RECENT NEWS & ANNOUNCEMENTS
Department of Human Resources regulation require that all requests for vital records include the signature of the requestor and the proper fee.
Access to birth records is limited to:
1. the person named on the certificate
2. the parents shown on the birth record
3. an authorized legal guardian or agent
4. grandparents of the person named on the certificate
5. an adult child of the person named on the certificate
6. an adult sibling of the person named on the certificate
7. the spouse of the person named on the certificate
Required Information
The person requesting a certified copy of a birth record must provide all the information below, a signed request form, and a photocopy of your valid photo ID, such as: driver's license, state issued ID card, or employer issued photo ID.
Vital Records Request for Search of Birth Form
NORTH GEORGIA HEALTH DISTRICT
County Board of Health Personnel Policy #1701
Cherokee, Fannin, Gilmer, Murray, Pickens, Whitfield
WORKERS' COMPENSATION AND SPECIAL INJURY
RETURN-TO-WORK PROGRAM
EFFECTIVE DATE: March 1, 2007 RELEASE DATE: March 1, 2007
REFERENCES: State Law (O.C.G.A. §34-9-1 through §34-9-367 - Workers'
Compensation)
State Law (O.C.G.A. §45-7-9 - Special Injury)
Rules of the State Personnel Board - Rule 18 (Leave)
DHR Human Resource/Personnel Policy #1701
The County Board of Health (CBH) is concerned about the health and safety of all of its
employees. Supervisors should be alert to any situation which could result in potential
injury or illness to employees, patients, clients and customers. Employees are to
immediately bring any potentially unsafe or unhealthful working condition to the
attention of their supervisors for review and resolution.
When work-related injuries, illnesses or exposures to occupational disease occur, all
employees will be returned to work, whenever feasible, as quickly and safely as possible.
CBH has adopted a comprehensive RETURN-TO-WORK (RTW) Program to
accomplish this objective.
ELIGIBLE All full-time and part-time employees in classified and unclassified
EMPLOYEES positions, except for temporary and hourly employees who are
short-term or hired for a specific project or function, are eligible
for the Return-to-Work Program.
PROCEDURES Whenever a work-related injury, illness or exposure to
occupational disease occurs, the employee is to be given work
time to seek appropriate medical attention.
1. Medical treatment must be rendered by a Workers'
Compensation Panel physician, unless an emergency
situation exists. (See #1.4 of this section) Failure to
comply will result in non-payment of treatment by the
Department of Administrative Services (DOAS) Workers'
Compensation Program.
NOTE: A current OFFICIAL NOTICE, BILL OF
RIGHTS FOR THE INJURED WORKER,
WORKER'S COMPENSATION FRAUD
NOTICE and WORKERS' COMPENSATION
Policy #1701 Page 1 of 7
WORKERS' COMPENSATION AND SPECIAL INJURY RETURN-TO-WORK
PROGRAM (continued)
REPORTING INSTRUCTIONS MUST be
posted in prominent places at each work
location. To receive these documents, please
contact the District Personnel Office at
706/272-2342.
1.1 The employee should transport himself/herself, if
possible, or may choose to contact a friend or
relative for transportation.
1.2 If the injury/illness/exposure requires immediate
medical attention and transportation is not otherwise
available, the employee should be transported by
the supervisor or qualified designee. Time used to
transport the employee is considered work time.
NOTE: The driver must have a valid driver's license.
1.2.1 Where practicable, transportation should be
provided using a State vehicle.
1.2.2 If a State vehicle is not available, the
supervisor or designee may determine that it
is appropriate to use a personal vehicle to
transport the employee.
1.2.3 The supervisor or designee may be
reimbursed for mileage, parking fees and
other expenses incidental to the use of the
personal vehicle for such transportation.
1.2.4 It is the responsibility of the supervisor or
designee to ensure that any personal vehicle
used is insured against loss. The State does
not insure private vehicles, even when they
are used to conduct State business.
1.3 The employee, supervisor or designee is to present
the completed GEORGIA ACTIVITY ANALYSIS
Form (See Attachment #1) to the treating physician
for review after the initial examination of the
employee.
1.4 In the event of an emergency, appropriate medical
Policy #1701 Page 2 of 7
WORKERS' COMPENSATION AND SPECIAL INJURY RETURN-TO-WORK
PROGRAM (continued)
attention for the employee should be sought
immediately (e.g., call 911 or transport to an
emergency room). In an emergency situation,
treatment does not have to be provided by a
Workers' Comp physician. All follow-up care
must however, be provided by a Workers' Comp
physician (or an approved physician's referral).
