Personnel Rules and Regulations

Health and Safety

Accidents On City Property

All accidents on City property resulting in personal injury or property damage involving the general public must be accurately and comprehensively documented. In the event of personal injury, employees on the scene should make every effort to make the injured person comfortable; if deemed necessary, an ambulance should be requested as soon as possible.

The City’s Risk Management Division of the Finance Department (revised June 1, 2004) should be contacted as soon as possible and no more than 72 hours after the incident (revised June 1, 2004). An Accident Report form must be completed and given to the Risk Management Division (revised June 1, 2004).

City employees who witness an accident or who are at an accident site should not speak on behalf of the City regarding responsibility for any loss sustained.

Alternative Employment For Employees Who Become Non-Occupationally Disabled, Impaired or Injured (Revised January 26, 2001) (Revised Nov. 15, 2004)

Employees who, as a result of non-occupational injuries or illnesses, cannot perform the essential functions of the job with or without accommodations may be eligible for assistance in finding alternative employment with the City.(Revised Nov. 15, 2004)

The City’s ADA Coordinator will oversee the administration of this policy. Departments should contact the ADA Coordinator and provide medical records describing the medical status of the employee, including diagnosis and restrictions. The ADA Coordinator will convene a meeting with the employee and representatives from the department to discuss the employee’s current medical status (Revised Nov. 15, 2004) and to explore employment alternatives. (Revised January 26, 2001)

A Designation of Duty Status form must be completed prior to the meeting. The Designation of Duty Status (Revised Nov. 15, 2004) form will establish the criteria by which alternative employment and reasonable accommodations (if needed) will be pursued. Employees who are not able to meet with the ADA Coordinator will be notified of the results of the meeting through written correspondence. (Revised January 26, 2001)

After the meeting with the ADA Coordinator, and if no suitable placement can be found, (Revised Nov. 15, 2004) if the employee is not already off work or is on light duty, the employee will be off work and receive any benefits he/she is eligible to receive (such as accrued leave benefits, etc.) (Revised Nov. 15, 2004) Employees who cannot perform the essential functions of their job may have up to 60 calendar days during which good faith efforts will be made to find a suitable vacant job in which the employee can perform the essential functions with or without reasonable accommodations. Vacant positions in the employee’s department will be sought first. If unsuccessful, a City-wide effort will be made. If a suitable position is found, placement and salary decisions will be governed by the applicable policies. The employee is expected to cooperate with the attempts to find a job and it is the employee’s responsibility to keep in touch with Human Resources during this time. If after 60 calendar days, suitable alternative employment has not been found, the employee will be laid off. (Typically, the termination code will be 934 – health, unable to perform job.) Eligible employees may apply for disability, early or regular retirement, as applicable. (Revised January 26, 2001)

At the time the meeting with the ADA Coordinator is convened, the current FCE, Designation of Duty Status and any other information pertaining to the employees’ health condition and ability to work, establishes the employee’s work status through the entire 60-calendar day period after the meeting. Any change in an employee’s status during the 60 calendar day period must be substantiated with a thorough written explanation which clearly validates the change in the employee’s work status; otherwise, an employee’s status will not change for the purposes of this policy. (Revised January 26, 2001)

Americans With Disabilities Act of 1990

The City is committed to comply with those provisions of the Americans with Disabilities Act of 1990 (ADA) that (Revised 2-10-06) apply to the City. A City ADA Coordinator has been designated to oversee the City’s compliance with the ADA.

All City services, programs, and activities provided or made available to the public will be accessible to persons with disabilities. Accessibility statements will be included on all notices announcing public meetings.

The City’s employment and selection process will provide reasonable accommodations to persons with disabilities.

Employment accommodations requests may be made to the ADA Coordinator.

Complaints alleging employment-related violations of the ADA may be filed with the Employee Relations Division of the Human Resources Department. Complaints, questions or concerns regarding services, programs, activities or facilities may be filed with the City ADA Coordinator. (See "Complaint Resolution Procedures for Persons with Disabilities" policy.)

Assisting Employees Who Become Ill at Work

The health and wellbeing (Revised 2-10-06) of employees is important to the City of Fort Worth. Employees who become ill at the workplace should be attended to immediately. If the employee’s medical (Revised 5-8-07) condition requires immediate medical attention:

He/she should seek medical attention from (Revised 5-8-07) the physician or hospital of his/her choice;
If the medical condition (Revised 5-8-07) is a serious life-threatening situation, the Department shall immediately call 911;
If communications with 911 are not immediately possible or feasible, the Department shall transport the employee to the nearest emergency medical facility; or
Departmental staff with management authority may require the ill employee to be seen by 911 emergency medical service personnel. (Revised 5-8-07)

If immediate medical attention is not required, but the employee is not capable of driving him/herself home, (revised June 1, 2004) the supervisor or designee (revised June 1, 2004) should:

Call the employee’s designated (Revised 5-8-07) emergency contact (Revised 5-8-07) in an attempt to arrange transportation (Revised 5-8-07) home.
If transportation is not arranged through the emergency contact, (Revised 5-8-07) a supervisor or designee (Revised June 1, 2004) will transport the employee to his/her residence.

If the employee’s medical condition is an occupational illness or disease that is determined to be compensable under the Texas Workers’ Compensation Act, the Occupational Injury Benefit (Workers’ Compensation) provision of the Personnel Rules and Regulations apply. If the employee’s medical condition is not a compensable occupational illness or disease under the Texas Workers’ Compensation Act, the employee is responsible for all medical expenses, including the cost of 911 emergency medical service vehicle transportation, associated with the illness or medical condition incident for which they received medical attention. A Department that required an ill employee against their will to be evaluated by 911-called emergency medical service personnel and is transported to a health care facility shall be responsible for the costs of such transportation. (Revised 5-8-07)

Employees who become ill at work and who leave the workplace must use appropriate accrued leave if available (Revised 5-8-07) for the time they are off work (revised June 1, 2004).

Employees who become ill at work will not be permitted to operate any city-owned (Revised 5-8-07) any equipment or vehicle.

Commercial Driver's License (CDL) Program (New policy effective February 1, 2005)

The Human Resources Department is responsible for the administration and implementation of the Commercial Driver’s License (CDL) program, in compliance with the Code of Federal Regulations (CFR) Title 49, the federal Commercial Vehicle Safety Act of 1986 and the Texas Commercial Driver License Law of 1989.

Commercial driver’s license (CDL) is a license issued by the State, in accordance with the standards contained in 49 CFR part 383, which authorizes an individual to operate a class of commercial motor vehicle.

CDL position is a job classification that requires the employee to possess a commercial driver’s license. This position is defined by the position’s criteria and position control number. The position control number has DOT in the crew identifier. Departments, using the criteria listed on the CDL Position Audit Form, identify CDL positions. Changes should be forwarded to HRIS on the Position Audit Form. Position Audit Forms may be obtained from HRIS or found on the intranet.

Commercial motor vehicle (CMV) is a motor vehicle that has any of the following characteristics:

A gross combination weight rating (GCWR) of 26,001 pounds or more inclusive of a towed unit(s) with a gross vehicle weight rating of more than 10,000 pounds.
A gross vehicle weight rating (GVWR) of 26,001 pounds or more.
Regardless of weight, is designed or used to transport 16 or more passengers, including the driver.
Regardless of weight, is used in the transportation of hazardous materials and is required to be placarded in accordance with the Code of Federal Regulation.

Hazardous material (HAZMAT) is a substance or material which has been determined by the Secretary of Transportation to be capable of posing an unreasonable risk to health, safety, and property when transported in commerce, and which has been so designated.

Intracity zone is the corporate limits of the City of Fort Worth.

Prescribed Medication is Medicine that has been authorized for a patient by a licensed physician.

CDL Medical Review Board Request/Decision Form is utilized by the CDL Medical Review Board to capture pertinent pre-hearing information about the referrals and record its final decision.

Commercial Driver’s License (CDL) Physical Examination Summary Form is completed by the examining physician at the City’s health provider at the conclusion a DOT physical examination of an employee to summarize his/her findings and provide follow-up instructions to the employee.

City of Fort Worth Medical Examiner’s Card is a wallet-size card signed by an examining physician from the City medical provider certifying that the employee is medically qualified to operate a City commercial motor vehicle.

Driving Prerequisites

City employees, including temporary employees, who operate a commercial motor vehicle for the City of Fort Worth, must be in a CDL position and possess a valid CDL from the State of Texas. All personnel in a CDL position must successfully complete the physical fitness requirements outlined in this policy. Civil Service employees are exempt from the provision of this policy.

Employees will not be permitted to drive until a valid CDL is issued by the State. It is the employee’s responsibility to submit a renewal application to the Texas Department of Public Safety before the license expiration date.

Employment Prerequisites

To be considered for employment in a CDL Position, applicants must meet the following requirements. Current employees who wish to promote into CDL positions must also meet the requirements.

Be a resident of the state of Texas.
Be at least 18 years of age.
Possess a valid CDL from the State of Texas.
Certification as to physical qualifications by the City’s medical provider. The requirements for certification include, but are not limited to:
1. No loss of limb that has not been waived,
2. No impairment of hand, finger, arm, foot, or leg that interferes with driving,
3. No diabetes requiring insulin for control,
4. No heart problems which could impair or incapacitate the operator,
5. No high blood pressure which is defined as being greater than or equal to 140 systolic and/or 90 diastolic (defined as > 140/90),
6. No rheumatic, arthritic, orthopedic, muscular, neuromuscular, or vascular problems that could affect vehicle control,
7. No epilepsy or other condition likely to cause loss of consciousness,
8. No mental, nervous, organic, or functional disease or psychiatric disorder likely to interfere with vehicle control,
9. Vision 20/40 or better in each eye (with corrective lenses), not color blind,
10. Ability to pass a hearing test
11. No drug or alcohol addiction (s)
Possess a satisfactory job history based on a ten-year job history check conducted by the Human Resources Department.

Job History

Applicants for employment in CDL positions must provide employment history information on all driving jobs held for the past ten (10) years to the Human Resources Department. The information must be provided at the time the employment application is submitted. The information must include:

A list of the names and addresses of previous employers for which the applicant operated a commercial motor vehicle (CMV);
The dates the applicant was employed by the employers listed;
The applicant’s reason for leaving employment.

The completed application will be forwarded to the requesting department for hiring action. The department, in turn, will return a list of prospective new hires to HR, Staffing Services, for employment history verification. The results are relayed to the department to complete the hiring process. A copy of the final report is filed in HR in accordance with applicable regulations with the returned referral.

Physical Examinations

The City’s occupational health provider is the only authorized agency to administer DOT physical examinations. The test will be administered as part of the hiring process and periodic renewal for all CDL drivers. Any offer of employment into a CDL position will be contingent upon the applicant’s ability to satisfactorily complete the post-offer physical examination.

The City health provider will report the condition of the driver to operate a commercial motor vehicle in four categories on a CDL Certification Form:

Qualified: meets all physical requirements.
Medical Hold: clinically does not meet requirements. More information is needed to determine the final medical status.
Probationary: qualified on a short-term (less than 2 years), renewable basis. The examining physician regularly monitors the driver in this category and will set renewal schedule.
Disqualified: does not meet minimum physical requirements. Referral to the medical review board is automatic.

Once hired, all drivers, with the exception of those in a “probationary” status, must satisfactorily complete a physical examination every two years. The examination requirement for personnel in a probationary status is detailed above. The medical provider will issue employees who meet the requirements a City of Fort Worth Medical Certification Card. The card is for intracity zone use only. Refusal to undergo a periodic examination may result in disciplinary action up to and including termination.

