Separation Actions

Procedure 66: Medical Separation

This UCI Personnel Procedure is being revised.
Please contact your Human Resources Business Partner for guidance and
REFER TO POLICIES FOUND AT UCNET PERSONNEL POLICIES FOR STAFF MEMBERS.

Responsible Office: Human Resources
Issued: November 2002

A. References

Personnel Policies for Staff Members

Personnel Procedures for UCI Staff Members

B. Authority and Responsibility

The department head is responsible for taking and/or approving any Medical Separation action. Consultation with Human Resources (Human Resources Consultant and Disability and Rehabilitation Consultant) is required prior to taking any action.

C. Guidelines

  1. General

    An regular status employee with a disability may be separated from the University if the impairment prevents safe and effective performance of the essential job functions of the employee's position, with or without reasonable accommodation. Medical Separation will generally occur after efforts to provide reasonable accommodation are unsuccessful. The separation action is initiated by the department head in consultation with Human Resources and, if applicable, Workers' Compensation and should be considered the final step in the disability management process. (See Policy 81, Reasonable Accomodation and Procedure 81, Reasonable Accommodation.)

  2. Determining Appropriate Action

    An employee may be separated under one or more of the following conditions:

    1. The employee is disabled to the extent that the employee can no longer perform the essential functions of the current position. Essential functions include the fundamental job duties of the position.
    2. Reasonable accommodation was requested by the employee, evaluated by the department in consultation with Human Resources (Human Resources Consultant and Disability and Rehabilitation Consultant) and determined by the department not to be feasible.
    3. Efforts to find alternative employment within the University were unsuccessful.
    4. The employee has been approved for disability benefits from a retirement system to which the University contributes;
    5. The continuation of a medical leave is placing undue hardship on the operations of the unit (see Policy 81, Reasonable Accommodation, G. Undue Hardship). This may include:
      • 1) significant financial hardship for the University;
      • 2) significant disruption to the business activity of the University.
    6. In the case of a Workers' Compensation claim, the department head must consult with the Worker's Compensation Unit before proceeding.

D. Procedure

  1. The department head will review the situation to ensure that the employee has had an opportunity for reasonable accommodation in accordance with Policy 81 and Procedure 81, Reasonable Accomodation.
  2. The department head will submit a Request for Review of Leave Without Right of Reinstatement and/or Medical Separation of Employee to the designated Human Resources Consultant and Disability and Rehabilitation Consultant, with a copy to the campus Benefits Office.
  3. The request shall include supporting data including employee's job description, medical documentation submitted by the employee, any documentation relevant to attempted accommodation of the employee, and any other supporting documentation as requested.
  4. In cases where the employee declines referral to vacant positions and continues to be unable to return to work, the department may submit a Request for Review of Leave Without Right of Reinstatement for undue business hardship.
  5. The Request for Review of Leave Without Right of Reinstatement shall include the following information:
    1. department name, employee name, position title;
    2. why the employee should be considered for medical separation (attach all relevant documentation);
    3. what essential functions of the job the employee can no longer perform (attach job description);
    4. what accommodations, job modifications, or attempts to reassign the employee have been considered and/or implemented; and
    5. how unit operations are being adversely affected by the continued absence of the employee, supported by specific data, if applicable.
  6. Written Notice of Intent - subsequent to review, if Medical Separation is deemed appropriate, the Supervisor shall provide the employee with a Written Notice of Intent to Medically Separate. (See Exhibit A.) The Notice, which must be issued to the employee at least 18 calendar days prior to the intended effective date of the Medical Separation, shall:
    1. cite the policy (Policy 66, Medical Separation) under which the action is taken;
    2. state that the action to be taken is a Medical Separation;
    3. state the reason for the Medical Separation;
    4. state the effective date(s);
    5. include a copy of the supervisor's statement and any other pertinent material considered;
    6. state the employee's right to respond orally or in writing within 8 calendar days from the date of the written notice;
    7. be accompanied by a Proof of Service prepared by someone who is not a party to the intended action (see Exhibit C or Exhibit D)
  7. Written Notice of Medical Separation - after consideration of the employee's response, if any, or within 8 calendar days from the date of the Written Notice of Intent, whichever comes first, the supervisor will provide the employee written notice of any action to be taken (see Exhibit B). This notice shall:
    1. state the action to be taken;
    2. state the effective date(s) of the action. The effective date of separation shall be at least 10 calendar days from the date of the notice of separation or 18 calendar days from the date of the notice of intent
    3. state the employee's right to request a review of the action under Policy 70, Complaint Resolution
    4. be accompanied by a Proof of Service (see Exhibit C and Exhibit D)
  8. A copy of the Proof of Service must accompany the Written Notice(s). Proof of Service provides verification of mailing or personal delivery, and establishes the date of issuance of the notice(s) (see Exhibit C and Exhibit D).
    1. Written Notice of Intent or Written Notice of Medical Separation may be sent through the U.S. Postal Service, First Class, to the employee's last known home address. (It is each employee's personal responsibility to inform the University in writing of any change(s) to the employee's home address.)
    2. Written Notice or Written Notice of Final Decision may be delivered to the employee in person.