1.5 If the employee is dissatisfied with the physician
assigned, the employee should contact their case
manager.
2. After ensuring that proper medical treatment has been
arranged, the supervisor or designee is to report all injuries,
illnesses and exposures to occupational disease that require
medical treatment or result in time lost from work through
the telephonic reporting system at 1-877-656-RISK (7475).
(See Attachment #2)
2.1 The report should be made immediately and in no
case more than 24 hours from the time the
supervisor or designee has knowledge of the
injuries, illnesses or exposures to occupational
disease.
NOTE: If the injuries, illnesses or exposures to
occupational disease do not require
medical treatment and do not result in lost
time from work, supervisors or designees
should complete a CBH INCIDENT
REPORT and retain for their records. (See
Attachment #3) Should the employee
require treatment or lose time away from
work at a later date, the claim should be
reported by calling the telephonic
reporting system.
3. A determination based on the GEORGIA ACTIVITY
ANALYSIS Form must be made by the treating physician
regarding the employee's ability to immediately return to
regular or modified duty.
Policy #1701 Page 3 of 7
WORKERS' COMPENSATION AND SPECIAL INJURY RETURN-TO-WORK
PROGRAM (continued)
3.1 If the physician is not able to release the employee
immediately to regular or modified duty, the
employee will not return to duty that day.
NOTE: The employee will not be charged leave for
the absence from work on the day of the
injury, illness or exposure to occupational
disease.
3.2 The supervisor and/or designee are to arrange
follow-up contact with the employee within 24
hours to check on the employee's well-being
and begin preparation for a TRANSITIONAL
EMPLOYMENT PLAN.
4. As soon as the employee is released to work activities, the
employee will be asked to meet with the supervisor to
develop a TRANSITIONAL EMPLOYMENT PLAN. (See
Attachment #4)
NOTE: Time spent by the employee in Transitional
Employment meetings will be considered
work time.
4.1 The plan will specify the following:
Start and end date of transitional duty;
Specific duties to be performed;
Signatures of both the supervisor and
injured/ill employee; and,
Next review date.
4.2 A DETAILED JOB ANALYSIS Form may be
completed for review by the treating physician as
determined necessary or appropriate. (See
Attachment #5)
4.3 Responsibilities and duties identified for the
employee must be of value to the Agency while
ensuring the employee's safety at all times.
Policy #1701 Page 4 of 7
WORKERS' COMPENSATION AND SPECIAL INJURY RETURN-TO-WORK
PROGRAM (continued)
4.4 If possible, tasks should be similar to the
employee's regular work and within the same
functional unit to help the employee maintain
relationships with co-workers. If this is not
feasible, however, other alternatives should be
considered utilizing the following guidelines:
4.4.1 Focus on unique skills and abilities of the
employee,
4.4.2 Consider duties outside of the employee's
regular work unit,
4.4.3 Provide tasks which add value to services
normally provided by the Agency,
4.4.4 Explore training or other on-the-job learning
experiences to help enhance the skills of the
employee,
4.4.5 Allow an employee to share skills through
mentoring other employees,
4.4.6 Provide employees with special projects
which need to be completed.
MONITORING 1. As the employee's medical condition improves, the
TRANSITIONAL supervisor will revise the plan to increase activities. This
EMPLOYMENT should help the employee gain strength and endurance to
PLANS expedite the transition to regular employment.
2. The plan should be reviewed on a regular basis;
assignments should be changed periodically to reflect
improvement in the employee's physical capacities, as
documented by the treating physician.
3. Transitional Employment will continue for that period of
time determined necessary and appropriate, up to ninety
(90) calendar days.
PROVIDING 1. If an employee is unable to resume regular duties within
REASONABLE ninety (90) days, the supervisor will initiate a reasonable
ACCOMMODATION accommodation evaluation in order to comply with Title
I of the Americans with Disabilities Act (ADA). Because
Policy #1701 Page 5 of 7
WORKERS' COMPENSATION AND SPECIAL INJURY RETURN-TO-WORK
PROGRAM (continued)
of the complex nature and responsibilities of the CBH
under this Act, the District Personnel Office will
coordinate this process to ensure compliance with all
related statutes.
