11.02.03.08

.08 Work Injury Leave.

A. Definition.

(1) In this regulation, "injury" means an accidental personal injury occurring during the performance of an employee's actual job duties.

(2) "Injury" does not include occupational diseases.

B. Work injury leave with sick pay is leave that is allotted to an employee who, in the actual performance of the employee's job duties, sustains an injury which is determined to be compensable according to the Maryland Workers' Compensation Law, Labor and Employment Article, §§9-101—9-1201, Annotated Code of Maryland.

C. The injured employee or someone on the employee's behalf shall provide notice of the injury to the employee's appointing authority or the appointing authority's designee immediately after the injury occurs.

D. Work injury leave with sick pay may be allotted only if the following conditions are met:

(1) The injury occurred in the actual performance of the employee's job duties;

(2) The injury is determined to be compensable under the Maryland Workers' Compensation Law, Labor and Employment Article, § 9-101—9-1201, Annotated Code of Maryland;

(3) A physician verifies the employee's injury and inability to work; and

(4) The Department Medical Advisor verifies the medical necessity and specifies the duration of the employee's absence from work.

E. Allotment. Starting with the first full workday, work injury leave with sick pay may be provisionally allotted pending a determination of compensability by the Workers' Compensation Commission or, in the absence of a Workers' Compensation Commission order, by the Injured Workers' Insurance Fund.

F. The injured employee's appointing authority or the appointing authority's designee shall file an Employer's First Report of Injury with the Injured Workers' Insurance Fund, the Workers' Compensation Commission, and the Division of Labor and Industry immediately after receipt of the notice of the injury as set forth in §C of this regulation.

G. If the Workers' Compensation Commission determines the injury to be noncompensable or, in the absence of a determination by the Workers' Compensation Commission, the Injured Workers' Insurance Fund determines the injury to be noncompensable, then work injury leave with sick pay provisionally allotted shall be rescinded and the employee's accumulated leave balance shall be adjusted to cover that period of time.

H. Rate of Payment.

(1) Work injury leave with sick pay is paid at the rate of 66 2/3 percent of the employee's gross pay starting with the first full workday.

(2) For work injuries occurring on or before June 30, 1994, that are compensable under this regulation, work injury leave with sick pay is paid at the rate of 70 percent of the employee's gross pay.

(3) The rates set forth in §H(1) and (2) of this regulation may be adjusted to conform to any Internal Revenue Service rulings or judicial decisions.

(4) Payment for work injury leave constitutes a separate benefit on account of an accidental personal injury occurring during the performance of an employee's actual job duties and is not a continuation of salary.

I. The Department's Medical Advisor is responsible for evaluating the employee's medical claim and making an initial determination as to approval within 10 workdays of the employee's injury. In making this evaluation, the Department Medical Advisor may require the employee to submit to a medical examination. The Department Medical Advisor shall file a report stating the findings and conclusions with the appointing authority or the appointing authority's designee and the Injured Workers' Insurance Fund.

J. Requests for work injury leave may not be granted if the employee refuses to submit to a medical examination.

K. The Injured Workers' Insurance Fund shall determine whether the claim is compensable under Maryland Workers' Compensation Law within 30 calendar days after the Injured Workers' Insurance Fund receives the employer's report of injury.

L. Acceptance of work injury leave constitutes an agreement to repay the Department for all work injury leave allotted if the injury is determined to be noncompensable as specified in §G of this regulation. This agreement remains in force upon separation from the Department.

M. Acceptance of work injury leave constitutes an agreement by the employee that the Department, after notice to the injured employee, has the exclusive right of subrogation to the rights of the injured employee against any third person who may have caused the compensable injury to the extent of the compensation paid or owed to the injured employee under this regulation.

N. Exhaustion of Work Injury Leave.

(1) After work injury leave has been exhausted and an employee is receiving temporary total benefits, the employee may apply for a leave of absence—illness, as specified in Regulation .12D of this chapter.

(2) During a period of leave of absence—illness granted under this section, the Department shall pay the employee's portion as well as the State's subsidy for health care coverage for the first 60 workdays and the State's subsidy only for up to a total of 2 years, including the original 60 workdays.

(3) An employee on leave of absence—illness shall provide continuing medical documentation to the Department.

(4) The Department may request a review of the employee's medical condition by the Medical Advisor.

(5) An employee may not be eligible for health care coverage as provided in §N(1) of this regulation if the employee refuses to submit to a medical examination requested by the Medical Advisor.

O. An injured employee may be entitled to temporary total benefits for loss of wages according to the Workers' Compensation Law only after all available work injury leave has been used.

P. Medical and hospital expenses may be paid on behalf of an injured employee who is on work injury leave or leave with pay, according to the Workers' Compensation Law.

Q. Work injury leave may be used for continuing treatment for the injury for which the leave was granted, and may be used only for time taken within an employee's scheduled shift, including reasonable travel time.

R. Work injury leave terminates on a date specified by the Department's Medical Advisor. Work injury leave may not extend beyond 1 year from the date of injury.