial Commission and another claim form will be sent to you.

3. Is it necessary to fill out any forms with US Airways?

• A: Yes. It is necessary to fill out a claim form with US Airways as soon as possible after the injury. US Airways must send a claim form into Hartford Insurance in order for your claim to be processed and in order for you to be paid any compensation from Fremont.

 4. Does the insurance company have a certain amount of time to accept or deny the OJI claim?

• A: When the Industrial Commission receives your claim they officially notify the insurance carrier that you have filed a claim. The insurance company must then either accept or deny your claim within 21 days from the date of notification.  Again, if you are not notified of the receipt of your claim within two weeks of filing, contact the Industrial Commission and another form will be mailed to you.

 5. If the insurance carrier denies the claim is there any recourse?

• You will receive a “notice of Claims Status” from the insurance company if your claim is denied, which provides for a 90 day protest period, within which you may file a request for a hearing with the Industrial Commission.

6.  Do I have to see the company doctor before seeing my own doctor?

• Per our contract (Section 17, C.1.a.), if it is a non life-threatening injury it is necessary to obtain initial treatment from the AWA Medical Clinic or other facility designated by the Company. After receiving initial treatment from the Company doctor, you may choose to see your own doctor for a second opinion. Voluntarily seeing a doctor more than once after an OJI is interpreted as officially choosing that doctor as your physician of record.

 7.   If I am not happy with my doctor, is it possible to change doctors?

• Once your physician of record has been determined, you may not change doctors with out the approval of your current doctor, the insurance company or the Industrial Commission.

8. If both the company doctor and my own doctor have seen me, which doctor determines when I am well enough to return to work?

• Your physician of record determines when you are well enough to be released for any type of duty.

9.  Can US Airways’ insurance provider override my “doctor of records’ decision to determine when I’m able to return to work?

• The Company’s insurance provider has the right to have you examined at a reasonably convenient time and place by a doctor of the insurance company’s choosing. The insurance company may accept the opinion of its consulting doctor and base a change in your claim status, or close your claim based on that doctor’s opinion.  Please be aware that even if your Doctor or the examining Doctor releases you to full duty you may still be asked to perform and pass the essential functions testing at the AWA clinic.

 10.  Is there any recourse if the insurance providers’ doctor has a different opinion from my physician of record in regards to the status of my health?

• Yes.  If there is a change in the status of your claim, you will receive a “Notice of Claim Status” from the insurance company.  If you disagree, you must file your “Request for Hearing” with the Industrial Commission within 90 days from the date of the “Notice of Claim Status”.

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How is my pay determined while on OJI ?

1.  How is my compensation determined while recovering from an “on the job” injury?

•       Per our contract the company shall pay protect a F/A for the greater of the scheduled or actual credit hours for the duty period in which an illness or injury occurs. If the F/A is released to go back to duty during the trip in which the OJI occurred, she/he must do so. (Section 17, D. 1.)

•      There is a statutory 7-day waiting period before Worker’s Compensation begins. During this waiting period, a F/A may elect to use her/his sick and/or vacation bank to pay for any trips/s or reserve shifts, which were missed due to the illness or injury. The company will assume that the F/A wishes to use accrued sick leave bank unless advised otherwise by the F/A. (Section 17-D.2)

•       On the 8^th day (excluding the actual day of the injury), worker’s compensation begins to pay. Workman’s Compensation pays 662/3 of the last 12 months average wages. The Company’s insurance provider pays this, which is currently Hartford. US Airways timekeeping reports this to payroll with your 12-month average hours worked.  AWA Workers’ Compensation department in turn provides to payroll the amount that has been paid by Fremont on a weekly basis.

•       If you are off 14 full days, Worker’s Compensation is retroactive to the date of the injury. If a F/A receives retroactive compensation for the 7 day waiting period, in which vacation/sick bank was used to pay for trip/s or reserve shifts which were missed due to the OJI, it is necessary for the F/A to reimburse the company for the sick/vacation pay. The Company in turn will credit back the F/A’s sick/vacation bank accordingly.  In the month in which the injury occurred the company will supplement the workers’ compensation benefit for trips, which were scheduled at the time of the injury and missed due to the injury as long as the supplement does not exceed more than 85 credit hours for the month.

•       In the month/s following the injury, Workers’ Compensation will continue to pay 66 2/3% of the monthly last 12-month average hours worked.  In addition, US Airways will continue to supplement your Workers’ Compensation payment up to your 12-month average but not to exceed the Minimum Bid Period Guarantee (70hrs or 75hrs for Grand fathered Reserves).  Your Contract provides for you to be able to supplement your pay from your OJI Bank, Sick Bank or Accrued Vacation to provide pay up to your 12 month average or a maximum of 85hrs per month, whichever is less.  For example if your 12 month average is 92 credit hours then the Company would supplement your Workers’ Compensation up to 70 hrs and you in turn can use 15 hrs from your OJI Bank, Sick Bank or Accrued Vacation to supplement your pay up to 85 credit hours.  

