EMPLOYEE ACCIDENT REPORTING PROCEDURE:
Employees may be eligible for workers' compensation benefits when injured in a work-related accident. Benefits include medical treatment at no cost to the employee and possible wage replacement depending on the length of disability.
IF YOU ARE INJURED ON THE JOB:
- Seek medical assistance, if necessary, and notify your supervisor.
- Complete an Employee Accident Report, available from your supervisor, Human Resources or click here for the online form.
- Call the Accident Reporting System (ARS) at 1-888-800-0029 to report the injury and to obtain an incident number. Please retain this important number. The ARS Call Center hours are 8am - 9pm, M-F. Callers will be able to leave a message after hours and on weekends and holidays.
- Promptly forward accident report and any medical documentation to Human Resources.
- Review the Claimant Information Packet. This packet contains valuable information about workers compensation benefits, including prescription coverage (pg. 9-10) and direct deposit for your benefits (pg. 13-14).
- If you are unable to report for work due to the accident, be sure to notify your supervisor and Human Resources that your absence is the result of your occupational injury.
MEDICAL DOCUMENTATION AND RETURN TO WORK PROCEDURES:
- Return to work as soon as you are able, with proper authorization from your physician. You will be required to provide a note from your physician to Human Resources authorizing your return.
- All medical documentation taking you in and out of work should be completed by a Medical Doctor (MD).
- If you are taken by ambulance for your accident and have been released back to work, you MUST receive documentation from the physician/hospital releasing you back to work and submit to Human Resources prior to returning.
THINGS TO REMEMBER AFTER THE ACCIDENT:
- Keep HR and the State Insurance Fund updated with medical information, address changes, lost time and return to work.
- Keep your supervisor informed.
- Attend hearings, if necessary, and submit to medical examinations when requested.
- Submit satisfactory medical documentation.
- Contact HR before returning to work, follow return to work procedures.
FAQ:
2/3 x average weekly wage x % of disability = weekly benefit. The weekly maximum total disability is up to 60% of the usual wage.
You will have two options available to you:
- Receive direct billing for the usual amount that was deducted from your paycheck. The state will continue to pay the balance.
- Pay nothing until you return to work. A maximum of $55 (in addition to your usual health insurance deduction) will be deducted per pay until the back amount is caught up.
The employee is responsible for making payments for any such deductions during periods of leave without pay.
Your first 5 days of absence are charged to sick time or other accruals of your choice. You may be eligible to have this time restored to you only if your total lost time exceeds 14 calendar days, if the accruals would not have already expired.
Yes
Yes, you may see the physician of your choice without the need for prior authorization. Some doctors may not accept workers' comp insurance; please verify that they do before your appointment.
Yes.
Yes. The employer or insurance carrier is entitled to have the worker examined by a qualified physician. Refusal to submit to an exam may affect the worker's claim.
A person who willfully misrepresents the circumstances surrounding his or her case in order to obtain benefits is guilty of a felony.
The NYSIF—New York State Insurance Fund, 225 Oak St., Buffalo, NY 14203
BILLING INFORMATION:
NYSIF - New York State Insurance Fund
225 Oak Street
Buffalo, NY 14203
Ph: 716-851-9109
Fredonia Representative: Nathan Glowny
You will need the following information to use the above link:
- New York State Insurance Fund (NYSIF) Claim Number
- Last four digits of Social Security Number
- Date of Birth
HELPFUL LINKS: