WORKERS’ COMPENSATION PROCEDURE For State Employees

The injured employee must obtain first aid or other necessary medical treatment as soon as possible. The doctor needs to be informed that the injury is work related.

All medical fees must be billed to our insurance carrier:
The State Insurance Fund
8 Corporate Center Drive, 3^rd floor
Melville, NY 11747-3166
Policy number 24096-0
(631) 756-4000

• The employee is required to notify his or her supervisor of the incident.
• All State employees must call the ARS (Accident Report System) to report the accident. (1-888-800-0029) An operator will take the report of an injury or illness quickly and confidentially. After providing the operator with the required information, the employee will receive an incident number, which can be used for Express Scripts prescriptions and tracking purposes. Your call to ARS helps make sure all of your Workers’ Compensation benefits are available to you as soon as possible.
• An “Employee Accident and Investigation Report” (SUSB3019) must be completed by the employee and submitted to his or her supervisor. The report must:
  • be complete and accurate
  • include both the signature of the supervisor and the employee
  • include a detailed statement by the employee describing what the employee was doing at the time of the accident and specify what part or parts of the body were injured
  • include the ARS incident number
  • The supervisor must submit the report to Time and Attendance within 24 hours of the accident.
• Time and Attendance completes form C-2 and files it with the State Insurance Fund and the Workers’ Compensation Board.
• The State Insurance Fund files the required forms with the Workers’ Compensation Board.
• The injured employee’s supervisor must notify Time and Attendance immediately if the injured employee is losing time due to the work related injury.
• If medical treatment is not required at the time of the accident, but needed at a later date, the employee must notify Time and Attendance.
• When an employee is losing time, the injured employee is required to submit ongoing medical documentation to his or her supervisor. The documentation should be attached to the employee’s timesheets during the time the employee is on Workers’ Compensation leave. Satisfactory medical documentation must include the following:
  • Original letter head or pad imprinted with the doctor’s name, address and telephone number
  • Brief statement of diagnosis
  • Inclusive dates of disability, and anticipated date of return to work
  • Signature of the medical practitioner
• Return to work procedure: A doctor’s note must be provided to the supervisor 24 – 48 hours prior to the disabled employee returning to work. The supervisor must call Time and Attendance immediately with notification of the employee’s return to work. A doctor’s note documenting the employee’s return to work must be attached to his or her current time sheet.

WORKERS’ COMPENSATION INFORMATION For State Employees

INTRODUCTION

If a State employee is injured while on the job or becomes ill because of conditions in the work place, he or she may be entitled to benefits under the Workers’ Compensation Law. These benefits include payment for medical care and cash payments for time lost from work.

In addition to the benefits provided under the Workers’ Compensation Law, employees represented by PEF, CSEA, Council 82 and NYSCOPBA unions have negotiated additional benefits.

If your claim is disputed, you will have a hearing before an Administrative Law Judge. You are entitled to legal representation at the hearing by either your own attorney or a licensed claimant’s representative. Any fees due your representative are set by the Administrative Law Judge and are deducted from your award.

EMPLOYEE RIGHTS

An employee injured on the job has certain benefits available under the Workers’ Compensation Law.

An injured worker is entitled to all necessary medical care as the nature of the injury and the process of recovery may require. The employee is free to choose any medical practitioner authorized by the Workers’ Compensation Board to render treatment. The practitioner cannot collect a fee from the employee. Payment for medical treatment, prescription drugs, and transportation costs are the liability of the State Insurance Fund. For assistance in identifying authorized practitioners in obtaining medical treatment, contact your local medical society.

Workers who suffer total or partial disability found compensable by the Workers’ Compensation Board receive wage replacement benefits after the seventh day of disability. If the disability exceeds 14 days, cash benefits are payable from the first day of disability.

An employee may request a Workers’ Compensation Board hearing regarding any disputed issues.

EMPLOYEE’S RESPONSIBILITIES

In order to guarantee these rights, an employee has certain responsibilities concerning the accident and their treatment.

The employee must inform the medical provider that the injury is work related and the State Insurance Fund is to be billed.
The employee must notify his or her supervisor about the injury and the way in which it occurred as soon as possible. Failure to notify the supervisor may jeopardize the employee’s right to benefits. It is the employee’s responsibility to complete the Employee Accident Report (SUSB3019).

Complete and accurate records are vital to an employee’s claim. The employee should note all events surrounding the injury or illness including when and where it occurred, the time of the incident, how the incident happened and the names of witnesses. The employee should write down any symptoms and note any continuing health problems related to the incident.

The employee should keep all receipts for prescriptions, a record of all transportation expenses incurred while obtaining medical treatment, and all medical documentation.

It is the responsibility of the employee to keep all medical appointments and exams scheduled by the State Insurance Fund.

The employee must provide his or her supervisor with a current home address and telephone number to ensure proper delivery of the benefit.

While an employee is losing time from work, they must keep in contact with their department and continually provide satisfactory medical documentation. Satisfactory medical documentation must include the following:

• Original letter head or pad imprinted with the doctor’s name, address and telephone number
• Brief statement of diagnosis
• Inclusive dates of disability, and anticipated date of return to work
• Signature of the medical practitioner

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 Worker's Compensation Incident Report Form as soon as possible and send it to Human Resources as follows:

State Employees:

Form:  State Employee Workers' Compensation Incident Report Form

Email: hrs_timeatt@stonybrook.edu

RF Employees:

Form: RF Employee Workers' Compensation Incident Report Form

Email: hrs_benefits@stonybrook.edu

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