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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.
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.
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.
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
- Direct Deposit Authorization
- Election of Rate of Charge
- Witness Statement Form WCD-26
- Employee's Notice of Injury (WCD-23)
- Supervisor's Toolkit
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.