E. Applicability

All staff members, except employees who are in a bargaining unit that has an exclusive representative (union) and are covered by the applicable provisions of the collective bargaining agreement.

Procedure 66: EXHIBIT A

Sample Written Notice of Intent to Medically Separate

Date

Name
Title

RE: Written Notice of Intent to Medically Separate

In accordance with Personnel Policies for UC Staff Members, Policy 66, Medical Separation, this is to inform you that effective (at least 18 calendar days from date of issuance), I intend to Medically Separate you from your position of (state position title), in the Department of (state department name).

This action is being taken as a result of (state the reason(s) for the medical separation).

You have the right to respond to me orally or in writing on or before 8 calendar days with reasons why this action should not be taken. You have the right to representation in presenting your response.

Supervisor

c: Department Head
Human Resources Consultant
Disability and Rehabilitation Consultant

Attachments:
Medical Separation Review Request
(Documentation as appropriate)
Proof of Service dated _______________

Procedure 66: EXHIBIT B

Sample Written Notice of Medical Separation

Date

Name
Title

RE: Written Notice of Medical Separation

After careful review of the information you provided me on (date), in your response to the Notice of Intent to Medically Separate, I find no basis to rescind the intended action. Therefore, effective (date), you will be medically separated from your position with (Department).

Please contact_______________, Benefits Representative, at 824-____ to discuss the important options available to you regarding your benefits.

You have the right to request a review of this action under Personnel Policies for UC Staff Members, Policy 70, Complaint Resolution.

Supervisor

c: Department Head
Human Resources Consultant
Benefits Representative
Disability and Rehabilitation Consultant

Attachment: Proof of Service dated _______________

Procedure 66: EXHIBIT C

Sample Proof of Service: Personal Delivery

PROOF OF SERVICE

Personal Delivery

I declare that I am over the age of eighteen years and am not a party to the action described in the attached notice. My work address is University of California, Irvine, Department/Unit Name, Room Number + Building Name + Zot Code, Irvine, California, 92697-Zot Code. On date, I personally delivered the attached (Written Notice of Intent to __________ or Written Notice of __________) to:

(Name of Recipient)
(Location)

I declare under penalty of perjury that the foregoing is true and correct and that this declaration was executed on (date) at Irvine, California.

Signature
Name Typed Here

Procedure 66: EXHIBIT D

Sample Proof of Service: Delivery by U.S. Mail

PROOF OF SERVICE

Delivery by U. S. Mail

I declare that I am over the age of eighteen years and am not a party to the action described in the attached notice. My work address is University of California, Irvine, Department/Unit Name, Room Number + Building Name + Zot Code, Irvine, California, 92697-Zot Code. On (date), I served the attached (Written Notice of Intent to __________ or Written Notice of __________) by placing a true copy enclosed in a sealed envelope with postage fully paid in the United States mail, addressed as follows:

(Name of Recipient)
(Street Address)
(City, State, Zip Code)

I declare under penalty of perjury that the foregoing is true and correct and that this declaration was executed on (date) at Irvine, California.

Signature
Name Typed Here