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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.
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, obtain from your supervisor, complete and return the Employee Report of Accident/Injury; and
- If a health care provider informs you that you cannot return to duty, obtain from your supervisor, complete, and return an Election of Rate Form (DP 2002).
- Contact your Leave Administrator to inform her/him of your absence from work and also when you are ready to return to work.
- To receive treatment for a work related injury you must seek treatment from a NYS Workers Compensation Board Participating Physician.
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.
- 1615 Supervisor's Report
- Authorization to Use OHS
- Election of Rate of Charge
- Witness Statement Form WCD-26
- Employee's Notice of Injury (WCD-23)
- Supervisor's Toolkit