Accidental Injury Clause Samples

Accidental Injury. Accidental bodily injury sustained by a Member that is the direct cause of the condition for which Benefits are provided and that occurs while this Agreement is in force. Acute Rehabilitation. Services provided to treat traumatic injury in an acute rehabilitation hospital.

Accidental Injury. 1. Employees who sustain injuries occurring in connection with their assigned duties and not as a result of their own negligence shall be eligible for leave of absence without loss of pay up to a maximum of one year from the date of the job-related injury. The leave is subject to the approval of the Board’s MRO or designee. The employee shall submit to re-examination by the Board’s MRO or designee periodically as required, but at least every three (3) months. In any case where the injury requires an extended leave of absence the Board may request that the employee be considered for retirement because of accidental disability. No employee shall be entitled to receive Workers’ Compensation benefits for temporary total disability during the time, or covering the period, that said employee is receiving his or her full salary for job injury leave as outlined above. 2. Absence due to disability resulting from an assault will be covered by an assault leave. This leave will not be charged to sick leave. The employee will be in full pay status for the duration of the disability. 3. There will be a Joint Union/BCPSS Oversight Committee established to review all employees rejected or released on the basis of decisions made by the Board’s MRO or designee. 4. The Union and the Board’s MRO or designee shall meet quarterly or more frequently as needs dictate to review and discuss problems of unit members who must report to the clinic because of job-related injuries.

Accidental Injury. Bodily Injury sustained by a Member as the result of an unforeseen event and which is the direct cause (independent of disease, bodily infirmity or any other cause) for care which the Member receives. It does not include injuries for which benefits are provided under any Workers’ Compensation, employer’s liability or similar law.

Accidental Injury. A condition occurring as a direct result of a traumatic bodily injury sustained solely through accidental means from an external force. With respect to injuries to teeth, the act of chewing does not constitute an injury caused by external force. Adverse Benefit Determination – Means denial or partial denial of a Benefit, in whole or in part, based on:

Accidental Injury. Teachers who sustain injuries occurring in connection with their assigned duties and who are absent for longer than three (3) consecutive workdays shall be given leave of absence with pay offset by Workmen's Compensation benefits, for a period not to exceed ninety (90) workdays. Beyond this limit, the teacher shall use accumulated sick leave, offset by Workmen's Compensation benefits, or request an unpaid leave of absence. The teacher shall be required to submit written notification from a licensed physician of being physically or mentally unable to perform his/her duties.

Accidental Injury. A condition that directly results from a traumatic bodily injury sustained only through accidental means from an external force. Injuries caused by chewing are not accidental injuries to teeth. Appeal – A request from a Member or a Member’s authorized representative to change a decision We made about Benefits.

Accidental Injury. A condition occurring as a direct result of a traumatic bodily injury sustained solely through accidental means from an external force. With respect to injuries to teeth, the act of chewing does not constitute an injury caused by external force. Allied Health Facility – An institution, other than a hospital, licensed by the appropriate state agency where required, and/or approved by the Plan Administrator to render Covered Services. Allied Health Professional – A person or entity, other than a hospital, Doctor of Medicine, or Doctor of Osteopathy, who is licensed by the appropriate state agency, where required, and/or approved by the Plan Administrator to render Covered Services. Allied Health Professional includes: Dentists, psychologists, certified nurse practitioners, optometrists, pharmacists, chiropractors, podiatrists, Physician’s assistants, registered nurse first assistants, advanced practice registered nurses, and any other health professional as mandated by state law for specified services, if approved by the Plan Administrator to render Covered Services. Allied Provider – Any Allied Health Facility or Allied Health Professional.

Accidental Injury. Absences due to job-related accidents shall be treated in the following manner: (a) The Board will pay employees the difference between their hourly job rate and benefits received under the Pennsylvania Workers’ Compensation Act, with a limitation of thirty (30) days for which the Board will be liable. (b) When an absence of this type exceeds the thirty (30)-day maximum, the difference between workers’ compensation payments and regular hourly job rate will be paid. This amount will be related to the employees’ per diem rate, converted to time, and deducted from their accrued sick leave. The District’s obligation to pay the difference will cease when the employee’s sick leave has been expended. (c) Absences caused by accidental injury incurred while the employee is engaged in remunerative work unrelated to school duties shall not entitle the employee to sick leave. A qualifying employee’s request for leave shall be considered under the Family and Medical Leave Act of 1993. If the employee does not qualify for leave pursuant to the Family and Medical Leave Act of 1993, an employee must submit a request for unpaid leave to their immediate Supervisor specifying the anticipated duration of the leave within four (4) business days following the accidental injury. Such leave shall be at the sole discretion of the School District, and should not be unreasonably denied. Such leave shall be for a period no longer than two (2) months.

Accidental Injury. If you are injured by someone else’s actions, such as being involved in an automobile accident, and you require additional medical care, Fallon Health ▇▇▇▇▇▇▇▇-▇▇▇▇ will provide that additional care. However, if you recover any money from the party who injured you or someone paying on behalf of that person, such as an insurance company, Fallon Health ▇▇▇▇▇▇▇▇-▇▇▇▇ has a claim upon that recovery. We will seek to recover the amount of the costs Fallon Health ▇▇▇▇▇▇▇▇-▇▇▇▇ had to spend to provide you with the additional medical care you received because you were hurt. These rules and regulations would apply under your usual Medicare and/or Medicaid benefits. Remember, you must notify Fallon Health ▇▇▇▇▇▇▇▇-▇▇▇▇ if you are involved in an accident.