Workers' Compensation Temporary Disability benefits and UC benefits

Pay and benefits while you are on an approved medical leave

If I am off work, am I entitled to benefits and who do I contact about these benefits?

While you are off work on an approved medical leave and recovering from your injury or illness, you will receive Temporary Disability (TD) payments from Sedgwick CMS.

Temporary Disability partially replaces lost wages. It is always less than 100% of your regular earnings. The amount of the TD benefit depends on your average weekly earnings at the time you were injured and upon maximums set by law. For most employees, TD pays approximately 2/3 of your gross earnings.

How will I be paid while I am off of work due to a disability?

If your claim is ACCEPTED by Sedgwick:

  • Sedgwick will send you a disability (TD) check every two weeks.
  • You can use your Sick Leave (Option A) or your Sick Leave and Vacation Leave (Option B) to supplement the TD check up to 100% of your regular earnings. Because TD is partially replacing your lost wages, you do not need to use as much Sick Leave or Vacation Leave as you usually would. How much you use will depend upon how much you receive in TD. Fill out the Sick Leave/Vacation Leave Authorization Form, which is sent to you by DMS.
  • If your Sick Leave, or your Sick Leave and Vacation Leave runs out and you are still disabled, you may be eligible for Extended Sick Leave benefits which will supplement your TD checks up to 80% of your wages plus shift differential for a maximum of twenty-six (26) weeks. In order to be eligible for ESL, you must have elected either Option A or Option B on the Sick Leave/Vacation Leave Authorization Form.

Here is the formula: ESL = (.80)*(Regular Earnings) - TD

For example:

If you usually earn $3,000 per month, and Sedgwick pays you $2,000 in TD for that month, then the University will calculate the Extended Sick Leave owed to you as follows:

80% of Regular Earnings = (.80)*(3,000) = $2,400
TD paid by Sedgwick = $2,000
ESL owed = $2,400 - $2,000 = $400

For that month, you will receive $2,000 in TD from Sedgwick, and $400 in ESL from the University. Your total income will therefore be $2,400 which is 80% of your regular earnings of $3,000.

  • If Extended Sick Leave benefits run out, and you are still disabled, call the UCPath Center at (855) 982-7284. You may be eligible for UC Supplemental Disability benefits through Liberty Mutual to supplement your TD check, and you may be eligible to have the full cost of your Medical insurance premium paid by the University's Contingency Fund. You should also contact the Payroll Office to make arrangements to pay the premiums for your Dental and Optical insurance.
  • TD payments end when you return to work or your medical condition stabilizes (e.g. you are determined Permanent and Stationary)

If your claim is DELAYED by Sedgwick CMS:

  • Call the UCPath Center at (855) 982-7284.
  • You may be eligible for UC Supplemental Disability payments through Liberty Mutual until Sedgwick CMS makes a decision on your claim.

If your claim is DENIED by Sedgwick CMS:

  • Call the UCPath Center at (855) 982-7284.
  • You may be eligible for UC Supplemental Disability through Liberty Mutual.

For more detailed information, see PPSM 44 (pdf), your Collective Bargaining Agreement, or the DMS Worker's Compensation Payroll Process website.

How will I be paid if I am disabled part-time?

You may be entitled to Temporary Partial Disability (TPD) payments from Sedgwick CMS. If so, this will pay a portion of your wage-loss while working on a part-time schedule:

  1. The University will pay you for the time you work.
  2. If eligible, Sedgwick will pay you TPD benefits.
  3. Sick Leave, or Sick Leave and Vacation, can supplement the above up to 100%.
  4. Afterwards, Extended Sick Leave can supplement the above up to 80%.
  5. Afterwards, UC Supplemental Disability may supplement the above. Call the Benefits & Financial Planning office at (415) 476-1400 to see if you are eligible.

For more detailed information, see PPSM 44 (pdf), your Collective Bargaining Agreement, or the DMS Worker's Compensation Payroll Process website.

How do I fill out my timesheet?

You fill out your timesheet, indicating the hours you worked, and sick or vacation leave used outside of the time you were off for your injury.

Then, each month, your department's Payroll Processor will reconcile your timesheet, based on any workers' compensation payments made by Sedgwick CMS.

If your claim has been accepted by Sedgwick, and you elected to use both Sick Leave and Vacation Leave to supplement the workers' compensation payments made by Sedgwick, you can begin to use your Vacation Leave hours once your Sick Leave hours run out.