2. At what point can a F/A use their Perfect Attendance OJI Bank?

• In the month/s following the injury a F/A may utilize their OJI Bank to supplement their hours up to 85 hours a month. (For example: If your 12-month average is 80 hours. Workers’ Compensation will pay 66 2/3% of the Minimum Bid Period Guarantee (70hrs or 75hrs for Grandfathered Reserves), and your OJI bank will pay the difference up to 80 hours.)

3.  At what point can a F/A USE their accrued sick/vacation bank?

• A F/A must exhaust their Perfect Attendance OJI Bank before supplementing their hours from their accrued sick/vacation bank.

4.  Can I be reimbursed for my miles driven to my doctor and therapy visits and if so at what rate?

• Only in special circumstances when you are asked to travel a far distance to see a Doctor. Mileage is paid at 31.5 cents per mile.  You must keep a log of mileage and it must be sent in to the Industrial Commission.

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What about light duty while on OJI?

1.  Am I required to do “light duty” while on an OJI?

• If your physician of record releases you for light duty and the company has work which fits your doctors’ parameters of your capabilities at that time, you may elect to work the Light Duty and get paid or elect not to work Light Duty and not get paid.

 2.  How are my hours calculated for working light duty? 

• A Flight Attendant will receive one hour of pay for every two hours of work performed.

 3.  If my seniority allows me to hold weekends off, can the company only schedule me to work Monday through Friday?

• The Company will make reasonable efforts to accommodate the need of the Flight Attendant when selecting days and times for light duty assignment. (Section 17, F.,3.)

 4.  Is there a maximum number of days per month, which the Company may assign me light duty?

• The number of days available for the company to assign per month is based on the Flight Attendants’ last twelve month average hours worked, and shall not be more that 70 hours or less than 40 hours. For example: If your past twelve month average was 80 hours, the company could not assign you for more than 70 hours. Remember that you receive one hour of pay for every two hours of work performed doing light duty. (70 hours of pay X 2 hours of light duty performance = 140 hours total hours of light duty divided by 4 weeks = 35 hours a week.)

 5.  Does the company provide for time off from light duty to attend to therapy and doctors visits and if so am I paid for this time?

• The Flight Attendant shall make reasonable efforts to schedule rehabilitation and/or physician visits necessitated by the OJI so as not to interfere with the light duty assignment. However, if this is not possible the company shall provide reasonable time off from light duty, with pay, for such rehabilitation and/or physician visits. Reasonable time has been interpreted by the company as not to exceed 11/2 hours. For example: The only time available to see my doctor is at 8A.M. and I’m scheduled for light duty at 8 A.M. I would go to my doctor’s appointment and would need to be to my light duty job by 9:30 A.M. and would get paid for this time. It is necessary to log your time spent at therapy or at the doctor on your daily time card or you won’t receive pay for this time.

 6.  What happens if the department I’m working light duty in is closed in observance of a holiday? Am I paid?

• You are paid only if you perform light duty on the holiday. It is necessary to notify the light duty coordinator if your department will be closed and you wish to be assigned in another department. You may elect to not work the holiday and not be paid.

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What about my benefits while on OJI?

1.  Q: Can I use my travel benefits while I’m on an OJI?

• Flight privileges for Employee’s and Dependants continue on US Airways for leaves of 6 months duration or less.  Leaves of more than 6 months duration will result in suspension of the Employee’s pass travel privileges.  Dependants will continue to be eligible.  You may apply for emergency travel but requests may not be submitted earlier than 24 hours of travel.  While on any leave of absence flight privileges are suspended on all other carriers.

 2.  Can I travel while working Light Duty?

• While you are working Light Duty you are considered on Active Status and retain all of your flight privileges.

 3.  Am I entitled to continue my insurance benefits while on OJI?

• All insurance benefits shall continue to be available to the Flight Attendant on the same basis as an active Flight Attendant for a maximum of 24 months.  Time periods during which a Flight Attendant performs a light duty assignment will not be regarded as part of this 24-month period. (SEC 17-5 E. 1.)

 4.  How are my insurance premiums paid while on OJI?

• You will receive information via US Mail from PayFlex giving you options for keeping your insurance premiums current.

 5.  Q:  How often am I paid when I’m on an OJI?

• You will be paid every 2 weeks from Hartford and your supplement from US Airways will be in your normally scheduled paycheck.

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