Employees who fail to comply with the physical examination requirement or who fail the physical examination will not be certified to drive until the requirement is satisfied. Disqualified employees will be counseled by the examining physician and offered options to re-certify. Options presented will include counseling available through the City’s Wellness Program and the Employee Assistance Program. Those who are not able to pass the physical examination will be categorized as “disqualified” and may be referred to the City’s Return to Work Committee for assistance in finding alternative placement within the City.

In cases where the employee disagrees with the decision of the City’s examining physician, he/she may forward opinions/test results from a physician of his/her choice to the City’s medical health provider for consideration. Correspondence should be addressed to Concentra Medical Centers, Attn: Center Administrator. The examining physician will, in turn, review and contact the employee to discuss his/her finding. Costs for the personal consultation will be at the employee’s expense. The City’s examining physician will, in turn, evaluate the documents submitted, and, when necessary, verbally consult with the employee’s physician, to determine whether there is sufficient information to reverse his/her decision. If the documents offer no evidence for change, the City examining physician will advise the employee accordingly and to resume/initiate the recertification options listed above. If the information submitted merits a change in decision, the City’s examining physician will notify the employee in writing.

Under a “medical hold” status, the examining physician has determined that he/she requires additional tests results and/or documentation to derive a final medical status. The examining physician will explain the requirement to the employee at the conclusion of the visit. The employee will acknowledge receipt of the requirement by signing the CDL Physical Examination Form. The employee has thirty (30) days after signing the form to deliver the required test results/documents to the physician.

The examining physician may also refer some cases to the CDL Medical Review Board. The Board will be comprised of an odd-number membership. It will be chartered to review cases and determine whether the driver can safely operate a commercial vehicle. As a minimum, the board will consist of a licensed physician, the City Safety Coordinator, the Wellness Program manager, Employee Assistance Program manager and a CDL-qualified member from the department to which the individual being boarded is assigned. The chairman of the Board is the City Safety Coordinator. The Board will convene within ten working days of being notified. The Board’s decision will be published within 15 working days after the review is completed. During both review processes, the employee is considered disqualified and should not operate a CMV.

The final results of the examination will be reported on a CDL Physical Examination Summary Form. One copy of the form will be maintained in the employee’s files within the department. The examination report will be maintained by the medical provider.

Once hired by the City, it will be the employee’s responsibility to notify management immediately if his or her physical condition changes. Failure to do so may result in discipline up to and including termination.

Use of Prescribed Medication

It is the employee’s responsibility to notify his or her supervisor when he or she is taking prescribed medication that causes dizziness, drowsiness, or other medication that may cause impairment. Failure to do so may result in discipline up to and including termination.

Record Keeping

The departments will establish and maintain a simplified driver’s qualification file for each CDL holder. The custodians of other qualification documents are listed below.

Department:
1. Certificate of Road Test.
2. Medical Examiner’s physical examination certificate.
3. Accident Review Board Results.
Human Resources:
1. A written record of each past employer who was contacted and a copy of the responses from those contacted. [Staff Services]
2. The driver’s license status of the biennial Department of Public Safety (DPS) license checks will be maintained on the Human Resource Information System (Genesys). [HRIS/Records]
3. Driver’s Application for Employment. [Staff Services]
4. Reports from the DPS license checks that contain information about moving violations; driver’s license suspensions and revocations will be kept in the Occupational Health & Safety Division of the Human Resources Department. [OHS]
5. Process Position Audit Forms. (HRIS)
City Medical Provider:
1. The medical examiner’s physical certification.
2. Letters from the state letters granting a waiver of physical disqualification, if applicable.

Notification of Driver’s License Suspension

It is the responsibility of the CDL holder to notify his or her supervisor immediately if his or her license is suspended, revoked, or canceled, or if he or she is disqualified from driving for any other reason. Failure to do so may result in disciplinary action up to and including termination. Upon such notification, the supervisor must notify the Department’s HR Coordinator. The departments may elect to reassign the disqualified employee internally or seek assistance from the Human Resources Department in reassigning the employee to another department.

Notification of Conviction for Driver Violations

CDL holders must report all traffic convictions (except parking) to their supervisor within 30 days after the conviction. Failure to do so may result in disciplinary actions up to and including termination. The supervisor will, in turn, notify the Department’s HR Coordinator in writing through HR Occupational Health and Safety.

Driver’s License Check

The Human Resource Department, Information Services will conduct a bi-annual Department of Public Safety (DPS) license check of all licensed drivers. Any negative results will be forwarded to the Department’s HR Coordinator for action.

Disqualification of Drivers

A CDL holder who is disqualified for any reason under this regulation must not drive a CMV. Drivers who are disqualified and who continue to drive are subject to disciplinary action up to and including termination and are subject to the disqualification rules and penalties established by the State of Texas.

CDL holders may also be disqualified if convicted of operating a CMV with a blood alcohol concentration (BAC) of 0.04% or more. For details, refer to the Alcohol Misuse and Drug Abuse Policy of the Employee Conduct section of the Personnel Rules and Regulations.

Employee Training

The Occupational Health and Safety Division of the Human Resources Department have the overall responsibility for CDL training program.

In addition to the tests and skills training required by the State and specialized training within the department, CDL holders must complete the required training below. The Occupational Health and Safety Division of the Human Resources Department will maintain training records for defensive driving. DDC records are accessible to the departments through the HR Coordinator and the HRIS system. Records for drug and alcohol training will be retained by HR, Learning Services and can be provided upon request. All training records will include date of instruction, subject and instructor’s name. Records will be retained in accordance with City’s document retention schedule.

The program of instruction will include the City’s CDL policy, drug/alcohol policy, and other training designed to ensure the employee is adequately trained.

Training	Training Hours	Frequency	Training References
Defensive Driving (DDC-CTD)	6	Every 3 years	National Safety Council Professional Truck Driver’s Defensive Driver’s Course
Vehicle Inspection & Maintenance	2	Every 3 years	Local and State Guidelines
Drug and Alcohol	3	Every 3 years	Federal & Local Laws
CDL Refresher	1	Annually	Guidance published annually by the CDL Administrative Board
Portable Fire Extinguisher	1	Annually	49 CFR 1910. 157

CDL position holders must complete the training above within 90 days of being hired. Drivers who have not completed the training will be suspended from driving until the training has been completed.

The CDL Administrator and Driver Certification Officer in departments with CDL positions are expected to complete the following training:

Training	Hours	Frequency
Drug and Alcohol	3	Every 3 years
CDL Orientation (initial)	4	Upon appointment
CDL Refresher	1	Annually

In additional to the above, departments must administer a road test to each new driver. A person who is qualified to evaluate and determine whether the person taking the test has demonstrated that he/she is capable of operating the CMV, and associated equipment will administer the test. The title of the test administrator will be Driving Certification Officer (DCO). Both are required to attend to attend semi-annual meetings chaired by the City Safety Coordinator.

CDL Logbook Requirement in the City

The City will operate under the 100 Air-Mile Radius Rule. Under this rule, the operator is not required to maintain a logbook. 100 Air-Mile Radius is defined as the radial mileage from the driver’s “normal work-reporting location.”

Drug and Alcohol Testing

Please see the Employee Conduct section of the Personnel Rules and Regulations for information about the City’s policies regarding the testing of CDL employees.

Driver Safety Training and Certification Program

To minimize the risk of city vehicular accidents involving city employees, the City strives to improve the quality of driving skill by permitting only those persons with safe driving records who are physically capable to operate vehicles or equipment in the performance of their duties.

Employees who operate a city vehicle/equipment or their personal vehicle as a part of their job duties are covered by the program. They must be 18 years of age and have a current valid Texas State driver’s license required for the type of vehicle to be operated.

The HRIS/Records Division (revised June 1, 2004) Department is responsible for performing a Motor Vehicle Record Check. HRIS/Records Division (revised June 1, 2004) will conduct a biennial review of current driving records obtained from the State Department of Public Safety of employees covered by this regulation.

The Human Resources Department is responsible for determining if the applicant has the appropriate, valid, current drivers license that covers the kind of vehicle to be operated.

The hiring department is responsible for ensuring that employees maintain the appropriate driver’s license.

Employees must inform their supervisor when involved in an at fault vehicular collision, arrested for, having a judgment pending or being convicted of a DUI or any other moving violation. Any conviction arising out of an arrest for Driving Under the Influence (DUI), including Obstruction of Highway, will result in a loss of City driving privileges for a period of twenty-four (24) months from the date of conviction. Loss of State of Texas driving privileges by reason of revocation, suspension, withdrawal or denial of license to drive or a requirement to have an interlock device on an employee’s personal vehicle will result in a loss of driving privileges for the City. When the driving license is renewed, the person may again apply for a city operator’s permit;

Employees who are arrested for a DUI offense two or more times within a 24-month period will have City driving privileges suspended for a period of 12 months or until the charges are cleared, whichever comes first. (revised June 1, 2004) Departments should contact the Human Resource’s Employee Relations Division (Revised June 1, 2003) for guidance.

Certification: Certification is the authorization, by the City, of an employee, who has met all the standards to operate a specific type of automotive equipment. Certification shall be required of all drivers operating vehicles requiring commercial or chauffeurs driver’s licenses or drivers of specialized equipment.

Each affected department/division shall appoint an experienced employee to act as Driver Certification Officer (DCO). The DCO determines if the employee or applicant has demonstrated the ability to operate specific automotive equipment in a safe and competent manner by requiring the employee or applicant to operate the equipment under his/her supervision.

A person will be certified to operate vehicles requiring commercial licenses or specialized equipment if that person can pass required tests administered by their departments. Certification of successful test completion will be maintained in the employee's department.

All drivers must complete the National Safety Council’s Defensive Driving Course. Newly hired employees must complete this course as soon as possible. All current drivers must complete the course once each three years. The Occupational Health & Safety Division of the Human Resources Department (revised June 1, 2004) will be responsible for scheduling defensive driving courses.

Employees authorized to operate one or more types of vehicles or equipment may be authorized for additional vehicles or equipment by passing additional tests administered by their departments.

Minimum standards for entry level Police Officers and Firefighters are listed in the City of Fort Worth Firefighters and Police Officers Civil Service Rules and Regulations. (Revised January 26, 2001)

The Police and Fire Departments are responsible to provide appropriate driver training for their personnel.

A person (whether subject to certification requirements or not) shall not be certified, recertified, or allowed to operate any City of Fort Worth vehicle if he/she has:

Had three moving violations or any conviction arising out of an arrest for Driving Under the Influence (DUI), including Obstruction of Highway, (Revised June 1, 2004) in the preceding 24 month period. (This includes all driving, i.e., city vehicle, private and other vehicles);
Lost, or loses State of Texas driving privileges by reason of revocation, suspension, withdrawal or denial of license to drive, or if he/she is required to have an interlock device on his/her personal vehicle. (Revised June 1,2004) When the driving license is renewed, the person may again apply for a city operator’s permit; or
been arrested for a DUI offense two or more times in the preceding 24-month period. City driving privileges will be restored after a period of 12 months or until the charges are cleared, whichever comes first.(Revised June 1, 2004)
Had, as determined by the Accident Review Board, three chargeable vehicle accidents or any combination of chargeable accidents or violations of this policy totaling four (4) within any consecutive 24-month period. (After each review of a chargeable vehicular accident, the Accident Review Board may decide whether or not an employee should be permitted to continue to operate a city vehicle.)

Vehicle Maintenance Responsibilities: It is the responsibility of the Equipment Services Division to develop a checklist to be used by all departments.

