Claims Program

Workers' Compensation

The Commonwealth of Virginia and the Institute's (VIMS) Workers' Compensation Program protects all state employees from financial loss due to medical expenses, lost wages, and other costs associated with a covered injury/illness arising out of and in the course and scope of employment, subject to the provisions of the Workers' Compensation Act. Employees who have suffered a covered on-the-job injury are provided access to quality medical treatment and rehabilitation services, all designed to bring the employee to full recovery, returning him/her to good health and gainful employment.

Based on recommendations and several evaluation studies conducted by the Department of Planning and Budget, the claims and cost containment program was developed and is administered by Managed Care Innovations (MCI). An Ombudsman and Quality Assurance Program are in place to assist employees with service issues.

The Virginia Institute of Marine Science is responsible for providing employees with a panel of three physicians from which to choose medical treatment. When a work-related injury/illness occurs, the following rules apply:

  1. In the event of a work-related medical emergency, the employee or employee's supervisor should seek immediate emergency medical help.
  2. When any work-related injury/illness does occur, it must be reported immediately when possible, or within 24 hours, to Libby MacDonald, the Workers' Compensation Representative for VIMS, at ext. 7201. If Libby MacDonald is not available, please contact Eric Fidler in the Safety Office at ext. 7322. The employee is responsible for reporting all minor incidents, including insect bites, even if medical treatment is not sought. The employee should also make their supervisor aware of the incident. After the claim has been forwarded to MCI, an investigation will be performed for safety prevention and claim compensability.
  3. Until the claim has been accepted as compensible by MCI, the medical bills are considered the responsibility of the injured worker.
  4. Under the Virginia Workers' Compensation Law, it is mandatory that all VIMS employees requiring treatment for a work-related illness or injury choose a physician or medical facility from a panel specified by the employer. The employee must inform the attending physician that this is a Workers' Compensation Claim administered for the Commonwealth by MCI. Non-compliance with this requirement shifts the cost of medical care to the employee.
  5. Absence from work as a result of the injury or illness must be documented, signed and dated by the attending physician. It must include dates of absence, date and time of return to work and details of any restrictions of duty. A copy must be provided to Libby MacDonald.
  6. It is the policy of William & Mary and VIMS to retain our valued employees, and achieve a safe and timely return to the workforce of employees who have been injured or taken ill due to a work-related incident. For this purpose, the Workers' Compensation Disability Management Program provides training for state agencies in disability management, and how to develop a Return to Work Program that will assure, whenever possible, a rapid return to work for injured employees, using a team approach to identify job duties which can be safely performed by the injured employee during the recovery period.