2. When it is determined that the Personnel representative
either needs assistance with reasonable accommodation or
no accommodation can be identified, the employee will be
referred to the DOAS Workers' Compensation Program for
rehabilitation evaluation.
NON- In the event that an employee refuses (or otherwise through
COMPLIANCE his/her actions declines) to participate in the RTW Program, the
WITH RTW District Personnel Office should be notified. Refusal to
PROGRAM return to work and refusing to follow directives given by a
supervisor in a job where the responsibilities and duties have been
approved by the treating physician may jeopardize an employee's
workers' compensation/special injury benefits.
FAMILY 1. A work-related injury, illness or exposure to occupational
LEAVE disease may qualify as a serious health condition under
family leave. An employee may be placed on available
family leave during the workers' compensation/special
injury absence, which may run concurrently.
2. At some point during the employee's absence, the treating
physician providing medical care pursuant to workers'
compensation/special injury may certify that the employee
is able to return to work in a transitional employment
position.
2.1 If the employer offers such a position, the employee
is permitted but not required to accept the
position.
2.2 If the employee does not accept the transitional
employment position, the employee may no longer
qualify for payments from the workers'
compensation/special injury benefit plan, but the
employee is entitled to continue on family leave,
either until the employee is able to return to the
same or equivalent job the employee left or until the
twelve (12) work week family leave entitlement is
exhausted, whichever is first.
Policy #1701 Page 6 of 7
WORKERS' COMPENSATION AND SPECIAL INJURY RETURN-TO-WORK
PROGRAM (continued)
3. If the employee returning from a workers'
compensation/special injury absence due to an injury,
illness or exposure to occupational disease is an individual
with a qualifying disability, he or she will have rights under
the ADA.
TRANSITIONAL Supervisors are to complete the TRANSITIONAL EMPLOYMENT
EMPLOYMENT TRACKING FORM (See Attachment #6) to maintain awareness of
TRACKING employees on workers' compensation/special injury leave.
FORM
For additional information or assistance, please contact the District Personnel Office at
706/272-2342.
*****************************
Policy #1701 Page 7 of 7
NORTH GEORGIA HEALTH DISTRICT
County Board of Health Personnel Policy #1702
Cherokee, Fannin, Gilmer, Murray, Pickens, Whitfield
LEAVE AND PAYMENT FOR WORKERS' COMPENSATION AND SPECIAL
INJURY CLAIMS
EFFECTIVE DATE: January 1, 2005 RELEASE DATE: January 1, 2005
REFERENCES: State Law (O.C.G.A. §34-9-1 et seq. - Worker's Compensation)
State Law (O.C.G.A. §45-7-9 - Special Injury)
Rules of the State Personnel Board - Rule 18 (Leave)
Rules and Regulations of the State Board of Workers'
Compensation
DHR Human Resource/Personnel Policy #1702
The County Board of Health (CBH) is subject to the requirements of the Workers' Compen-
sation Law and the Special Injury Law. All employees are to ensure that appropriate
procedures in this policy are followed.
ELIGIBLE 1. All employees of the District are covered by the
EMPLOYEES Workers' Compensation Law unless specifically
excluded by law or regulation.
2. All full-time employees who regularly work thirty
(30) or more hours each week are covered by the
Special Injury Law.
DENIAL OF No compensation will be allowed for an injury, illness, exposure to
COMPENSATION occupational disease or death:
1. due to the employee's willful misconduct, including
intentionally self-inflicted injury;
2. growing out of his/her attempt to injure another;
3. due to intoxication by alcohol;
4. due to being under the influence of marijuana or a
controlled substance, except as may have been lawfully
prescribed by a physician for such employee and taken in
accordance with such prescription;
5. due to willful failure or refusal to use a safety appliance or
perform a duty required by statute; or,
6. due to the willful breach of any policy and/or procedure of
the District of which the employee had knowledge prior to
Policy #1702 Page 1 of 7
LEAVE AND PAYMENT FOR WORKERS' COMPENSATION AND SPECIAL
INJURY CLAIMS (continued)
the incident.
REPORTING Work-related injuries, illnesses and exposures to occupational
ACCESS TO disease are to be reported immediately as outlined in County
INFORMATION Board of Health Personnel Policy #1701. Department of
Administrative Services (DOAS) Workers' Compensation
investigators acting as agents for the District are authorized to have
access to personnel and any other related files and information
necessary to complete a review or investigation of a workers'
compensation or special injury claim. An employee's medical
information is confidential and is available to individuals only on a
"need to know" basis.