Drivers are responsible to ensure that vehicles/equipment are in a safe and mechanically sound condition before placing the vehicle or equipment into operation. This will require that the operator perform pre-operation checks of oil, water, tire air pressure, fuel, test brakes and other preliminary checks that may be peculiar to that piece of equipment. Failure to perform these checks will be considered as vehicle neglect. Furthermore, operators of vehicles and equipment must realize that equipment maintenance is an ongoing process and the equipment must be observed and checked while in operation to insure that operations can safely continue. Any problem noted by an operator must be reported to his/her supervisor immediately and that vehicle or equipment’s operations must cease until restore to a safe mechanical condition.

In the event that a vehicle/equipment becomes non-operational and the cause is due to improper preventative maintenance, driver neglect, driver abuse, or improper operations, the costs for repair of the vehicle/equipment will be charged back to the using department/division.

Vehicle Collision Reporting, Investigation and Review: All vehicular accidents involving city equipment must be reported. Additionally, any operator receiving a citation for traffic violations while operating city equipment must report the incident to his/her supervisor.

Drivers involved in collisions will immediately notify their supervisors of the collision and the Fort Worth Police Department will be called to the collision scene. Any vehicle collision involving death or serious injury will require immediate notification of the Occupational Health & Safety Division of the Human Resources Department at 817-392-8524 (Revised June 1, 2004).

All collisions will be reported using Form 106 Revised. Distribution of this report will be made to include a copy to the Equipment Services Division and copies to the Claims Office and the Occupational Health & Safety Division of the Human Resources Department.(Revised June 1, 2004) The department/division will maintain a file copy of this report. All city vehicles should contain a Form 106 Revised.

Department/Division managers will insure all collisions are thoroughly investigated to determine all factors contributing to the collision. The department/division Safety Coordinators, and the City Safety Coordinator when appropriate, will investigate city vehicular collisions. The Occupational Health & Safety Division of the Human Resources Department (Revised June 1, 2004). may conduct research, analysis, and evaluation of factors contributing to collisions.

Each collision will be reviewed by the appropriate Accident Review Board within 10 days if practical, (but no later than 30 days from the date of the collision) to determine and recommend action necessary to prevent similar collisions from occurring. The board will also determine if the collision was a chargeable collision to the driver, equipment operator, or any employee, including supervisors. (Chargeable collision is one in which the employee’s negligence, driver’s error or traffic violation either caused or significantly contributed to the occurrence of the collision.)

In the event that a collision is determined to be chargeable, the board should recommend appropriate disciplinary action. Reports of the board should be submitted to the department/division director and to the Occupational Health & Safety Division of the Human Resources Department (revised June 1, 2004).

Major Collision – Personal injury and/or $500 or more total property damage.

Minor Collision - No personal injury and total property damage less than $500.

Department Directors/Division Heads will initiate disciplinary action for cases of vehicle abuse, failure to perform required maintenance, continued operation of an unsafe vehicle or equipment, misuse or misappropriation of vehicles or equipment, or involvement in chargeable vehicle collisions.

The nature of the offense or violation will be considered in determining appropriate disciplinary action. The following disciplinary actions are presented as a guide that should be followed when appropriate:

First offense – written warning and appropriate remedial action (renewed training, repeat Defensive Driving Course, testing, etc.).
Second offense (within one year of initial offense) – Written warning and suspension from position (transfer, demotion) for a period without pay.
Third or subsequent offenses (within two years of initial offense) – Removal of person from driving position and possible termination.
Any operator involved in three (3) chargeable accidents or any combination of violations of this policy or chargeable accidents totaling four (4) within any 24-month period will be removed from driving or equipment operator’s position (transfer, demotion) or be terminated.

Any employee terminated or removed from a driving position due to violations of this policy will not be eligible for rehire into a driver’s position or equipment operator’s position for a period of two (2) years and then only after successfully completing the certification process.

Red Light Camera Violations (added Nov. 12, 2010)

Though citations issued for running a red light are considered administrative, they will be counted as moving violations for City disciplinary purposes. Violations will be tracked by the Director, TPW. The Director, TPW will be responsible for providing a by-name monthly report of violations to the Human Resources Department. Violators may be subject to the 3-moving violations rule cited above and disciplinary action alternatives. (See "Disciplinary Alternatives, PRR")

Employee Work Status Resulting from Injury or Illness

This regulation establishes a standard procedure for the designation of duty status for employees: (1) who are unable to work or, (2) who are capable of reporting to work but, due to injuries sustained, are not capable of performing their normal duties.

Average Weekly Wage (AWW) is the calculation of thirteen (13) weeks of pay totaled, divided by thirteen (13). Specific calculations will be made in accordance with the Texas Labor code. (added 2-10-06)

Temporary Income Benefits (TIBs) is monies paid by the employer through a third party administrator (TPA) to compensate the injured employee for wages lost as a result of a compensable injury. (added 2-10-06)

Post Injury Earnings (PIE) is the documented weekly amount of all pecuniary wages paid to the employee after the date of injury including wages based on work performed while on modified duty and pecuniary fringe benefits that are paid to the employee whether the employee has returned to work or not. (added 2-10-06)

Third Party Administrator (TPA) is the city-contracted vendor for workers’ compensation services. (added 2-10-06)

The Designation of Duty Status (DDS) form (DWC-73) (Revised 2-10-06) is designed for reporting occupational injuries and the Non-Occupational Illness/Injury Status form is used for (Revised January 21, 2002) reporting non-job related injuries and illnesses. Keep in mind that the physician is not obligated to complete the City form, they do it as a courtesy. If the medical provider does use the City forms the following distribution applies: (Revised January 21, 2002)

Occupational	Non-Occupational
White - Occupational Health & Safety (Revised July 1, 2003)	White - Employee's Department
Yellow - Employee's Department	Yellow - Employee
Pink - Physician	Pink - Physician

Categories of Duty Status: Following a medical examination, the examining physician shall be requested to designate the employee's duty status as defined below:

Unable to Perform Work of Any Nature;
Very Light Duty - Work which requires minimum physical exertion and can be adapted to the particular limitations (Revised January 21, 2002) of the employee. Such work can include, but is not limited to: (a) answering of telephone and relaying of messages, (b) reviewing of calculations, (c) posting of data, (d) visual inspection of equipment, (e) inventory of equipment or supplies, and (f) filing;
Light Duty - Work which requires restricted physical exertion and can be adapted to the particular limitations (Revised January 21, 2002) of the employee. Such work can include, but is not limited to: (a) all of the activities under Very Light Duty, (b) dusting of furniture, (c) cleaning and replacing of light bulbs, (d) light maintenance work and cleaning of equipment, (e) washing of windows, (f) sweeping of floors, (g) nightwatching, and (h) groundskeeping; and,
Full Duty - Regular work assignment.

The examining physician shall be requested to complete City duty status forms. These forms shall be filled out at the following times: (Revised January 21, 2002) (1) At the conclusion of the initial visit in connection with a particular injury (even if the duty status of the employee remains unchanged). If the period of restricted duty (Light Duty, Very Light Duty, Unable to Perform Work of Any Nature) is less than one week and the examining physician has indicated that no re-examination is necessary, the employee will automatically revert to full duty on the designated date (barring any complications or unexpected developments requiring re-examinations). (2) any subsequent visits to the medical provider for the injury on duty (even if the duty status of the employee does not change).

Note: The medical provider is not obligated to complete the City forms (Revised January 21, 2002) and only does so as a courtesy to the City. Therefore if the medical provider does not complete the City forms (Revised January 21, 2002) and chooses to use his/her form the City will accept the other forms.

Occupational Illnesses/Injuries

An employee injured on the job is responsible for ensuring that the Designation of Duty Status form and/or other forms are (Revised January 21, 2002) delivered to his/her supervisor. In the event that the employee is incapable of securing this form his/her supervisor is responsible for delivering the form to the physician.

All employees in a restricted duty status shall do nothing to impair or delay the process of recuperation.

When an employee has been told by an examining physician to report for examination or treatment, the employee shall report as directed. Willful failure of the employee to report as directed shall result in the employee losing his/her eligibility to receive supplemental benefits (see Occupational Injury Benefit regulation).

If an employee is returned to work in less than a full duty status (Very Light Duty, or Light Duty), he or she will be subject to the provisions of the City’s Return to Work Policy. (Revised Nov. 15, 2004)

Supervisory personnel must ensure that employees on Very Light Duty or Light Duty know when and where they are to report for examinations or treatment. Supervisors are authorized to make time available to employees for such examination or treatment. Employees will receive full time credit pay while absent for examination or treatment.

Non-Occupational Disabilities

The Non-Occupational Illness/Injury Status form should be used by employees who are off the job due to injuries received off the job or who are subject to an extended illness. In the event that an employee returns to work in a less than full duty status from a non- occupational condition, he or she will be subject to the provisions of the City’s Return to Work Policy. If a limited duty assignment cannot be found for the employee under the terms of the Return to Work Policy, (Revised Nov. 15, 2004) the employee may be sent home and the time charged as major medical sick leave, sick time, short term sick leave/family leave, compensatory time or vacation leave (assuming the employee has such leave time accrued) or without pay if the employee is not eligible for leave time. (Revised December 16, 2000). Employees must use appropriate accumulated leave, or time without pay if no leave is available, while absent for examination or treatment.

Employees who miss more than three (3) consecutive working days due to an occupational or non-occupational injury or illness must be notified that their time off will be charged under their FMLA (use the Family and Medical leave Notification form) benefit. This time should be coded as “Z’ on the time sheet. (Revised 2-10-06)

Equipment/Vehicle Neglect and Abuse

Employees assigned to operate and maintain city equipment or vehicles will observe all maintenance procedures and schedules and operate such equipment and vehicles safely and appropriately. Negligent or abusive use/operation of city equipment or vehicles will result in appropriate disciplinary action.

Misuse, neglect and abusive use/operation of equipment or vehicles is categorized below:

Misuse (Revised 02/23/2009)

Operating a vehicle or piece of equipment in a manner not approved by the City of Fort Worth.

Disciplinary action may be taken for vehicle misuse. Disciplinary action for vehicle misuse should be consistent with the City’s procedure for Employee Conduct, “Conduct Warranting Disciplinary Action”.

This list is not intended to be all-inclusive; it is however representative of the kinds of conduct and incidents which warrant disciplinary action.

Using a City vehicle to conduct personal business
Operating a City vehicle off-road if it is not designed to do so
Failure to operate a vehicle or equipment in the most cost effective method to accomplish assigned duties or tasks. Examples of this type of activity would be: Using a 12 yard dump truck to attend a training class when a car was available, Operating an off road vehicle on road when it is not equipped for it, driving an off road vehicle from one work site to another when using a trailer would reduce costs, Operating a vehicle or piece of equipment with an unsafe number of passengers, excessive acceleration or braking.
Operating a City vehicle outside of your work area or region without authorization
Operating a City vehicle with unauthorized persons aboard
Operating a City vehicle or equipment that you are not authorized to operate
Idling excessively, this is defined by Council ordinance #3334-04-2006 which states, in part: Vehicle idling should only be allowed for safety, emergency response, vehicle maintenance, equipment activity, warm-up/operations in cold temperature, and manufacturer recommended minimum idle/warm-up times.
Driving out of your work area for lunch and break
Operating a vehicle or vehicle combination without a valid license to operate it
Removing a vehicle from Equipment Services possession without permission
Operating a vehicle in an unsafe manner.
Failure to observe traffic laws and regulations

Negligence (Revised 02/23/2009)

Minor Negligence: Improper use of equipment or a vehicle resulting in damage to it or the property of another totaling less than $500. Some examples include, but are not limited to: not securing doors, leaving windows down in inclement weather, not protecting the interior or exterior finish from harmful substances or damage, interior cigarette burns, etc.

