Benefits for work-related injuries or illnesses may be extended by the Plan where liability is being controverted by the employer in a proceeding before the particular workers' compensation agency with jurisdiction and participant's related claims are unpaid; or claims payments were made before notification to the Plan of their work-related nature.
Where the Plan does extend benefits for a work-related injury or illness, the Plan will be entitled to reimbursement where the employer acknowledges or the respective workers' compensation agency determines that the injury or illness is work-related. The Plan will be entitled to reimbursement even if a settlement does not specifically include payments for health care expenses. Reimbursement may be sought from the participant or directly from the employer or its workers' compensation liability carrier. The participant agrees to provide the Plan with prior notice of and opportunity to participate in any settlement proceedings.
The participant will take such action, furnish such information and assistance, and execute such papers as the Plan may require to facilitate enforcement of its rights and will take no action prejudicing the rights and interests of the Plan and/or the Department of Finance and Administration.
The participant must immediately notify the Plan of any injury, illness, or condition for which a claim has been or will be pursued under any applicable workers' compensation laws.