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Workers' Compensation
The HR Leaves Administration is responsible for administering the Workers' Compensation Program and all leaves of absence for NYC Health + Hospitals. We focus on the health and safety of our employees while striving to provide a high level of case management services.
Reporting A Work-Related Incident/Injury
Direct Deposit available for the transmittal of WC benefit payments to your financial institution, issued by The NYC Law Department/Worker’s Compensation Division and Office of the NYC Comptroller/Bureau of Accountancy-Workers’ Compensation Unit.
Employee
We are so sorry you were involved in a work-related injury or illness. Here is what you need to do:
- Seek medical treatment or first aid, if needed;
- Immediately, you must notify your supervisor of the incident verbally when it occurs: what, when, where, and how you were injured, include who witnessed this incident;
- Within 24 hours of incident, complete and return the Employee’s Notice of Injury (WCD-23) and Election of Rate (DP 2002) form via email directly to LeavesWC@nychhc.org;
- To receive treatment for a work related injury you must seek treatment from a NYS Workers Compensation Board Participating Physician;
- If a health care provider informs you that you cannot return to duty, inform your supervisor and request an extended leave of absence via email directly to HRSSLeaveAdministration@nychhc.org or through Employee Self Service Absence Management module in Peoplesoft.
- You must inform HRSS Leaves Administration of your extended absence from work and also when you are ready to return to work from your extended absence.
Supervisor
When an employee reports a workplace injury or illness to you:
- Ask the employee to complete the Employee Report of Accident/Injury
- Advise the employee to seek medical treatment or first aid, if needed;
- Complete Supervisor's Report of Occupational Accident/Injury form 1615
- If there are any witnesses, obtain a Witness Statement Form WCD-26 for their completion and submission;
- Complete authorization for employee to seek assessment with OHS if applicable;
- Submit completed Supervisor's Report, Employee's Report, Witness Statement(s) and OHS Report to LeavesWC@nychhc.org within 48 hours of the incident.
Workers' Compensation Process
Forms
- 1615 Supervisor's Report
- Authorization to Use OHS
- Direct Deposit Authorization
- Election of Rate of Charge (DP 2002)
- Witness Statement Form WCD-26
- Employee's Notice of Injury (WCD-23)
Requesting A Leave of Absence As Workers' Compensation
Employees absent from work due to the work-related injury are responsible for:
- Requesting a Workers’ Compensation Leave of Absence;
- Submitting current medical documentation supporting the entire absence due to the work-related injury;
- Submitting an Election of Rate of Charge Against Annual and/or Sick Leave form (DP-2002).
The above information must be emailed directly to HRSSLeavesAdministration@nychhc.org or through Employee Self SErvice Absence Management module in PeopleSoft.