Major Negligence: Same as above, resulting in repairs over $500 or equipment with a replacement value under $500 that is rendered inoperable.

Disciplinary action may be taken for vehicle negligence. Negligence violations involving monetary damage to the City will be reviewed using the same procedure outlined for vehicle collision damage under the “Driver Safety Training and Certification Program” policy.

This list is not intended to be all-inclusive; it is however representative of the kinds of conduct and incidents which warrant disciplinary action.

Failure to submit a vehicle to Equipment Services for scheduled maintenance within 1000 miles or 60 days of the past due date.
Failure to keep your assigned vehicle reasonably clean on both the interior and exterior
Failure to secure and/or tarp the contents of a truck bed or trailor.
Leaving the windows open during inclement weather
Not securing doors
Failure to protect the interior or exterior finish from harmful substances or damage
Putting the wrong fuel or lubricants in the vehicle

Abuse (Revised 02/23/2009)

Minor Abuse: Failure to make reasonable checks or evaluations of the equipment/vehicle. This includes failure to use any checklists required by the department prior to equipment operation. Some examples include, but are not limited to: failure to check engine oil, coolant, hydraulic oil, battery fluid, and tire pressure and condition, resulting in repairs under $500.

Major Abuse: Same as above, resulting in repairs over $500 or equipment with a replacement value under $500 that is rendered inoperable.

Disciplinary action may be taken for vehicle abuse. Abuse violations involving monetary damage to the City will be reviewed using the same procedure outlined for vehicle collision damage as outlined under the “Driver Safety Training and Certification Program” procedure.

This list is not intended to be all-inclusive; it is however representative of the kinds of conduct and incidents which warrant disciplinary action.

Removal or alteration of safety or limiting devices, switches, or guards
Exceeding recommended operating parameters (such as, loading a vehicle beyond its operating capacity)
Performing unauthorized repairs and/or modifications to a vehicle or equipment
Failure to check engine oil level prior to operating the vehicle
Failure to immediately notify ESD of an illuminated warning light, buzzer, gauge, or other devices
Failure to check tire pressure and condition and hydraulic oil level prior to operating the vehicle
Smoking in a City vehicle
Using the wrong vehicle or equipment for the task

Vehicle Abuse Review Committees shall be established by departments and select a Chairperson for the Committee. The Committee will consist of department/division supervisors and safety personnel. Departments may invite an Equipment Advisory Committee representative to be a committee member by calling the ESD Administration.

The departmental committee is responsible for evaluating the facts surrounding an incident. The committee will issue its findings and recommendations based on the facts presented, degree of responsibility and work record of the operator, to the appropriate department/division directors who have final responsibility/authority for determining and implementing appropriate disciplinary action.

Incidents wherein neglect or abuse is suspected shall be handled according to the following process:

Responsibility	Action
ESD Shop Supervisor	Upon identifying a suspected neglected or abused piece of equipment/vehicle, IMMEDIATELY contact appropriate department/ division Vehicle Abuse Review Committee Chairperson so damage may be viewed firsthand. Fill out Operator Abuse Report and forward to departmental Vehicle Abuse Review Committee Chairperson. Retain yellow copy of Operator Abuse Report for files. Begin repair work only after directed by department/division.
Vehicle Abuse Review Committee Chairperson	Call meeting, if warranted, to review alleged incident.
Vehicle Abuse Review Committee	Determine culpability, responsibility, extent of loss, and recommended disciplinary action by majority vote into one of the following categories: Operator Negligence/Minor, Operator Negligence/Major, Operator Abuse/Minor, or Operator Abuse/Major.

An Equipment Advisory Council Subcommittee reviews and rules on disputes between different departments/divisions concerning accidents and repairs. The subcommittee consists of three members not involved in the dispute and mutually chosen by both sides. The ruling made by the subcommittee will be binding on both parties.

Guidelines for progressive discipline addressing violations of this policy are as follows:

Operator Negligence/Minor
1st Offense - Written reprimand
2nd Offense - One day suspension without pay
3rd Offense - Three days suspension without pay
4th Offense - Demotion from an equipment/vehicle operating classification
for at least one year or termination

Operator Negligence/Major
1st Offense - Five days suspension without pay
2nd Offense - Demotion from an equipment/vehicle operating classification
for at least one year or termination.

Operator Abuse/Minor
1st Offense - One day suspension without pay
2nd Offense - Three days suspension without pay
3rd Offense - Demotion from an equipment/vehicle operating classification
for at least one year or termination.

Operator Abuse/Major
1st Offense - Five days suspension without pay; demotion from an
equipment/vehicle operating classification for at least one
year; or termination.

Demotion removes an otherwise productive employee from an equipment/vehicle operating classification. The employee is ineligible for rehire/promotion into an equipment/vehicle operating classification for a period of at least one year from the effective date of disciplinary action. At the end of one year, the employee is eligible to apply for any current openings that involve operating equipment/vehicles. The employee is not automatically reinstated to his/her previous classification.

Termination may be an appropriate action. Some departments/divisions may have non-operator classifications in which to place an individual, while others may have positions but no available openings for a demoted operator. Discretion in such instances will be left to the department/division director as to final discipline.

Any combination of four violations in a two-year period will result in demotion for a period of at least one year from an equipment/vehicle operating classification. An employee's Personnel file will be reviewed by the appropriate Vehicle Abuse Review Committee. Any violations during the previous 24 months will apply.

Employees may appeal disciplinary actions based on the findings of the Vehicle Abuse Review Committee through the City's grievance or appeal procedures.

HIV/AIDS and other Communicable Diseases

To comply with the Human Immunodeficiency Virus Services Act passed by the Texas Legislature on June 16, 1989, it is the policy of the City of Fort Worth that no employee infected with the Human Immunodeficiency Virus (HIV) shall be subjected to mandatory testing, shall be removed from employment status, nor shall be deprived of any employment privileges, except for clearly stated, specific and compelling medical or public health reasons. These reasons shall be based upon accurate scientific information. The City will review each HIV/AIDS-related situation on an individual basis. When, in the best interest of the City and employee, the City may take actions based upon prudent administrative considerations and based upon accurate scientific information.

Employees with HIV/AIDS infection shall be provided the same rights and equal employment opportunities as employees with other communicable diseases with respect to placement, upgrading, transfer, demotion, promotion, terms and conditions of employment, benefits, pay, training, layoff, termination or reinstatement, except for compelling medical and/or public health reasons based upon accurate scientific information. Accommodations will be made to keep employees with HIV/AIDS infection employed and productive for as long as possible.

General Employee HIV/AIDS Workplace Guidelines

(NOTE: The Police, Fire, and Health Departments have established separate HIV/AIDS protocols for their employees.)

Introduction

Current scientific and medical technology has determined that there is no risk of HIV/AIDS transmission in the normal work setting. Routine daily encounters with co-workers and the public pose no risk of transmitting the fragile blood-borne virus.

The City of Fort Worth recognizes that employees with HIV/AIDS may wish to continue to participate in as many of their normal activities as their health will allow, including work.

The City of Fort Worth also recognizes that continued involvement in normal activities, such as employment, may be therapeutically beneficial in the remission or recovery process and may prolong the employee’s life.

Toward the above stated goal, the City of Fort Worth establishes the following HIV/AIDS policy:

It is the policy of the City of Fort Worth that no employee infected with the Human Immuno-deficiency Virus (HIV) shall be subjected to mandatory testing, shall be removed from employment status or shall be deprived of any employment privileges, except for clearly stated, specific and compelling medical or public health reasons. These reasons shall be based upon accurate scientific information.

Ignorance and misconceptions about AIDS/ARC/SP may lead to denial of the individual’s rights and privileges to which the individual is legally entitled.

HIV-related policies will be consistent with current information from public health authorities, such as the Centers for Disease Control of the United States Public Health Service, and with state and federal law and regulations.

Definitions

"HIV" stands for Human Immunodeficiency Virus. HIV destroys a person’s defenses (immune system) against infections. Once infected with HIV, a person may remain without symptoms for a long period of time, but is able to infect others through sexual or direct blood contact. As the disease progresses, the immune system can become so weakened that a person may eventually develop life-threatening infections and cancers.
"AIDS" (Acquired Immunodeficiency Syndrome) is the final state of HIV infection. It is a serious condition characterized by a defect in the body’s natural immunity system against disease. With this loss in the body’s normal immune response, the individual falls prey to a host of what are called "opportunistic infections". These are unusual infections or tumors not ordinarily seen in otherwise health individuals.
"ARC" stands for AIDS-related complex. ARC is a term that is used to characterize an AIDS-related condition that carries a significant but still imprecisely determined likelihood of progression to AIDS. Individuals with ARC have been infected with the AIDS virus (HIV).
"SP" stands for sero-positivity. SP refers to individuals who have been exposed to HIV but who display no physical symptoms.
"Accurate scientific information" means current information from public health authorities, such as the Centers for Disease Control of the United States Public Health Service.

Purpose

These guidelines delineate the means whereby the City of Fort Worth will ensure its workforce becomes informed about HIV/AIDS, that HIV/AIDS-infected individuals at the workplace will not be subjected to discriminatory treatment because of their HIV/AIDS condition, that confidentiality is maintained when dealing with HIV/AIDS matters and that HIV/AIDS-infected individuals will enjoy all the privileges and entitlements afforded to employees with other communicable diseases.

Policy

It is the policy of the City of Fort Worth that no employee infected with the Human Immunodeficiency Virus (HIV) shall be subjected to mandatory testing, shall be removed from employment status, nor shall be deprived of any employment privileges, except for clearly stated specific and compelling medical or public health reasons. These reasons shall be based upon accurate scientific information.

The City will review each HIV/AIDS-related situation on an individual basis. Accommodations will be made to keep employees with HIV infection employed and productive for as long as possible. When, in the best interest of the City and employee, the City may take actions based upon prudent administrative considerations and/or compelling medical and/or public health reasons which shall be based upon accurate scientific information.

Terms and Conditions of Employment

Employees with HIV/AIDS shall be provided the same rights and equal employment opportunities as employees with other communicable diseases with respect to placement, upgrading, transfer, demotion, promotion, terms and conditions of employment, benefits, pay, training, layoff, termination or reinstatement, except for compelling medical and/or public health reasons which shall be based upon accurate scientific information.
No City department, commission/board or agency shall require its employees to undertake a screening for HIV/AIDS. The Department of Health will annually provide voluntary screening for employees in high/moderate risk job classifications at the City’s expense. In special cases where an employee has experienced possible HIV/AIDS exposure as a consequence of job activities, the employee may also request screening at the City’s expense. The HIV/AIDS screening results shall be confidential and the employee’s rights to privacy shall not be violated.
No official, supervisor nor employee shall refuse to work with HIV/AIDS-infected employee solely on the basis of his/her HIV/AIDS status. If such a refusal occurs and, subsequent to being given education counseling about HIV/AIDS, continues to occur, that person may be subject to disciplinary action.
1. If an employee refuses to work with an HIV/AIDS-infected employee, the supervisor will arrange a time to meet with the employee to discuss the reasons for his/her action. If the supervisor believes the problem is grounded in ignorance or misinformation about HIV/AIDS, the employee will be referred to the Public Health Department to receive counsel and information on HIV/AIDS.
2. The time spent counseling and educating an employee will be recorded as work time. If immediate counsel is not available, reasonable attempts will be made to reassign the employee until such counsel and education can be accomplished. If after receiving counsel and, no medical and/or public health reason which justifies refusal to work with an HIV/AIDS-infected employee exists, and an employee continues to refuse to work, such behavior constitutes insubordination and appropriate disciplinary action up to and including termination will be taken.
With the onset of HIV/AIDS-related symptoms, the employee is responsible for providing medically verified information relating to the ability to be available for or to perform work. Employees known to have HIV/AIDS shall not have their job assignments unreasonably modified. Exceptions may be made by the Human Resources Director in consultation with the Director of Health. Exceptions shall be based upon accurate scientific information.
Supervisors and employees should not engage in discrimination against persons with HIV infection, unless based on accurate scientific information. HIV/AIDS-infected employees who believe their HIV condition is the basis of decisions being made by supervisory personnel should call the Human Resources Representative assigned to his/her department for assistance. If warranted, a formal discrimination complaint may be filed and the incident will be investigated by the Human Resources Department.

