University Health Services

Lost Time 

When an injury results in time away from work, an employee receives Temporary Disability (TD) benefits for lost wages only if the physician certifies that the injury caused the employee to lose time from work and Sedgwick accepts the employee’s claim for Workers’ Compensation benefits. 

If the claim is approved by Sedgwick, these benefits are not paid for the first three days (waiting period) the employee is unable to work. If the employee is hospitalized as an inpatient or unable to work for more than 14 days, the three-day waiting period does not apply. 

Option Letter and Option Form

Once an injured employee is away from work for more than three days, Sedgwick will issue a check for Temporary Disability (TD) lost wages. This may be for lost wages for the day of the medical exam if the claim is pending or for lost wages if the claim is accepted. The employee also will receive in the mail an Option Letter and Option Form from Disability Management.

The Option Letter addresses the employee’s concerns regarding pay and employment. It offers the employee three options for receiving income, as outlined in the below table. The Option Form must be completed and returned to Disability Management within ten days from the date of the Option Letter. Should the employee fail to respond to this notice, Option 2 (using sick leave only) is automatically selected.

UC Berkeley’s Pay Process

Temporary Disability (TD) checks are mailed directly from Sedgwick to an injured worker’s home address. The employee’s department will provide normal salary checks to an employee who is using sick and/or vacation leave. Sedgwick will send paperwork to instruct Payroll to deduct the employee’s Temporary Disability (TD) amount from the employee’s paycheck.

Status Report and Instruction Sheet
Sedgwick notifies the employee and Disability Management of the claim status. Disability Management then notifies departments using the Workers’ Compensation Status Instruction Sheet. This sheet also contains information regarding the employee’s current pay status including the option chosen. The Workers’ Compensation Status Report is sent once a month until Temporary Disability (TD) ends. This report contains employee payroll and personnel information, Temporary Disability (TD) check dates, and amounts.

State Benefits/University Supplemental Benefits

State Mandated Benefits:

Medical Care
Employees are entitled to reasonable medical treatment to cure or relieve work-related injuries and illnesses.

Temporary Disability 
Temporary Disability (TD) benefits include compensation for lost wages for up to 66 2/3% of the average weekly salary up to statutory maximums until the employee’s medical condition is resolved or is determined to have reached Maximum Medical Improvement (MMI).

Permanent Disability 
Permanent Disability (PD) is any lasting disability from an employee's work injury or illness that affects the employee's ability to earn a living.  If an injury or illness results in PD, the employee is entitled to PD benefits as established by state law. 

Death Benefits
Death benefits are payments to a spouse, children, or other dependents if an employee dies from a work-related injury or illness.  These benefits are established by state law. 

Supplemental Job Displacement Voucher
Voucher for retraining/skills enhancement if the employee is unable to return to work.

University Supplemental Benefits: 

In addition to the state-mandated benefits, the University provides supplemental benefits described below: 

Supplemental Leave
An employee may remain on 100% of normal salary by using his/her sick leave and/or vacation leave to supplement the TD check(s). The employee receives one check from Sedgwick for TD payments and another check from the University. The department is credited with the amount of the TD check(s) by the campus Payroll Office. This will show on the Department’s Distribution of Payroll Expenses (PPP 5302) as WCA (Workers’ Compensation Adjustment).  

Extended Sick Leave (ESL) 

An employee may remain on 80% of normal salary as long as the employee continues to receive TD payments for up to 26 weeks after exhausting his/her sick leave. The employee receives one check from Sedgwick for TD payments and another check from the University. The salary supplement is paid by the department. The department is credited with the amount of the TD check(s) by the campus Payroll Office. This will show on the Department’s Distribution of Payroll Expense (PPP 5302) as WCA (Workers’ Compensation Adjustment).

Since they do not accrue sick leave, employees with less than a 50% appointment are not eligible for either Supplemental Leave or Extended Sick Leave.  

Lincoln Financial Group - Short-Term Disability (University Paid) & Supplemental Disability (Employee Paid) Plans 

Short-Term Disability (University Paid) 

This benefit does not apply for work-related disabilities unless the Workers' Compensation claim has been denied or is on delay status.  

Supplemental Disability (Employee Paid)

This benefit could supplement Workers’ Compensation temporary disability after the Extended Sick Leave benefit has been exhausted.

Coordination of Benefits  

Coordinating these benefits and making the appropriate calculations can be complicated and confusing. Disability Management can assist department personnel and the employee during this process.  

Workers' Compensation Supplement Benefit Options: