Alabama Administrative Code › Title 355 - STATE OF ALABAMA DEPARTMENT OF FINANCE › Chapter 355-8-1 - DIVISION OF RISK MANAGEMENT › Section 355-8-1-.03 - Benefits For Accidental Occupational Injuries

Current through Register Vol. 42, No. 9, June 28, 2024
(a) Compensation, according to the schedules
			 hereinafter contained, shall be paid by the employer, in every case of personal
			 injury or death of his or her employee caused by an accident arising out of and
			 in the course of his or her employment, without regard to any question of
			 negligence. Notwithstanding the foregoing, no benefits shall be allowed for an
			 injury or death caused by the willful misconduct of the employee, by the
			 employee's intention to bring about the injury or death of himself or herself
			 or of another, his or her willful failure or willful refusal to use safety
			 appliances provided by the employer or by an accident due to the injured
			 employee being intoxicated from the use of alcohol or being impaired by illegal
			 drugs.
(b) A positive drug test
			 conducted and evaluated pursuant to standards adopted for drug testing by the
			 U.S. Department of Transportation in  49 C.F.R. Part 40  shall be a rebuttable
			 presumption of impairment resulting from the use of illegal drugs. No benefits
			 shall be allowed if the employee refuses to submit to or cooperate with a blood
			 or urine test as set forth above after the accident after being warned in
			 writing by the employer that such refusal would forfeit the employee's right to
			 recover benefits under this chapter.
(c) No benefits shall be allowed if, during
			 the time of employment or in the course of entering into employment or at the
			 time of receiving notice of the removal of conditions from a conditional offer
			 of employment, the employee knowingly and falsely misrepresents in writing his
			 or her physical or mental condition and the condition is aggravated or
			 reinjured in an accident arising out of and in the course of his or her
			 employment. Willful failure of an employee to abide by physician-directed
			 physical activity restrictions arising from a covered injury, or willful
			 misrepresentation by an employee of his or her physical activities while under
			 physical activity restriction, will result in termination of
			 benefits.
(d) In the event an
			 injury covered by this program results in temporary or permanent total
			 disability the employee or the employee's representative must elect in writing
			 either to utilize accumulated sick and/or annual leave or to accept employee
			 injury compensation benefits as set forth in
Rule .04
. Such
			 election shall be made by the employee and received by DORM or its agent before
			 any benefits are paid. An employee who elects to utilize sick and/or annual
			 leave may later change his election in writing prospectively but not
			 retroactively. When the employer no longer pays the employer's portion of
			 retirement or the employee's health insurance premium, said portion will be
			 paid by DORM or its agent directly to the employee as set forth in
Rule
			 04
.
(e) DORM or its agent
			 may direct an injured employee to specific medical providers, and shall monitor
			 the progress of the injured employee to encourage and facilitate his/her return
			 to work. The injured employee must cooperate with DORM or its agent; failure to
			 cooperate will result in termination of benefits.
(f) All of an employee's medical costs which
			 are directly attributable to injuries by an accident arising out of and in the
			 course of employment will be paid by DORM or its agent.
(g) For the purposes or this article and
			 Article 3 of this program, minors shall have the same power to contract, make
			 settlements and receive compensation as adult employees.
(h) For fiscal year 1995-96 and thereafter,
			 the Departments of Transportation and Public Safety will pay benefits through
			 and will be subject to the SEICTF rules for injuries occurring on or after
			 October 1, 1995.
(i) The employer
			 and employee may settle all matters of benefits, whether involving
			 compensation, medical payments, or rehabilitation, and all questions arising
			 under this program between themselves, and every settlement shall be in amount
			 the same as the amounts or benefits stipulated in these rules. No settlement
			 for an amount less than the amounts or benefits stipulated in these rules shall
			 be valid for any purpose, unless the Review Board determines that it is for the
			 best interest of the employee or the employee's dependent to accept a lesser
			 sum and approves the settlement. The Review Board shall not approve any
			 settlement unless and until it has first made inquiry into the merits of a
			 claimant's claim and the Review Board may hold a hearing thereon.
(j) An agency, department, board or
			 commission may, with the approval of the Risk Manager and upon payment of the
			 assessed costs, elect to cover employees as defined by this program subject to
			 the following limitation: SEICTF wage replacement benefits, defined in this
			 program as "compensation," paid to a contract employee, combined with salary
			 payments made to the contract employee pursuant to the contract, may not exceed
			 the total amount payable to the contract employee under the terms of the
			 employment contract.
P. Maddock
Statutory Authority:
Code of Ala.
				  1975
, §§
										36-29A-1,
et seq
.