Confidentiality

Based on the Federal Privacy Act, the Texas Commission on Human Rights Act, and the Texas Communicable Disease Prevention and Control Act, any medical documentation or information provided by an HIV/AIDS-infected employee to medical or management personnel must be considered confidential and private information. As such, employers are forbidden by law to disclose this information without the employee’s knowledge and consent, except as required by Public Health laws.
With the consent of the HIV/AIDS-infected employee, or as stipulated otherwise, appropriate officials such as medical staff, Human Resources representatives, and/or direct supervisors may be informed. Anyone who has access to confidential information is charged with maintaining strict confidentiality and privacy. Any employee of the City who violates the HIV-infected employee’s rights has committed a serious offense. This breach of privacy may be cause for litigation, resulting in both civil and criminal penalties.
Any employee, regardless of position or nature of association, if any, with an HIV/AIDS-infected employee, who reveals information which either breaches the City’s policy on confidentiality about HIV/AIDS situations or discriminates against an employee or refuses to work with a employee solely on the basis of that employee’s alleged HIV/AIDS status will be subject to appropriate disciplinary action up to and including termination.
1. Employees who believe a breach of confidentiality has occurred or a malicious attempt to label an employee as an HIV/AIDS-infected individual has occurred should contact the Human Resources Representative assigned to his/her department. An inquiry into the matter will be conducted by the Human Resources Department and based upon the information gathered, appropriate action will be taken, including disciplining any persons who violate this policy.
HIV-infected employees who disclose their medical condition to co-workers severely thwart any possible liabilities which co-workers might have had in regard to violating this policy. Self disclosure may render subsequent allegations of breaches of confidentiality null and void.

Employee Education

The Human Immunodeficiency Virus Services Act requires the City to provide and all employees to receive some education about methods of transmission and methods of prevention of HIV infection and related conditions.

Within the City of Fort Worth some employees operate in high/moderate HIV/AIDS-infection risk job classifications. These employees will receive specific education and training that will be provided by the City’s Department of Health. High/moderate risk job classifications generally involve the Health Department and Public Safety employees.
Non risk job classifications involve the majority of the City’s job classifications. These employees shall also receive education about HIV/AIDS through new employee orientation and general HIV/AIDS information materials.
The Department of Health and/or the Employee Assistance Program shall provide training and assistance to managers and supervisors in departments in handling HIV/AIDS related personnel problems and in educating employees.
Counseling shall be available for HIV/AIDS-infected employees, their dependents, relatives and co-workers by contacting the Employee Assistance Program or the Department of Health. Such counseling shall be confidential.
Information and training materials about HIV will be prepared by the Department of Health and the Employee Assistance Program Coordinator. Such materials will include printed media, videotaped presentations, and staff presenters. This information will address the five (5) areas cited in the model guidelines promulgated by the Legislature:
1. Modes of Transmission
2. Methods of Prevention
3. Behaviors Related to Substance Abuse
4. Laws Concerning the Rights of HIV/AIDS-infected Individuals
5. Behaviors Associated with HIV Transmission which are in Violation of Texas Law
Printed materials will be distributed to City employees and education classes will be scheduled for the benefit of those employees who wish to become better informed about HIV/AIDS. Health Department staff and the Employee Assistance Program Coordinator will be available for personal counseling for employees, their dependents and relatives.

Mandatory Seat Belt Usage

All employees and occupants of vehicles driven by employees on City business must have their seat belts and harnesses fastened while the vehicle is in motion. This directive applies to both City-owned vehicles and privately owned vehicles used for City business.

Occupational Injury Benefit (Workers’ Compensation)

This policy is intended to explain the Texas Labor Code’s provisions regarding Workers’ Compensation for government employees. Any differences will be in favor of the Texas Labor Code (Revised 2-10-06)

The Workers' Compensation Act applies to employees who occupy full-time, part-time, and extra help positions. The Act applies only to physical injuries and occupational diseases that arise out of and in the course of employment, but does not apply to ordinary diseases of life.

The Workers' Compensation Act provides full medical services and cash benefits for temporary disabilities and for permanent disabilities. The widow and dependents of employees killed in industrial accidents are entitled to death benefits.

The Occupational Health and Safety Office (Revised July 1, 2003) is responsible for the overall supervision, coordination, and implementation of the City's Workers' Compensation Program.

Department Directors shall establish a policy statement which establishes realistic goals and objectives for controlling occupational injuries and appoint a departmental safety coordinator.

Department Directors or designees shall insure that all occupational injuries are immediately reported. Failure to report accidents in a timely manner may cause a delay in the payment of benefits, and subject the City to the imposition of monetary penalties.

Department Directors or designees shall ensure that a departmental representative is with the injured worker at the medical provider for the initial visit.

Department Directors or designees shall arrange for a personal contact with all employees who suffer major lost time injuries within 48 hours after the initial report of injury. Concern for the morale and well being of an injured employee will partially alleviate anxieties he or she may have.

Department Directors or designees should review all accident reports and take appropriate, corrective action to minimize the reoccurrence of such accidents.

An Employer’s First Report of Injury (DWC-1) form must be completed by the department within twenty-four (24) hours of the injury and immediately forwarded to the (Revised 2-10-06) Human Resources Occupational Health and Safety Office, immediately (Revised July 1, 2003). If an injury occurs on a holiday or a weekend, it should be reported on the first workday after the occurrence. (Revised 2-10-06) An website has been set up to report occupational injuries immediately. The address is http://apps.cfwnet.org/Employer_Injury_Reportsp/. The DWC-1 form is available electronically from the Human Resources Forms page on the intranet. Whenever possible departments should complete the DWC-1 electronically, otherwise a hard copy of the DWC-1 form is acceptable. (Revised July 1, 2003). If lost time is involved call 817-392-8524(revised June 1, 2004). and leave a voice mail message immediately after your notification.

A Supplemental Report (DWC-6) form must be completed and submitted to the Occupational Health and Safety Office (Revised July 1, 2003) when:

An employee begins losing time from work due to the occupational injury which was not reflected on the DWC-1 and the employee is not at Maximum Medical Improvement (this includes if employee retires as a result of the injury); or
the employee is terminated or laid off while on light duty as a result of an injury on duty; or
an injured worker has a change in the number of hours worked as a result of an occupational injury (and the employee is not at Maximum Medical Improvement);
employee returns to work from an injury on duty.

The initiation and discontinuance of Workers’ Compensation benefits is contingent upon the completion and timely submission of the DWC-1 and 6 form. The department should telephone Occupational Health & Safety Office (revised June 1, 2004). immediately by telephone whenever a DWC-1 or 6 is required. Call the Occupational Health and Safety Office (Revised July 1, 2003) immediately at 817-392-7766 or 817-392-8524 (Revised 2-10-06) (Revised June 1, 2004). after your notification.

Maximum Medical Improvement means either (whichever comes first): the expiration of 104 weeks from the date temporary income benefits begin to accrue, or a date beyond 104 weekds that is ordered by the Commissioner of Workers' Compensation, Texas Department of Insurance; or the date a doctor certifies that the employee can no longer reasonably anticipate further recovery or lasting improvement from the compensable injury. (Revised 02/23/2009)

In case of serious accident or death, the Occupational Health and Safety Office (Revised July 1, 2003) must be notified immediately. If the accident occurs during other than normal working hours leave a voice mail message at (817) 392-8524 (Revised 2-10-06) and then call the Occupational Health and Safety Office at (817) 392-8524 (Revised 2-10-06) as soon as normal working hours resume.

Employees who miss more than three (3)) consecutive working days due to a job related injury or illness must be notified (use the Family and Medical Leave Notification form) that their time off will be also be charged under their FMLA Benefit. This time should be coded as “Z’ on the time sheet, in addition to “O”. (Revised 2-10-06)

When an employee who is injured on the job suffers an extended absence (greater than 30 calendar days or anticipated greater than 30 calendar days) the department may remove the individual from their assigned department into the Workers’ Compensation Control Group.

When the injured worker is declared at Maximum Medical Improvement and has permanent medical restrictions that prevent him/her from performing the essential functions of his/her job or he/she is still off work, he or she will be subject to the terms of the City's Return to Work Policy (Revised Nov. 15, 2004).

Employee Responsibilities

All employees who are injured on the job, however minor, must immediately notify their supervisors. The Workers' Compensation Act requires an employee to notify his/her employer within thirty (30) days of the date of the injury and to report such injury to the DWC within one (1) year. In the event the injury involves lost time from work, the DWC will send form (DWC-41) to the employee to be completed. In failing to do so, an employee forfeits his/her rights to all benefits.

It is the responsibility of all employees injured on the job to have a Designation of Duty Status form filled out by the examining physician and returned to their supervisor immediately.

An employee who is on occupational injury leave must contact h is/her supervisor at least once every five (5) working days or have someone contact his/her supervisor on his/her behalf if he/she is unable to do so personally. (The City must be aware of the employee’s status in order to plan and assign work duties and responsibilities in an efficient manner.)

An employee who suffers an occupational injury or illness shall be required to return to work immediately when released to do so by the examining physician. Failure to return to work when released shall result in appropriate action up to and including termination.

An employee who is released to return to work in less than a Full Duty Status will be subject to the terms of the City’s Return to Work Policy. (Revised Nov. 15, 2004)

All employees who are in a less than Full Duty Status shall not engage in any secondary employment whatsoever. Employees who engage in any secondary employment shall be subject to disciplinary action up to and including termination.

Medical Treatment: City employees covered under the Workers’ Compensation Act shall have the sole right to select or choose the physicians and/or facilities to furnish medical aid, chiropractic services, hospital services and nursing. The employee must ensure that a physician accepts workers’ compensation patients. During normal working hours (8:00 a.m. to 5:00 p.m., Monday through Friday), the Concentra Medical Center located at 2500 West Freeway (I-30), Ste. #100 (revised Nov. 15, 2004) remains the primary care clinic for those employees injured on the job who indicate no preference of physician or facility.

When an injured employee is initially referred for medical treatment, the supervisor will ensure that the employee is provided with a Designation of Duty Status form.

All employees who require emergency treatment as a result of the injuries sustained in the course of employment must notify his/her immediate supervisor.

Occupational injuries occurring during other than normal hours in which the injured employee indicates no choice or preference will be referred to the nearest medical facility which is equipped to handle the injury needing treatment. Any minor emergency clinic or the emergency room at a hospital may be used. The employee will be treated only for an emergency by the emergency room staff. The emergency room physician will refer the employee to his/her private physician or a specialist for continuance of care.

At any time an employee suffers a major injury and obviously requires treatment beyond the capabilities of the Concentra Medical Center (revised Nov. 15, 2004) he/she should be taken by ambulance to the nearest hospital for emergency treatment.

If hospitalization is required following initial emergency or subsequent medical care, the injured employee will be admitted to the hospital of his/her choice.

Compensation for Employees not Subject to Municipal Code, Local Chapter 143, Revised Civil Statutes of Texas

The maximum compensation benefits that will be paid injured employees will be determined under provisions of the Texas Workers' Compensation Act beginning the eighth day after the first day off from work. If the disability continues for four weeks or more, the initial week of compensation will be paid retroactively.