If your claim has been delayed by Sedgwick, you are not automatically permitted to use your Vacation Leave. You must obtain the approval of your department.

If your claim has been denied by Sedgwick, follow your department's usual procedures.

Do I use Sick Leave to attend medical visits?

You fill out your timesheet as you normally would, using hours of Sick Leave for your lost time to attend medical appointments. TD is paid during periods of time you are medically precluded from working, and attendance at a doctor's appointment does not constitute a medical preclusion from work.

Do I use Sick Leave for the three day waiting period?

Yes. Temporary Disability is usually not paid for the first three days of disability.

You must use your Sick Leave. If you do not have sufficient Sick Leave to cover the entire three days, and if you are eligible for Extended Sick Leave, then Extended Sick Leave will apply to the remainder of the three days, and will pay you at 80% of your regular earnings, even though Temporary Disability is not being paid.

Will I continue to accrue Sick Leave and Vacation Leave while off work?

While using Sick and/or Vacation Leave to supplement Temporary Disability payments:

  • You continue to accrue Sick Leave and Vacation Leave at your regular rate.
  • The accruals are credited to you immediately, and you can use them as soon as you accrue them.
  • If you separate from the University without returning to work:
  • Vacation Leave accrued in this period is paid to you.
  • Sick Leave accrued in this period is not paid to you.

While using Extended Sick Leave to supplement Temporary Disability payments:

  • You continue to accrue Sick Leave and Vacation Leave at your regular rate.
  • The accruals are credited to you upon your return to work, and you can use them after you return to work.
  • If you separate from the University without returning to work:
  • Vacation Leave accrued in this period is paid to you.
  • Sick Leave accrued in this period is not paid to you.

After Extended Sick Leave runs out, while you are on Leave of Absence Without Pay and still receiving Temporary Disability payments:

  • You continue to accrue Sick Leave and Vacation Leave at your regular rate.
  • The accruals are credited to you upon your return to work, and you can use them after you return to work.
  • If you separate from the University without returning to work:
  • Vacation Leave accrued in this period not paid to you.
  • Sick Leave accrued in this period is not paid to you.

How will being on Temporary Disability affect my retirement service credit?

While using Sick Leave and/or Vacation Leave to supplement the Temporary Disability payments, you continue to earn retirement service credit at your regular rate.

While using Extended Sick Leave to supplement the Temporary Disability payments, you earn retirement service credit at 80% of your regular rate.

After Extended Sick Leave runs out, while you are on Leave of Absence Without Pay, you do not earn retirement service credit.

How will my Medical, Dental, and Optical insurance premiums be paid?

While Sick and/or Vacation Leave are supplementing the TD checks from Sedgwick, all contributions to your Medical, Dental, and Optical insurance premiums continue as usual.

While Extended Sick Leave is supplementing the TD checks from Sedgwick, all contributions to your Medical, Dental, and Optical insurance premiums continue as usual.

However, after the twenty-six (26) weeks of Extended Sick Leave runs out, your department will place you on Leave of Absence Without Pay, and alternate arrangements must be made to assure that payment of your Health insurance premiums continues. If you continue to be a University employee, continue to be disabled, and continue to receive workers' compensation Temporary Disability benefits from Sedgwick CMS, then:

  • Medical Premium:
    • The University will continue to pay its contribution to your Medical premium. In addition, the University will begin to pay that portion of your Medical premium that you were previously paying through deductions from your paycheck. In other words, the University will begin to pay the full cost of your Medical insurance premium.
  • Dental Premium:
    • You must call the Payroll Office and make arrangements to pay the full cost of your Dental premium, if you wish that insurance coverage to continue.
  • Optical Premium:
    • You must call the Payroll Office and make arrangements to pay the full cost of your Optical premium, if you wish that insurance coverage to continue.

What is the Contingency Fund?

The Contingency Fund is the fund the University uses to pay your portion of your Medical premium after Extended Sick Leave has run out.

The Contingency Fund is managed by the UC Office of the President. Each month your department writes a memorandum to the Benefits & Financial Planning department, who contact the Office of the President and request that your Medical premium be paid for another month.

If you have questions regarding the Contingency Fund, contact the Benefits department at (510) 987-0900.

Who do I contact about my insurance premiums and retirement service credit?

Contact the Benefits department at (510) 987-0900.