Employee Information For Injury on Duty
ALL accidents or injuries that occur while on duty are to be
reported IMMEDIATELY to your supervisor
ALL MATERIAL CONTAINED HEREIN IS FOR INFORMATIONAL
PURPOSES ONLY AND IS SUBJECT TO CHANGE AT ANY TIME
IF YOU HAVE AN ACCIDENT OR ARE INJURED ON DUTY
- Notify your supervisor immediately.
- Call into IVR and indicate you are IOD.
- Only one (1) notification to the medical call-in line is required. Some departments may require additional notifications—PLEASE CHECK WITH YOUR DEPARTMENT.
- You will be carried IOD until you are returned to work or your claim is denied.
- Contact the Pension Board (a separate unit) at 312-603-1200 regarding additional benefits you may be eligible for.
DOCUMENTATION REQUIRED FOR ALL INJURY ON DUTY CLAIMS
- ALL employees claiming an Injury on Duty shall complete the following and give it to his or her immediate supervisor:
- Employee’s Accident Report; and
- Employee’s Authorization to Release Medical Information
- The immediate supervisor shall investigate the allegation immediately and see that the following are completed with in 24 hours of the reported IOD:
- Supervisor’s Investigation Report;
- Witness Statement Report; and
- Other supporting data, if any
- Upon receipt of the above-mentioned documents, the immediate supervisor shall give the documents to the Unit Supervisor for immediate distribution to the Sheriff’s Safety Office. If possible, all documents should be scanned and emailed to email@example.com
- It is the employee’s responsibility to follow up to see that all medical documentation is forwarded to:
- Cook County Department of Risk Management,
Workers’ Compensation Division
Cook County Building, Rm. # 1072,
118 North Clark Street, Chicago, IL, 60602
- For DOC employees with last names A-M, call 312-603-6376
- For DOC employees with last names N-Z, call 312-603-6274
- Court Services & Police, call 312-603-3568
- Cook County Department of Risk Management,
RETURN TO WORK AUTHORIZATION
- Prior to an employee returning to work from a Short-term (less than forty (40) consecutive hours off work) Absence as a result of a duty injury and/or Medical Emergency, the employee shall obtain an original medical statement from his/her respective treating physician, on the physician’s official letterhead or script. The medical statement must include all of the following:
- The start date of the duty injury/Medical Emergency;
- The date the treating physician has identified the employee may
return to work;
- The employee’s ability to return to work Full Duty (no restrictions);
- Physician’s name, medical license number and date; and
- Physician’s original signature.
- If the medical statement indicates medical restrictions, the employee must make an appointment with the Cook County Medical Unit at 312.603.4135 and then report to the Cook County Medical Unit located at 118 N. Clark St., Room 849, Chicago Illinois in order to obtain a Physician’s Approval to Return to Work form. Upon reporting to the Cook County Medical Unit, the employee must submit a comprehensive diagnostic medical statement which indicates any medical restrictions identified by the employee’s physician and which includes the date the physician has identified the employee may return to work. Upon receipt of the Physician’s Approval to Return to Work form, the employee must immediately report to the Sheriff’s Personnel Office, located in the Richard J. Daley Center, Room 702.
- If the medical statement is acceptable, Personnel shall provide the employee with a Release for Duty Authorization form. For duty injury releases, Personnel shall forward copies of the Release for Duty Authorization and full duty physician’s note to the Sheriff’s Safety Office and to Cook County Risk Management.
- Any employees absent from a duty injury and/or Medical Emergency for forty (40) consecutive hours or more must report to the Cook County Medical Unit for clearance before reporting to their respective Personnel Office, following the return to work procedures as noted in SEAM Article T Personnel Policies and Procedures, Section IV.I and compliance with Cook County Ordinances and any applicable Collective Bargaining Agreements
TEMPORARY TOTAL DISABILITY FOR INJURY ON DUTY (IOD)
Employees are paid Temporary Total Disability as follows:
- 66 2/3% of salary by County Risk Management.
- Additional benefits of 8 1/3% from the Pension Board.
- If time lost from IOD is three (3) days or less, County Risk Management makes no payment to the employee.
- The pension Board pays 75%
- If time lost from IOD is more than three (3) but less than fourteen (14) days:
- The first three (3) days—75% is paid by the Pension Board; and
- The rest of the days are paid by County Risk Management at 66 2/3% and 8 1/3% from the Pension Board.
- If time lost from IOD is fourteen (14) days or more:
- County Risk Management pays 66 2/3% from the first day; and
- The Pension Board pays 8 1/3%.
If any Sheriff’s Office employees have any questions regarding Injury on Duty Claim procedures, he or she may email firstname.lastname@example.org
FILING A FALSE OR FRAUDULENT WORKERS’ COMPENSATION CLAIM IS A CRIME
Workers’ Compensation Act—Unlawful Acts; Penalties
820 ILCS 305/25.5(a)(1-2)
(a) It is unlawful for any person, company, corporation, insurance carrier, healthcare provider, or other entity to:
(1) Intentionally present or cause to be presented any false or fraudulent claim for the payment of any workers compensations benefits
(2) Intentionally make or cause to be made any false or fraudulent material statement or material representation for the purpose of obtaining or denying any workers’ compensation benefits.
Report suspected fraud to the Workers’ Compensation Fraud Unit anonymously by email at: DOI.email@example.com (or ) call toll-free at 877-923-8648
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