An injured employee is entitled to medical aid and hospital services which are reasonably required at the time of injury and at any time thereafter as may be necessary to recover. All medical expenses incurred as a result of the occupational injury will be paid by the City of Fort Worth in accordance with the provisions of such act.

Salary Supplement: In addition to the benefits prescribed under the statute, injured employees may receive a salary supplement, the amount depending on the employee's length of service with the City.

Length of Service to Date of Injury	Percentage Disability Supplement Due
Six (6) months or less and all temporary employees	None
Six (6) Months through five (5) Years	50 % of normal salary minus the Workers’ Compensation payment.
Five (5) Years through ten (10) Years	75 % of normal salary, minus the Workers’ Compensation payment.
More than ten (10) Years of service	100 % of normal salary, minus the Workers’ Compensation payment.

Length of service is calculated from the date of employment or the adjusted service date to the date of injury. The benefits received are those the employee would have received on the date of injury. For example, an individual injured in the fifth (5th) month of service who loses time in the seventh (7th) month of service because of the same injury would not be eligible for salary supplement.

Injured employees shall be eligible for benefits effective the eighth calendar day of lost time (and may utilize in the following order; accrued sick leave, old sick leave (Revised 2-10-06) vacation leave, short term sick leave/family leave (Revised December 16, 2000); then other accrued leave shall be used including accrued holidays, personal holidays, wellness leave and compensatory time off. (Revised 5-8-07) [Exception: Marshals will receive full pay for the first seven (7) days of lost time. After the 7^th day off, Marshals will receive the salary supplement benefits which they are eligible to receive based on his or her seniority beginning the day lost time began.](Revised January 26, 2001)

To receive Supplemental Benefits, employees are subject to the following provisions of the Supplemental Benefit Plan: (Revised Nov. 15, 2004)

Reported the disabling occupational injury or disease in accordance with the City reporting procedures;
Agrees in writing to release to the City or authorized agents thereof, all medical histories which may be relative to the occupational injury or disease, its diagnosis and treatment, and/or the prognosis as to duration and degree of disability, if any;
Completes and submits Designation of Duty Status form in accordance with City procedures; and
Complies with the examining physician’s request to report for examination or treatment.

Salary supplement can be paid initially for a period not to exceed twelve (12) months cumulative for any occupational injury or disease. When eligibility for salary supplement expires, an employee may elect to use accrued benefits in lieu of the salary supplement. Major Medical Sick Leave, Short Term Sick Leave/Family Leave (Revised January 26, 2001) and old Sick Leave cannot be used; vacation leave (Revised December 16, 2000), compensatory time, personal holidays and accrued holiday time (K days) may be used.

Employees who are not eligible for Salary Supplement or whose payroll deductions exceed the calculated Salary Supplement payment, must take appropriate action to ensure pay out of items such as Credit Union loans and employee and dependent health insurance. (Check rules for paying health insurance for injured worker when he/she is on FMLA)

In the event that the disability appears to be questionable, the City may exercise its rights under the Texas Workers’ Compensation Act by requesting an Independent Medical Exam and/or a Designated Doctor examination through the Texas Workers’ Compensation Commission. The results of an Independent Medical or Designated Doctor Examination shall be the determining factor in deciding the employee’s eligibility to receive supplemental benefits.

Attorney Fees and Representation. (added 2-10-06) As stipulated by DWC Rule 152.1, employees do have the right to engage an attorney in their workers compensation matters. If an employee hires an attorney to represent him/her in the workers’ compensation claim, the attorney fees would be deducted from the employee’s TIBs payments by the City’s TPA.

Payroll Reporting Under the Workers' Compensation Program

The first seven (7) days (consecutive or cumulative of lost time due to an occupational disability should be carried with sick leave, vacation leave, short term sick leave/family leave (Revised December 16, 2000) or without pay. The time and attendance should be marked S8 or W8 (or S10, W10 if applicable) on the top line and 0-1 on the second line. Do not count the 0-1’s from the first seven (7) days in the total column.

Employees will be paid for an entire shift on the day an injury occurs. (Revised January 26, 2001) An employee receiving 50% salary supplement should be shown with four hours (or five hours if applicable) each day on the top line and 0-1 on the second line of the Time and Attendance Report, beginning the eighth day (consecutive or cumulative) of occupational disability.

An employee receiving 75% salary supplement should be shown with six hours each day, beginning the eighth day (consecutive or cumulative) of occupational disability.

In the column immediately below the employee number and the hourly rate, the Time and Attendance clerk should write in the fund, Department-Division-Section, code WC, and the current Workers Compensation daily rate. For each day an employee is off on occupational injury, the code of 0-1 should be entered. (This will be done for all employees receiving a salary supplement, regardless of the amount.)

The leave time an employee uses (Revised 5-8-07) for the first seven (7) days of occupational disability, these would be recorded in the normal manner with 0-1 on the line below. Then in the column immediately below the employee number and the hourly rate, the Time and Attendance clerk should write in the fund, Department-Division-Section, code WC, and the current daily compensation rate. For each day an employee is off on occupational injury, the absentee code of 0-1 should be entered.

Employees not entitled to a salary supplement are carried "Without 8" on the top line, and code WC at the current daily compensation rate would be used with the absentee code of 0-1 on the line below.

A Workers’ Compensation instructional manual, Time and Attendance (T&A) Procedures for Workers’ Compensation Lost Time, is available through the Reprographics Division. This is a tool to guide those responsible for the posting of T & A sheets through the process. The manual is useful for non-civil and civil service employee T&A records for those workers who have sustained an occupational lost time injury.

The manual will give you the necessary information concerning the use of appropriate accrued leave (Revised December 16, 2000) and compensatory time.

Detailed information is available from the Occupational Health and Safety Office (Revised July 1, 2003) or the Payroll Department.

Accrued Leave Usage Supplement (New provision effective July 1, 2003)

Employees who are eligible to receive a salary supplement may request approval to use accrued vacation, personal holiday, accrued holidays or compensatory time to further supplement their income while off work on workers’ compensation.

Major medical sick leave, short term sick/family leave, old sick leave, voluntary leave bank and donated leave cannot be used under this provision.

The accrued leave usage is limited to the amount up to which the employee will receive their regular salary. The workers’ compensation benefit, plus salary supplement, plus accrued leave usage supplement cannot exceed the employee’s regular salary.

To utilize this supplement employees must submit a written request to his/her Department Director. The employee’s workers’ compensation benefit, salary supplement benefit (if eligible), and accruals of appropriate leave and compensatory time will be reviewed. If the Department Director or designee determines that the employee may utilize this benefit, his/her recommendation will be forwarded to the Human Resources Director for review and final approval. If the department decides to deny the request, a written explanation will be sent to the employee and there will be no further review or appeal of the matter.

Upon approval of the leave usage supplement, the department and the employee will work together to determine the amounts and the types of leave that will be used to supplement his/her salary.

Compensation for Employees Subject to Municipal Code, Local Chapter 143, Revised Civil Statutes of Texas (Police and Fire Civil Service) (Revised 2-10-06)

The provisions of this policy will apply to injuries sustained on/or after October 4, 2003. Civil Service employees are subject to the rules in this policy except where there is conflict with Chapter 143 rules.

Civil service employees, who are subject to Chapter 143, will receive full salary equivalent to AWW for up to one (1) year in accordance with Chapter 143 of the Texas Local Government Code for a leave commensurate with the nature of a compensable on the job injury. Full salary is defined as average weekly wage (AWW) of the employee and includes shift differential. All full salary payments paid to civil service employees are subject to the required payroll deductions to include health insurance, retirement contributions, and any court-mandated deductions (i.e. child support, etc.)

Full salary payments begin with the first day of lost time. If AWW is less than regular pay, (40) forty hours for Police Officers and (40) forty or (56) fifty-six hours for Firefighters, the employee will receive full salary pay while off work for an occupational injury for up to 365 days. Civil service employees will receive bi-weekly pay from the City, based on the employee’s AWW.

If AWW is less than regular pay, (40) forty hours for Police Officers and (56) fifty-six hours for Firefighters, the employee will receive regular pay while off work for an occupational injury for up to 365 days. Civil Service employees will receive pay biweekly from the City, based on the employee’s average weekly wage (AWW).

The City will comply with the DWC rule 128.3 (d) to determine the average weekly wage for an employee:

“If an employee has worked for 13 weeks or more prior to the date of injury, or if the wage at time of injury has not been fixed or cannot be determined, The wages paid to the employee for the thirteen weeks immediately preceding the injury are added together and divided by 13. The quotient is the average weekly wage for that employee.”

If the civil service employee does not earn AWW when he/she returns to work, a DWC 6 must be completed and submitted to the Human Resources Occupational Health and Safety Division, showing the difference in Post Injury Earnings (PIE). If PIE is more than AWW, the employee is due no money from the City’s TPA. When PIE is less than AWW, the employee is due 70% of the difference between PIE and AWW or the State mandated maximum.

The civil service employee is eligible to receive TIBs if he/she returns to work and full salary payment is terminated and there is no extension of full salary benefits until he/she attains Maximum Medical Improvement (MMI) or AWW equals or exceeds PIE prior to MMI.

Extensions of Full Salary Benefits. Civil Service employees will be notified approximately (60) sixty-days prior to the expiration of their full salary so that he/she, if necessary, may petition for an extension of full salary benefits. At the written request of the employee, the City Council may extend the full salary benefit in part or whole for a period of six months per extension.

When a year has passed and/or all extensions have been exhausted and the employee is not at MMI and/or is still eligible to receive TIBS; the City’s TPA will begin to send the employee his/her appropriate amount of TIBS weekly. The employee may then use accumulated sick leave, vacation leave, or other accrued benefits to supplement his or her salary, before being placed on Temporary Leave as defined in Chapter 143 of the Texas Local Government Code.

Attorney Fees and Representation. (added 2-10-06) As stipulated by DWC Rule 152.1, civil service employees do have the right to engage an attorney in their workers compensation matters.

If an employee hires an attorney to represent him/her in the workers’ compensation claim, normally the attorney fees would be deducted from the employee’s TIBs payments by the City’s TPA. The City’s Finance Department/Payroll Division performs administration of full salary and therefore any attorney fees and payments will need to be settled between the civil service employee and the attorney. (revised 2-10-06)

Deductions. (added 2-10-06) All normal paycheck deductions (i.e. taxes, health and dental insurance, court ordered child support, retirement etc.) will continue to be deducted from the full salary payments that the injured employee receives from the City.

Holiday Pay. (added 2-10-06) Civil Service employees who are off work for an occupational injury/illness on a holiday will receive holiday pay if they are receiving full salary benefit or earn a “K” day for the holiday if they are not receiving full salary benefit. General employees who are off work for an occupational injury/illness on a holiday will earn a “K” day for the holiday.

Leave Accrual (added 2-10-06) General and Civil service employees will continue to accrue all leave (i.e. sick, vacation) while off work for a compensable occupational injury/illness.

Noncompliance (added 2-10-06)
General and Civil Service employees who fail to comply with the rules and regulations set out in the Texas Labor Code and the Workers Compensation rules are subject to the penalties associated with noncompliance.

Overpayments (added 2-10-06)
If there are overpayments regardless of cause, while the employee is receiving full salary from the City, the amount of the overpayments will be recovered in whole or in partial payments, as agreed upon by the department and the employee, from future checks from the City and the recovery may begin while the employee is on occupational injury leave. Any overpayment created, regardless of cause, when an employee is eligible to receive workers compensation benefits will be recovered by the City’s TPA from workers compensation benefits and future indemnity benefits.

