City of Charlottesville, VA Fire
|Chapter:||V - Personnel Policies and Procedures|
|Subject:||Off Duty Employment|
A. To establish uniform guidelines regarding the reporting of injuries and/or illnesses which are suffered by Fire Department members in the course of or as a result of their official duties.
B. To establish Fire Department policy in relation to on-duty injury and/or illness.
A. All injuries and/or illnesses occurring to Fire Department members, arising from the performance of their official duties, shall be reported on Workmen's Compensation Form #3 and signed by the Officer-In-Charge within twenty-four (24) hours of the injury. Additional forms which must be completed are the: Supervisor's Investigation Report, Authorization for Medical Treatment Form, and Light Duty Verification Form (CFD Form #74).
B. The on-duty Fire Battalion Chief shall be notified immediately of on-duty injuries and/or illnesses occurring to Fire Suppression personnel.
C. The Deputy Fire Chief shall be notified as soon as possible if any member of the Fire Department suffers an on-duty injury and/or illness that requires a person to be relieved from duty.
D. Members suffering on-duty injuries and/or illnesses which require medical treatment at a medical facility shall be treated at one of the City of Charlottesville's designated medical treatment facilities. If the doctors are unavailable for treatment of the employee or the injury needs immediate emergency care, then the employee may report to the emergency room of the closest medical facility.
E. Regardless of where the medical treatment is obtained, the employee must have the treating physician fill out the Authorization for Medical Treatment Form and a Light Duty Verification Form, CFD From #74. Return these forms with the initial report to the Executive Secretary.
F. Members returning to work after an injury and/or illness must complete and submit to their Fire Battalion Chief a City of Charlottesville Leave Request Form (CHPER 4). Injury leave is recorded hour for hour.
To cover those policies and procedures concerning work related injuries and/or illnesses.
A. All members are responsible to operate in a safe manner, following all safety guidelines and procedures as well as using safety equipment provided by the Department.
B. All members are responsible to report any on-duty injury or illness to their direct supervisor as soon as possible.
C. All supervisors are responsible to make sure that those members who are injured and/or ill and who are in need of medical attention, receive medical attention promptly.
D. All supervisors are responsible to insure that the required forms, reports and log entries are made concerning injured and/or ill members.
A list of approved medical treatment facilities officially designated for treatment of injuries and/or illnesses incurred by City employees on the job is available in the Executive Secretary's Office and/or the City of Charlottesville Personnel Department.
A. When a Fire Department member incurs an injury and/or illness in the line of duty, said member shall report the incident as soon as possible to his/her supervisor.
B. The member must complete and submit a Workmen's Compensation Form #3 to the Officer-In-Charge within twenty-four (24) hours of the injury and/or illness.
C. The Officer-In-Charge will investigate the incident immediately and will write a Supervisors Investigation Report - Yeager and Company Form Y-50 and attach same to the Workmen's Compensation Form.
D. The supervisor shall make note of the injury and/or illness in the Journal relating to the member's name, a brief description of the injury and the current disposition of the case.
E. If the injury and/or illness occurs while operating on an alarm, this shall be noted in the Incident Report.
F. The Deputy Fire Chief and the on-duty Fire Battalion Chief shall be notified as soon as possible whenever a Fire Department member is injured.
G. Members requiring treatment at a medical facility shall receive said treatment at a City designated facility in accordance with current policy. (See l0.02)
H. Members shall identify themselves as a City of Charlottesville employee at the medical facility.
H. Members receiving medical treatment at a medical facility must have the attending physician complete the Authorization for Medical Treatment Form and a Light Duty Verification Form. These forms must be attached to the Workman's Compensation Form and the Supervisor's Investigation Report.
I. After receiving initial medical care following an injury and/ or illness, the member shall bring back to the supervisor a completed Light Duty Verification Form which addresses ability to work. Should the member be absent after the doctor indicates ability to do restricted or regular work, or should he/she decline a light duty assignment, that person will be referred back to the treating physician for another examination and another determination of ability to work. If both documents indicate ability to work, the member will not be paid for the period of absence.
J. If members are unable (due to their injuries and/or illness) to fill out the Workmen's Compensation Form, their immediate Supervisor shall complete this form and make note of this action next to the supervisors signature.
K. Members who have returned to work after an illness and/or injury shall complete and submit a City of Charlottesville Leave Request Form in accordance with the policy established in this manual (See l-V-6 Leave of Absence).
L. Any employee who has incurred an injury which is compensable under the Workmen's Compensation Act shall receive injury leave for the time missed.
M. An employee who is placed on injury leave may remain in that status as long as there is satisfactory medical evidence that he/she is unable to perform his/her regular duties, is unable to perform any other work that is then available in the City service or until it has been determined that the employee should be retired or terminated.
N. As long as an employee is on injury leave, he/she shall receive the same net pay received before the injury, according to the following formula: the pay shall consist of Workmen's Compensation (not taxed) and an injury leave payment, taxed like a salary. The amount of the injury leave payment will be gross pay minus Workmen's Compensation. The employee's rate of pay will be subject to the same non-performance related changes as other City employees.
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