Employee and Retiree Service Center → Employees → Leave information → Worker's Compensation Leave

Workers' Compensation  Leave

Workers’ compensation is the largest and oldest of the government insurance programs. Workers’ compensation offers medical coverage, as well as lost wages protection to employees for accidental injuries arising out of, and in the course of, employment. The law provides for 66 2/3 of average weekly wages to be paid to an employee once a claim for work-related injuries has been accepted.

At MCPS, the employee can choose to use an in-network physician for medical care and receive workers’ compensation leave at 100 percent of their average weekly wages up to one year. If the employee elects to be treated by a physician who is outside the network of preferred providers, the employee will receive the state-mandated 66 2/3 wages and may supplement that amount with their own leave (subject to availability).

When an MCPS employee is injured at work, the employee must inform his or her supervisor, who then contacts CorVel Corporation–the MCPS claims administrator.

Once CorVel Corporation receives information about the injury, they will mail you a Notice of Employee's Claim form for you to complete and return. A claims adjuster at CorVel Corporation will then review the incident and determine compensability or eligibility for workers’ compensation benefits. Once the claim is determined compensable, CorVel Corporation and the ERSC Leave Administration team will work with the employee to ensure benefit continuation until the employee is able to return to work.

If an employee will need time away from work, the employee will be required to submit two forms, MCPS Form 430-1: Leave Request along with MCPS Form 440-35: Certification of Physician or Health Care Provider, to his or her supervisor.

When completing the Leave Request form, the “From” and “To” dates sections must be completed. The initial “From” date will be the first date of lost time; and the “To” date will be the date the employee is medically cleared to return to work, or the date of the next physical evaluation by the employee’s treating doctor, if the return to work date is unknown.

The employee must continue submitting Leave Request and Certification of Physician or Health Care Provider forms until he/she is cleared to return to work. In addition, the employee must to keep all scheduled medical appointments. Failure to do so may hold up processing of the employee’s workers’ compensation benefits.

The determination of when an employee is able to return to work may take an unpredictable length of time, based primarily upon the extent of the employee’s injuries, and the requirements of their position with MCPS.

It is the goal of MCPS and CorVel Corporation to return the employee to work. Prior to returning to work, the employee must have the physician complete MCPS Form 440-40: Return to Work Evaluation, ensuring that the employee is able to resume his/her position with MCPS.

If you have been injured and filed a claim, and would like to access the names and/or addresses of in-network doctors and/or urgent care centers, please visit the Montgomery County Government Self-Insurance Program (MCSIP) workers' compensation, liability and property programs web site at: http://mcsip.org