Seniority (added 2-10-06) Seniority shall continue to accrue during an occupational injury/illness leave.

Return To Work (new policy effective August 2, 2004)

Policy Statement

The City recognizes that there are many instances in which an injured or ill employee can make a significant contribution to the City’s mission during the employee’s recovery period. To that end, the City adopts this Return to Work program to facilitate the speedy return of injured or ill employees to full duty.

Definitions

For the purpose of this policy, the following terms have the indicated meanings:

“Alternative Assignment” is job redesign or placement to meet the needs and abilities of the individual, with work restrictions as determined by their treating physicians.

“Business Days” is Monday through Friday, excluding City holidays.

“Designation of Duty Status form” is a medical work release form used for non-occupational injuries or illness.

“Employee” means current employees only, but does not include those who are ineligible for City benefits, including SO1, and temporary employees. (Revised Nov. 15, 2004)

“Extended Limited Duty” is an extension of limited duty status for non-probationary employees who have been on limited duty in excess of 6 months.

“Extended Limited and/or Limited Duty Assignment” is a temporary work assignment, including limited, partial, and part-time work, which meets the following criteria:

The work must be productive;
The work must be consistent with medically determined restrictions; and
The employee must possess the necessary skills to perform the assignment.

“Full Duty” is a medical determination that an employee can safely perform all of the essential functions of his/her job with no limitations or restrictions or with reasonable accommodations.

“Limited Duty” is a medical designation that an employee may return to work with specific detailed limitations or restrictions.

“Independent Medical Examination”(IME) is a physical exam of the injured employee required by the Texas Workers’Compensation Commission.

“Maximum Medical Improvement (MMI)” is the earlier of:

The point in time that an employee’s injury or illness has improved as much as is medically possible based on the ability to perform the essential functions of his or her job; or
105 weeks from the date an occupationally injured worker became eligible to receive worker's compensation income benefits.

“Preferential consideration” is the procedure of interviewing the laid off employee before other candidates for vacant positions (transfers or demotions) for which he or she is qualified and which meet the employee’s medical restrictions. If the individual is not selected, the non-selection reason will be reviewed by the Return to Work Committee.

“Return To Work Committee” is a committee that may assist in placement efforts for injured employees in limited duty assignments and extended limited duty assignments. The committee consists of the City’s ADA Coordinator, Disability Coordinator, Staffing Services representative and mid-level management personnel representing various city departments.

“DWC73 Work Status Form” is a medical work release form required under the Texas Workers’ Compensation Commission (DWC) form for occupational injuries.

Determination of Assignments

Due to the limited availability of limited and extended limited duty positions, preference shall be given to employees who have suffered an on-the-job injury/illness except as otherwise required by the Americans with Disabilities Act.

If a limited duty or extended limited duty position is not available in the department or elsewhere within the City during the employee’s recovery period, an employee whose impairment is the result of occupational illness or injury shall remain on injury leave until (a) a position becomes available; (b) such time as the employee is returned to work by his/her treating physician; or (c) the employee reaches MMI, whichever comes first. Employees whose impairment is not the result of an occupational injury/illness must use appropriate accumulated leave, or time without pay if leave is not available, until the employee is returned to full duty status by his or her personal physician.

If an employee with an occupational injury/illness refuses to accept a limited duty or extended limited duty job assignment which he or she can perform and for which he or she is qualified, the employee shall be disqualified from participating in the limited duty program for the duration of his/her injury and may not be allowed the usage of personal accrued leave to supplement workers compensation benefits for the duration of his/her injury. Refusal to accept a limited or extended limited duty assignment may result in discipline up to and including termination.

Obligations of Employees

All employees with occupational or non-occupational illnesses or injuries are responsible for communicating to their physician that the City does have a return to work program.

Employees on limited or extended limited duty shall:

Participate in activities within their medical restrictions in order to progress toward a successful recovery.
Be allowed to promote into other positions if the employee can perform the essential functions, and meets the minimum qualifications for the promotional position. Civil Service employees will follow the applicable procedure as outlined in Chapter 143 of the Texas Local Government Code.
Be allowed to work a regular work-week while in this status. Employees will not be able to work overtime or earn compensatory time until returned to full duty status. The Department Head must approve all secondary employment.
Not wear a uniform if the employee is a licensed Peace Officer.

During the employee’s placement in a limited duty assignment, the employee is required to provide an updated medical status when his or her condition changes or when he or she returns for a follow-up visit to the treating physician.

Limited Duty

The department’s Return to Work Coordinator will oversee the coordination of the limited duty assignments. Each department head will assign a Return to Work Coordinator, who will have the authority to work with employees and management to find appropriate limited duty assignments. The Return to Work Coordinator will assess assignments based upon the employee’s skills, knowledge, ability, recovery period, medical prognosis, status of maximum medical improvement (MMI), and duration of restrictions. The process of requesting a limited duty assignment begins with the employee submitting the Work Status Report Form (DWC-73) or the City’s Designation of Duty Status (DDS)to the Return To Work Coordinator.

Limited duty assignments will be made only after the department’s Return to Work Coordinator has received a Work Status Report form (Texas Workers’ Compensation Commission, DWC-73) for employees who have incurred an occupational injury/illness or the City’s Designation of Duty Status (DDS) form for employees who have incurred a non-occupational injury/illness.

Assignments will be commensurate with the employee’s medical restrictions. The purpose of a limited duty placement is not to create a permanent limited duty career path, but rather to provide an injured employee with a temporary position with the understanding and expectation that he or she will return to full duty.

The City will follow the policy already established in the Personnel Rules and Regulations for occupationally injured employees under the Texas Workers Compensation Act regarding Independent Medical Exams (IME) or Designated Doctor examinations. Refusal to undergo an IME is grounds for termination. If the IME results and the employee’s physician’s assessment are significantly different, another mandatory IME shall be required. In such instances, the City and the employee must agree upon a physician to do the final IME. The results of this IME will be the final status of the employee’s condition.The City will pay for all IME’s and the requesting department will be charged for all IME costs.

In the event of a non-occupational illness or injury, the Department Head has the right to request the employee to have a physician complete the City’s Designation of Duty Status (DDS) form for employees who have incurred a non-occupational injury/illness. The designation of duty status form (DDS) is designed for reporting the medical restrictions of an employee who has incurred non-occupational injury/illness. An employee who has incurred a non-occupational injury will be responsible for having the DDS form completed by his/her physician and submitting the form to the Department’s Return To Work Coordinator for placement in a limited duty assignment. If the employee's physician will not complete a DDS form, the City will ask for a Functional Capacity Evaluation by a physician of the City’s choice, the cost of which shall be borne by the employee’s department.

An employee with an non-occupational injury or illness can be placed in a limited duty assignment for up to six (6) months if he or she is released to return to work with temporary restrictions, except as otherwise required by the Americans with Disabilities Act.

When an employee is released to work with medical restrictions, the department is expected to:

Ensure the employee has turned in the completed DWC-73 or the City’s DDS form to the department’s Return to Work Coordinator. The form should outline the physical/mental restrictions criteria for the limited duty assignment.
Assign the employee to a temporary limited duty assignment (if available), the essential functions of which the individual can perform in accordance with the medical restrictions and for which he or she is qualified.
Contact the department’s Return to Work Coordinator in a timely manner to begin the process of placing the employee in a limited duty assignment.
In the event that the department cannot locate a position within the department, the employee will be referred to the Return to Work Committee. The Committee will consult with the employee, department personnel, and other departments within the City in an attempt to place the employee in a temporary limited duty assignment in another department, the essential functions of which the individual can perform in accordance with the medical restrictions and for which he or she is qualified. (Revised Nov. 15, 2004)

Extended Limited Duty

Employees who have an occupational injury/illness and are assigned to a limited duty assignment and require additional recovery time, shall, within fifteen (15) days and no more than thirty (30) days prior to the expiration of the limited duty assignment, provide a written request for extension to the department with an updated medical status (DWC-73 or DDS form) from the treating physician. Should further extensions be requested, the employee is responsible for providing a DWC-73 form for each additional request.

The Department Director, based on the department’s needs and work priorities, can extend limited duty assignments in 30-day increments for up to an additional six (6) months. Employees who have incurred a non-occupational injury/illness are ineligible for extended limited duty, except as required by the Americans with Disabilities Act.

After the first six (6) months of an extended limited duty assignment, future extensions of extended limited duty assignments may be granted in up to twelve (12) month increments until the employee is released to full duty, released with permanent restrictions that cannot be accommodated in his/her present position, or the employee reaches MMI, whichever comes first. Extended limited duty assignments will be made only after the Return To Work Coordinator in coordination with the Department Head receives a Work Status Report for (DWC-73) or the City’s DDS form.

During the employee’s placement in an extended limited duty assignment, the employee is required to provide an updated medical status if his or her condition changes or when he or she returns for a follow up visit to the treating physician. Department Heads have the authority to discontinue or amend the type and length of assignment if it is in the best interest of the department, except as required by the Americans with Disabilities Act. The requirement to provide an update on medical status ceases when an employee is permanently transferred to an alternate assignment.

Appeal Process

In instances where an employee’s’ request for a limited duty assignment or for an extended limited duty assignment is denied by the department, the employee may file an appeal to the City Manager through the Human Resources Director or designee within fifteen (15) calendar days after the denial is issued. The appeal must be in writing and include any medical documentation pertinent to this decision.

The employee has the burden to establish his or her ability to perform the essential functions of the position he or she is seeking. The employee also has the burden to establish that he or she is qualified for the position being sought. This appeal process is not meant to dispute assignments or to create additional light duty assignments but instead to determine the employee’s qualifications for limited duty assignments or for extended limited duty assignments. Once Human Resources receives the employee’s appeal, Human Resources will have five (5) business days to contact an independent expert to perform a job site assessment.

Protocol for Job Site Assessments:

Job Site Assessment (JSA) is referred from the City’s Human Resources Department
The employee will provide the independent expert access to all of the recent medical information indicating the employee’s medical status and physical abilities;
The expert will retain or obtain an objective Functional Capacity Assessment on the employee;
The City shall provide the independent expert with the job description, access to the job site and the site supervisor as appropriate.

Once the assessment is completed, the independent expert will submit a report within ten (10) business days to Human Resources. Human Resources within (10) business days will review and make a recommendation to the City Manager. The City Manager will evaluate the recommendation and will make the final decision regarding the employee’s eligibility for a limited duty assignment.

If placement into a limited duty or extended limited duty assignment cannot be made for an employee due to the nature of the work restrictions, the employee may choose to use all available leave in accordance with either Chapter 143 (if the employee has not exhausted full salary leave), the City’s Personnel Rules and Regulations, worker’s compensation benefits or salary supplement benefits (if applicable) until placement can be made or the employee is released to return to full duty.

Alternative Assignment

Occupationally Injured Employees (Revised Nov. 15, 2004)

When an employee who has experienced an occupational injury/illness is released to work with permanent restrictions (reached maximum medical improvement, MMI) (Revised Feb. 23, 2009) that will not allow him or her to perform the essential functions of his or her original position, the employee will be referred to the Employment Options process. (Revised)

Upon completion of the Employment Options meeting with the employee, the employee will be referred to the Return to Work Committee. For the next 60 calendar days (Revised 02/23/2009) the Committee will consult with the employee, department personnel, and other departments within the City in an attempt to place the employee in a vacant position citywide. In attempting to find a position for the employee, the Committee will look only at vacant positions, and is not required to create a new position solely to accommodate the employee. The Committee will continue working to place the employee from the inception of the case until the end of the one (1) year preferential hiring period.

