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Workers' Compensation

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Employee Accident and Investigation Report
(To Report a Work Related Injury or Illness)

  1. Call the Accident Reporting System (ARS) at (888)-800-0029 to report a work related injury or illness as soon as possible. Write down the incident number the operator gives you.
  2. Complete the Workers' Compensation/State Employee Injury/Illness Incident Report as soon as possible and send it to:

    Human Resource Services
    Stony Brook University
    State Time & Attendance / Leave Unit
    390 Administration Building
    Stony Brook, NY 11794-0751

  3. When Completing the Form:
    • Be specific when answering questions concerning how the accident occurred.
    • It is very important to indicate if you received medical treatment. If you do not seek medical treatment at the time of the injury, but do so at a later date, notify Time & Attendance immediately. If you are losing time from work due to your injury, Time & Attendance must be notified. You must provide ongoing medical documentation to your department during your absence.
    • Time & Attendance must be notified when you are losing time from work and when you return.
    • You and your supervisor must sign this report. This report is needed to process your Workers' Compensation claim.
    • Personal Health Insurance cannot be used for Workers' Compensation claims.
All fees for medical treatment must be billed to:
State Insurance Fund
Policy Number: 24096-0
8 Corporate Center Drive, 3rd Floor
Melville, NY 11747-3166