SATISFACTORY 1. An employee must provide satisfactory medical
MEDICAL documentation of an injury, illness or exposure to
DOCUMENTATION occupational disease to the designated organizational unit
representative and the immediate supervisor.
2. Satisfactory medical documentation is certification from a
workers' compensation panel physician or emergency
health care provider that the employee is physically unable
to perform the duties of employment as a result of the
injury, illness or exposure to occupational disease on the
specified date.
3. Failure by the employee to submit satisfactory medical
documentation of a work-related injury, illness or exposure
to occupational disease within two (2) weeks may result in
the employee's benefits being suspended.
4. An employee who does not initially use a workers'
compensation panel physician is not eligible for workers'
compensation benefits unless the employee received
emergency treatment.
WORKERS' COMPENSATION PAYMENT AND LEAVE PROCEDURES
USE OF LEAVE 1. If employees are absent due to workers' compensation
OR LEAVE claims, employees have the option of:
WITHOUT PAY
1.1 using some or all of their accrued FLSA
compensatory time, sick, annual or personal leave;
or,
1.2 receiving workers' compensation payments for lost
Policy #1702 Page 2 of 7
LEAVE AND PAYMENT FOR WORKERS' COMPENSATION AND SPECIAL
INJURY CLAIMS (continued)
salary during the period of disability.
2. Employees must provide written notification of the selected
option by using the SELECTION OF PAYMENT OPTION
Form. (See Attachment #1)
3. Employees who choose to receive workers' compensation
payments for lost salary will be placed on leave without
pay. Employees cannot receive workers' compensation
payments and regular salary (i.e., use of accrued FLSA
compensatory time or leave) at the same time.
4. Absences due to a workers' compensation claim which
qualifies as a serious health condition will be charged to
family leave with and/or without pay if available and as
determined appropriate.
5. The designated organizational unit representative must
notify the DOAS Workers' Compensation Program when
the employee loses work time or when the employee
returns to work.
WAGE LOSS 1. The waiting period for workers' compensation wage loss
PAYMENT payments is seven (7) calendar days. Usually no payment is
due for the first week of the disability.
2. Entitlement to benefits for the first seven (7) calendar days
of disability or any portion of the time, requires that the
employee be disabled for at least twenty-one (21)
consecutive calendar days and that the first seven (7)
calendar days were leave without pay.
3. In the event available leave is inadequate to cover the entire
period of disability [in excess of the first seven (7) calendar
days of disability] the employee would be entitled to
weekly benefits as of the day the leave was exhausted.
MEDICAL 1. Medical expenses arising from a work-related injury, illness or
PAYMENTS exposure to occupational disease are covered if the claim is
accepted by the DOAS Workers' Compensation Program. This
includes hospital bills, prescribed drugs, ambulance charges,
physician fees and other medical expenses. Expenses connected
with a work-related injury, illness or exposure to occupational
disease are excluded under the State Health Benefit Plan.
2. For treatment that is for some reason not covered by
Policy #1702 Page 3 of 7
LEAVE AND PAYMENT FOR WORKERS' COMPENSATION AND SPECIAL
INJURY CLAIMS (continued)
worker's compensation benefits, or if workers'
compensation benefits terminate, employees should seek
treatment from their personal health care provider.
SPECIAL INJURY LEAVE AND PAYMENT PROCEDURES
LEAVE AND 1. An eligible employee who becomes physically disabled as
PAYMENT a result of a physical injury incurred in the line of duty and
caused by a willful act of violence committed by a person
other than a fellow employee shall be entitled to regular
compensation, up to a maximum of 180 work days, for the
period of time that the employee is physically unable to
perform the duties of employment.
2. Benefits will not be provided for more than a total of 180
work days for injuries resulting from a single incident.
3. Special injury claims are to be reported in the same manner
as other workers' compensation claims. (See County Board
of Health Personnel Policy #1701).
4. Requests for special injury leave should be carefully
reviewed. The individual responsible for workers'
compensation reporting should review all available
information with the designated organizational unit
representative to determine if the injury falls within the
provisions of the Special Injury Law.
5. Notification of the decision should be sent to the employee.
NOTE: If special injury leave is approved or extended
but the medical documentation of physical
disability does not give a definite return to
work date, the designated organizational unit
representative should select and approve a
reasonable period of time.