The employee must be qualified for the position and be able to perform the essential functions of the position except as required by the Americans with Disabilities Act. In an effort to minimize the loss of salary, the employee will be transferred at the current salary rate, unless the current salary rate is above the maximum pay of the top of the salary range, in which case the employee will be paid the maximum pay for the position.

If the Return to Work Committee locates an appropriate vacant position within the City, the Committee will make a recommendation to the Department Director and Human Resources Director that the employee be placed in the position. Final placement of employees in a position will be at the discretion of the hiring department.

In the event that the Return to Work Committee is unable to place the employee in a position, the employee will be laid off. (Revised 02/23/2009)

Employees who are (Revised 02/23/2009) lay-off will be given preferential consideration for vacant positions that they are qualified to fill for one (1) calendar year. Preferential consideration provisions are governed by the city’s Layoff Policy. The Committee will continue to attempt to place the employee during the one (1) year preferential consideration period. Persons hired into an “S” key code position before the end of the one (1) year period will continue to have preferential hiring consideration until the period ends. (Revised 02/23/2009)

Non-Occupationally Injured Employees

Non-occupationally injured employees may be eligible for assistance in finding alternative employment with the City under the terms of the City’s Alternative Employment Policy (See Health & Safety page 1) (revised Nov. 15, 2004).

Safety Program

It is the policy and desire of the City of Fort Worth to provide safe working conditions for all employees. The City will provide the equipment and training required for personal safety and health in keeping with the highest standards. Effective safety is a shared responsibility, and to that end:

The City accepts the responsibility for leadership of the Safety and Health Program, for its effectiveness and improvement, and for providing the safeguards required to ensure safe conditions.
Mid-management personnel (persons to whom first line supervisors report) are responsible for ensuring that identified deficiencies are corrected in a timely manner; and, reviewing training programs, safety inspections, and accident investigation reports.
Supervisors are responsible for ensuring safe working conditions, providing appropriate safety equipment, enforcing safety rules and guidelines, providing safety training, conducting safety inspections, investigating accidents, and keeping safety-related records.
Employees are responsible for wholehearted, genuine cooperation with all aspects of the Safety Programs – including compliance with all rules and regulations – and for conscientiously practicing safety in the performance of their duties.

A well-organized safety policy and procedure, supported by each employee, will benefit both the employee and the citizens of Fort Worth. Maintenance of safety standards and continuous review of all matters pertaining to safety can result in the significant reduction of accidents and injuries which cause pain and suffering, avoidance of losses of time and efficiency, and in monetary savings to the individual and to the City.

First line supervisors and all managerial personnel have the responsibility of providing a safe place to work for all employees of the City of Fort Worth.

All city employees are obligated to abide by all safety rules established by minimum OSHA standards or management. Failure to do so will result in disciplinary action up to and including termination.

Employees who witness an accident or view damages which affect the public and possibly involve the City should take appropriate action as outlined in this regulation.

Employees of the City of Fort Worth are expected to:

Follow all safety regulations, posted signs, job training and operating procedures established by the City of Fort Worth. This includes specific departmental or division safety rules, wearing prescribed safety equipment, safety apparel, and proper work clothing. Immediately report accidents and injuries, regardless of how minor, to a supervisor. Immediately report all unsafe conditions, equipment, unsafe acts, fire or suspicion of fire to a supervisor. Maintain work areas and the facility in which employees work, in a clean, healthful, and sanitary condition and not commit unsanitary or unhealthful acts. Abide by all rules governing the movement of traffic, speed, and parking. Properly display any vehicle I.D. numbers that may be required on City equipment. Smoke only in authorized areas; consume food and beverage in designated areas only.

When an employee begins a new job it will be the responsibility of the supervisor to train and instruct the employee in the safe method of performing the job assigned. The supervisor and the designated Safety Coordinator will have the responsibility of providing safety training as an ongoing project. During safety meetings and, when new equipment or processes are introduced, the supervisor will have the responsibility to provide training when necessary.

All City employees will wear personal protective equipment in all areas requiring such equipment. Designated areas will be properly identified as to what type of clothing or equipment is required. All supervisors will be responsible for the maintenance, administration, and the purchase of required personal protective equipment which may include but not be limited to: Head Protection; Ear Protection; Face and Eye Protection; Respiratory Equipment; Safety Belts; Protective Footwear and, Special Work Clothing.

Steel toed shoes will not be furnished by the city.

Safety inspection tours will be conducted by the Division Safety Coordinator or designee at least once a month. Monthly inspection reports will be reviewed by Division Managers.

Departments must establish a safety inspection schedule to meet the necessity of ensuring facilities and work areas are safe. A copy of the departmental safety inspection schedule must be sent to Occupational Health & Safety Division of the Human Resources Department (revised June 1, 2004).

Safety inspections will be conducted by the Department Director/Division Head or the Department Director/Division Safety Coordinator or designee and will be accompanied by one key employee from that department/division. Reports will be audited by the Department Director/Division Head for corrective action. Within fifteen (15) calendar days, a copy of the report will be sent to Occupational Health & Safety Office (revised June 1, 2004).

The City Safety Coordinator will, at least semi-annually, conduct safety inspections of the City facilities. Inspection reports will identify necessary corrective actions which should be completed within fifteen (15) days of the inspection.

Department Safety Committee – Department Directors/Division Heads shall appoint a Safety Committee within the Department/Division. The make-up of this committee should include the Department Safety Coordinator and key hourly employees. The Committee shall meet on a monthly basis to discuss, evaluate , and solve safety matters.

Department Safety Coordinator - Department Directors/Division Heads shall designate a Safety Coordinator with such assistants as may be required by the size and organization of the department, who shall assist in the implementation of the City's Safety Programs and keep the Department Director advised of all aspects of its operation. Safety Coordinators shall ensure that all safety policies or programs approved by the Department Director/Division Head are followed uniformly throughout the department and shall promptly advise the Department Director of any matters requiring attention. The Safety Coordinator shall confer at regular intervals with the City's Safety Coordinator.

Safety Coordinators Meetings – Safety Coordinators and/or assistants designated by their Department Director/Division Head shall attend a monthly Safety Coordinators Meeting. The meetings will be chaired by the City Safety Coordinator. The meeting will be used to communicate safety policies and procedures and other safety related materials.

Accident Review Board - The following departments will establish, organize, and actively operate Accident Review Boards: Transportation/Public Works, Water, City Services, Public Health, Engineering, Aviation, Fire, Police, Parks and Community Services, and Municipal Court Services.

All other departments and offices will operate under a Combined Accident Review Board unless and until, at the option of the Department Director, a Departmental Accident Review Board is established and in operation. The Combined Accident Review Board shall be organized by the Occupational Health & Safety Office (revised June 1, 2004)and shall operate under rules established and promulgated by the department.

Accident Review Board Meetings are set-up to establish accountability for all accidents involving City employees or property by: insuring that all accidents are fully reported and reviewed by the responsible supervisor; determining whether an accident was caused by a safety violation and what corrective action might have been taken to avoid the accident; reviewing or recommending disciplinary action(s), which are based on safety violations and are reasonable, appropriate, prompt, and consistent with prior action in similar cases; and, recommending appropriate recognition for good performance.

Employer's First Report of Injury - When a death, lost time, or first aid injury occurs, or when a supervisor is made aware of an injury, the supervisor will complete an Employer's First Report of Injury (Form DWC-1) as expeditiously as possible and forward this report to the Occupational Health & Safety Office (revised June 1, 2004) as soon as possible but at least within 72 hours. If the injury involves death or serious injury, this information must be reported to the Occupational Health & Safety Office (revised June 1, 2004) by telephone as soon as possible.

Accidents that cause death or lost time and, near miss or vehicular collisions will be investigated by the Department Director/Division Head and should be fact-finding and not fault finding. The value of investigations lies in uncovering contributing causes. A written report answering the who, what, where, when, and why, or the Supervisor's Accident Investigation Report form must be completed after each investigation. The report will be separate from the Employer's First Report of Injury and will be used during the accident Review Board meetings. The investigation and report should be completed as soon after the accident as possible. (See policy entitled "Employee Work Status Resulting from Injury or Illness" for more information)

Emergency and Medical Treatment - See the regulation entitled "Occupational Injury Benefit (Workers’ Compensation)."

Workers’ Compensation Control Group

The Workers’ Compensation Control Group (WCCG) has been established so departments can temporarily fill positions occupied by persons who are are either unable to work or who are in a less than full duty status (Revised July 1, 2003) due to an occupational injury or illness. Employees who have been off work for 30 calendar days may be transferred into the Workers’ Compensation Control Group (Fund 999, Department 15, Division 73, Section 10, Pay Group 180) (Revised July 1, 2003). The initial 30 calendar day period may be waived if an employee submits a Designation of Duty Status form indicating an absence or a less than full duty status (Revised July 1, 2003) in excess of 60 days or for an indefinite period.

Departments must continue to pay the salaries of those employees who are transferred into the WCCG when they are in a less than full duty status. Those employees who are transferred into WCCG because they are unable to work will be compensated in accordance with the Workers’ Compensation policy. (Revised July 1, 2003)

Transferring into the WCCG

Send requests to transfer an employee into the WCCG to the Workers’ Compensation Coordinator in the Occupational Health & Safety Division of the Human Resources Department (Revised July 1, 2003). The Department Director or designee making the request must explain the rationale for the request in terms of diminished productivity. Documents accompanying the request should include Designation of Duty Status forms and a Personnel Action Request (PAR) form authorizing the transfer. Use the employee’s "home" department Locator Code and, Index Code and/or Mars Code on the PAR.

During an employee’s assignment into the WCCG, all current Workers’ Compensation rules and regulations continue to apply including: contacting one’s supervisor at least once every five (5) working days; refraining from engaging in any unauthorized secondary employment; ; following doctor’s orders (Revised July 1, 2003) and, submitting Duty Status forms after every physician’s examination or upon request.

Employees in the WCCG will continue to accrue Vacation and Major Medical Sick Leave and Short Term Sick Leave/Family Leave hours. (Revised December 16, 2000)

Returning to Work

Unable to Work Status Employees (Revised July 1, 2003)

Employees who were transferred into the Control Group while completely off work (unable to perform any duties) must return to work when their duty status allows their return to work (very light, light, full duty status). (Revised July 1, 2003).

Less than Full Duty Status Employees (Revised July 1, 2003)

Employees who were transferred into the Control group while in a less than full duty status must remain there until they receive a full duty status release to return to work. (Department Directors may request a waiver to this provision when deemed necessary.) (Revised July 1, 2003).

When an employee is released to return to work (very light, light or full duty status), the "home" department must notify the Occupational Health & Safety (Revised July 1, 2003) Division and prepare a Personnel Action Request form authorizing the employee’s return to his/her original position.

If the employee’s position was filled with a temporary employee, the temporary employee will be released. If the position was filled with a regular employee, that employee will be laid off, and entitled to the benefits under the City’s Layoff policy.

Maximum Medical Improvement

Employees who reach maximum medical improvement must be removed from the WCCG. If the employee is not able to perform the essential functions of his/her job (with or without accommodation), the employee will be subject to the terms of the Return to Work Policy.(Revised Nov. 15, 2004)

Replacement Employees

Temporary employees may be hired to fill positions vacated by employees being transferred into the WCCG. If it is medically determined that the injured/ill employee will not be able to return to his/her position in full duty status, the department, with the approval of the Loss Control Administrator, may fill the position with a regular employee.

Persons hired into such positions must sign an Employment Agreement which states that in the event that an employee is able to return to their position, the replacement employee will be laid off and be entitled to the benefits under the City’s Layoff policy.