LOS ANGELES COUNTY
DEPARTMENT OF MENTAL HEALTH
  Policy 604.06 Leave for Follow-Up Medical Appointments for Industrial Injuries/Illnesses
 
  PROCEDURES
  1. Responsibilities of the Designated Approver
     
    1. Supervisor or his or her designee shall contact the Leave Management Unit (LMU) to determine the status of a claim prior to approving Code 150 leave.
       
    2. Supervisor or his or her designee shall obtain, verify, and maintain documentation of the employee's request for time off and medical certification, indicating that they attended an appointment related to their accepted Workers' Compensation claim.
       
    3. The supervisor or his or her designee shall provide a copy of the time-off request and medical certification to the LMU within one week (seven [7] calendar days) of the employee's appointment date.
       
    4. Supervisor or his or her designee must ensure that all leaves designated as Code 150 leave are coded correctly on employees' timecards.
       
    5. Supervisor or his or her designee must notify the employee of this policy, and when they are no longer eligible for this leave.
       
  2. Medical Certification
     
    1. An employee shall submit a satisfactory medical certification on official letterhead of the medical provider to include the date of injury, physician's name, signature, telephone number, and time in and time out for each appointment to the Department indicating they attended an appointment.
       
    2. If an employee is unable to return to work, medical certification indicating that they attended an appointment should be faxed by the medical provider, or scanned and emailed by the employee, to the supervisor or LMU. It is the employee's responsibility to ensure the certification is provided within one (1) business day from the date of the visit.
       
  3. Appointments
     
    1. Employees shall request time off in advance for all non-emergency medical appointments. Employees are required to submit a Request for Overtime or Time Off (ROTO) at least one (1) business day prior to the date of the appointment.
       
    2. If permissible, appointments are to be scheduled at the beginning or end of the employee's work shift.
       
    3. Appointments may be scheduled by the employee, the LMU, or the TPA.
       
    4. Employees shall work a minimum of four (4) hours (Code 099) on the day of the appointment. This does not apply to exempt employees.
       
  4. Time Limitations
     
    1. A maximum of four (4) hours of Code 150 leave per work day, including transportation time and treatment time, shall be authorized and subject to the approval by the LMU or supervisor.
       
    2. Additional time taken off in excess of four (4) hours may be authorized with verification from the TPA, and shall be coded as follows:
       
      1. Non-exempt employees: "Sick" or other benefit time subject to the approval of the supervisor.
         
      2. Exempt employees: "Exempt Leave" (019), unless they are using Family and Medical Leave Act (FMLA) time.
         
    3. A maximum of eight (8) hours of Code 150 leave in any one work week shall be authorized and subject to the verification by the LMU or supervisor.
       
    4. Travel time to and from will not exceed a total of one (1) hour (60 minutes).
       
    5. Appointments outside of regular working hours are not compensable. No overtime may be claimed for appointments outside of regular working hours.
       
    6. Prior to Workers' Compensation claim acceptance, employees are to use their available benefits for follow-up medical treatment for work-related injuries or illnesses. If a claim is subsequently accepted by the TPA, employees who initially used their own time prior to the claim being accepted may submit, for approval, a timecard adjustment within one (1) year from the date of the injury to charge Code 150. Prior to submitting the timecard adjustment, the employee should provide the LMU with all pertinent medical certifications for the time/dates claimed as Code 150.
       
  5. Interaction with Anything Other Than 5/40 Work Schedule
     
    1. If an employee is on a 4/40 or 9/80 alternate work schedule and any of the circumstances listed below apply, the 4/40 or 9/80 work schedule may be terminated and the employee may be placed on a 5/40 work schedule.
       
      1. Prolonged leaves or recurring intermittent absences;
         
      2. Ongoing treatment such as physical therapy; or
         
      3. Restrictions requiring a reduced work schedule.
         
    2. Alternate work schedule may resume when the above conditions no longer apply.
       
  6. Exclusions from Using Code 105 Time
     
    1. Employees who are impacted by any of the following are not authorized to use Code 105 time if:
       
      1. Appointment is beyond two (2) years from the original date of injury;
         
      2. Workers' Compensation Appeals Board granted an award;
         
      3. Case was agreed upon by Stipulated Settlement;
         
      4. TPA closed the case; or
         
      5. It is during a Salary Continuation or post-Salary Continuation period.