Workers Compensation Procedures for Submitting a Claim April 2011 Introduction Workers Compensation laws are enacted to protect employees against loss of earning power through injury sustained in their employment. Workers compensation is insurance that provides cash benefits and/or medical care for workers who are injured or become ill as a direct result of their job. The NYC Dept of Educations Workers Compensation Unit is committed to providing the dedicated service necessary to ensure that claims are submitted expeditiously and accurately. Table of Contents Important Facts About Workers Compensation. 4 Rights Paraprofessional (Subs also), School Aide, Therapist, Nurses, SAPIS and Administrative titles. All pedagogical titles file for LODI and are handled by HR Connect. When in doubt, contact the WC unit for assistance. All injuries/accidents must be reported to the employer and documented immediately. Many employees are reluctant to notify their employer they had an injury because the extent of their injury is minor, there was no lost time and because they do not want to be bothered with the paperwork. By Law, all work related injuries must be reported/filed within 10 days from the date of the injury however, the State WC Board will accept a claim for up to 2 years from the date of the accident. Employer cannot approve/disapprove a WC claim. If the employer feels that the WC claim is fraudulent and should be contraverted, it is suggested that a letter is mailed to the insurance carrier for review explaining the reason why. 4 4 Rights & Responsibilities of the Employee C3 form The C3 form is the “Employees Report of Injury” form and it is the responsibility of the employee to submit and mail the C3 form to the State Workers Compensation Board. By Law, the C3 form must be submitted to the State Workers Compensation Board within 2 years from the date of accident. Insurance carrier The City of New York Law Department is the insurance carrier for workers compensation recipients. The carrier case number will be mailed to the employee once they have reviewed the C2 form. All bills, authorizations, surgeries, therapies and prescriptions are to be mailed to the Law Dept for approval and payment. The employee may not use their personal insurance however, should they incur out of pocket expenses, it should be mailed to the Law Department for reimbursement. Reimbursement of wages and sick time The rate for reimbursement of wages and sick time will be determined by the State WC Board based on the degree of disability and the employees rate of pay. All restorations are processed by the WC Unit and then notification is made to the payroll secretary via mail. 5 5 Responsibility of the Employer Notice of Compliance* By Law, these notices must be posted somewhere in the work place where the employee can view them, preferably by the time clock or posted in a bulletin board. This notices advise the employee who their insurance carrier is should they have a work related injury on the job. Claimant Information Packet* The NY State WC Board has compiled a packet that consist of reading materials and forms that the employee is responsible for submitting to the WC Board. It is to be provided to the employee every time they have an accident on the job. In this packet the employee will receive the C3 form. C2 form It is the responsibility of the employer to submit the C2 form on line and is accessible only thru the Payroll Portal. If the employee submits their own C2 form, the Law Dept will reject the claim. Timekeeping It is critical that all timekeeping entries relating to WC are accurate as to avoid overpayments. *Click here to print the Notices of Compliance, Claimant Information Packet and other forms. 6 6 Documents to Print Notice of Compliance: Post in the workplace. Claimant Information Packet: Provide to the injured employee every time they have an accident on the job. 7 7 Timekeeping Date of the accident In the event that the employee has to leave work to seek medical attention, the date of the accident is a regular paid day. Non Chargeable Days The employee may apply for up to the next five (5) consecutive working days as non chargeable days pending supervisory approval of the OP198/ PD 19 form. Anything beyond 5 days non-chargeable constitutes an overpayment. For all absences beyond the five days, the employee has as option on how they want their absences coded. Option 1 Employee notifies payroll secretary that they are opting to use their accruals for the duration of their absences relating to WC. The employee has to contact their examiner at the Law Department to initiate the process of restoring their time. An employee can also go on Option 2 when they have exhausted their accruals. Option 2 The employee opts not to use their accruals, or may not have any time therefore they will be payroll deducted. Depending on the length of the absence, the