6. The designated organizational unit representative must also
notify the DOAS Workers' Compensation Program when
the employee loses work time or when the employee
returns to work.
7. If supported by satisfactory evidence of physical disability,
ANY absence during the first seven (7) days of physical
disability is covered by special injury leave and MUST
NOT BE CHARGED to sick leave, annual leave, personal
Policy #1702 Page 4 of 7
LEAVE AND PAYMENT FOR WORKERS' COMPENSATION AND SPECIAL
INJURY CLAIMS (continued)
leave, FLSA compensatory time or leave without
pay (LWOP).
7.1 Any leave charged in error to the employee during
this period must be restored.
7.2 Salary adjustments must be made if the employee
was placed on LWOP.
PROCESSING & 1. During the first seven (7) days of physical disability, the
COORDINATION employee is not eligible for workers' compensation
benefits; therefore, coordination of benefits with the DOAS
Workers' Compensation Program is not necessary at this
time. The employee will receive the regular salary from the
District during this time. [See #3 of this Section if absence
due to disability exceeds twenty-one (21) consecutive
calendar days.]
2. Coordination of workers' compensation benefits with the
DOAS Workers' Compensation Program is required for
employees absent due to physical disability beyond the first
seven (7) days. The designated organizational unit
representative and the District Financial Services
Manager (FSM)-Payroll Subsection will process special
injury leave beyond the first seven (7) days, as follows:
2.1 Districts
2.1.1 The appropriate transactions center is
responsible for entering personnel actions
for special injury leave. The FSM - Payroll
Subsection is responsible for monitoring
special injury leave data entry and will
immediately reduce the injured employee's
regular salary by two-thirds (2/3), resulting
in the injured employee receiving one-third
(1/3) of the regular salary from the District
2.1.2 The designated organizational unit
representative must contact the DOAS
Workers' Compensation Program to
determine the amount of any workers'
compensation award and forward that
information directly to the FSM - Payroll
Subsection.
Policy #1702 Page 5 of 7
LEAVE AND PAYMENT FOR WORKERS' COMPENSATION AND SPECIAL
INJURY CLAIMS (continued)
3. If the employee is physically disabled for twenty-one (21)
consecutive calendar days as the result of a special injury,
the employee becomes eligible for workers' compensation
salary benefits for the first seven (7) days of physical
disability.
3.1 Since the employee has already received the regular
salary for the first seven (7) days from the District
(See #1 in this Section, above), the workers'
compensation salary benefits will result in an
overpayment to the injured employee.
3.2 Adjustments in compensation should be put into
place as soon as feasible to recoup the overpayment.
3.2.1 For employees in Districts, the appropriate
transactions center representative should
communicate directly with the DOAS
Workers' Compensation Program to
determine the amount of the overpayment
and should notify the FSM - Payroll
Subsection who will adjust compensation as
soon as feasible to recoup any overpayment.
CHANGE IN 1. The employee's supervisor must notify the designated
WORK STATUS organizational unit representative when the employee
returns to work or has any other change in employment or
workers' compensation status. (This includes time status
changes.) The designated organizational unit representative
must immediately notify the DOAS Workers'
Compensation Program.
2. If the employee returns to work from a period of special
injury leave, the supervisor or designated organizational
unit representative should notify the appropriate
transactions center staff to enter personnel action to return
the employee from special injury leave.
EXPIRATION An employee who remains physically disabled after 180 work days
OF SPECIAL is no longer eligible for special injury leave benefits. Regular
INJURY LEAVE workers' compensation benefits will then apply. The supervisor or
BENEFITS designated organizational unit representative is to notify the
appropriate transactions center to enter personnel action to return
the employee from special injury leave.
Policy #1702 Page 6 of 7
LEAVE AND PAYMENT FOR WORKERS' COMPENSATION AND SPECIAL
INJURY CLAIMS (continued)
HEALTH/ The employee's designated organizational unit representative is
FLEXIBLE responsible for ensuring that the employee continues to have
BENEFITS payroll deductions for any health insurance and/or flexible
PREMIUMS benefits premiums for which the employee is responsible during
the period of special injury leave. If payroll deductions are not
possible, the designated organizational unit representative must
ensure the employee is made aware of the employee's responsibility
to make direct payment(s).
For additional information or assistance, please contact the Personnel Office at 706/272-
2342.
******************************
Policy #1702 Page 7 of 7