Human Resources: Workers Compensation: Accidents

If you, as an employee at ºÚÁÏÊÓƵ, sustain an on-the-job injury or illness, you are covered under workers' compensation and are entitled to medical treatment at no cost. Wage reimbursement procedures vary. Please contact Human Resources for information on your specific situation and follow the procedure outlined below.

Accident Report Procedures

(Work Related Accidents and Workers' Compensation)

Employee's Role:

  1. Get first aid or other treatment.
  2. Use ambulance (Harpur's Ferry 777-3333) if you need transport in an emergency situation.
  3. Notify your supervisor as soon as possible if you have a work-related injury.
  4. Inform medical provider that you believe injuries are work-related and send medical information to the State Insurance Fund. Do NOT pay your doctor or the hospital.
  5. Call ARS (Accident Reporting System): 1-888-800-0029, if you have medical expenses or lost time. The ARS Call Center hours are 8:00 a.m. to 5:00 p.m. EST, Monday through Friday and the Call Center is closed on State holidays. Callers may leave a message after hours and on weekends and holidays. A Call Center Representative will return their call the next business day in order to report the injury or illness and obtain an ARS incident number.
  6. Prescriptions should be filled without a copay by pharmacies by contacting CVS Caremark(866-493-1640). When submitting a prescription, you should give the pharmacy the following information
    • The ARS incident number
    • GROUP is: NYSIF
    You will receive a permanent ID card and packet fromCVS Caremark within 10 days of NYSIF's confirmation of the accident.
  7. Complete the accident report (s). You will need to complete a form CS-13 and an Employee Accident Report (Part I. Numbered 1-22) as soon as possible. Delays in reporting may adversely affect your claim.
  8. Supervisor sends original completed accident report to Human Resources and a copy to Environmental Health & Safety (Health Services Building IN-101A).
  9. If you are unable to report for work as scheduled subsequent to the accident, be sure to notify your supervisor and let them know that your absence is the result of your occupational injury.
  10. Supervisor should notify Human Resources.
  11. Return to work as soon as you are able. You will be required to provide a note from your physician authorizing your return. Any return to work with restrictions will require permission from both Human Resources and your supervisor.

PLEASE NOTE: Many Walk -In Centers and Primary Care facilities will not provide medical documentation or follow up care with a Workers’ Compensation injury and will refer you to another facility.

To avoid delays in your Workers’ Compensation case, it is suggested that you go to one of the two local facilities that handle Workers’ Compensation injuries for treatment.

UHS Occupational Medicine
33 Mitchell Avenue
Summit Building
Binghamton, NY 13903

Lourdes Occupational Health
 3101 Shippers Road
Suite 101
Vestal, NY 13850

Medical Documentation and Return to Work Procedures:

  • All medical documentation taking you in and out of work should be completed by a Medical Doctor (MD).
  • Use the Confidential Medical Statement (CMS) Work-Related form to report leaves from work, returns to work, or for updating Human Resources monthly of your progress.
  • Prior to returning to work you must submit medical documentation to Human Resources for review. If there are restrictions, Human Resources will speak with your supervisor regarding the ability to accommodate the restrictions with an alternate duty assignment.
  • If you are taken by ambulance for your accident and have been released back to work, you MUST receive documentation from the physician/hospital releasing you back to work and submit to Human Resources prior to returning.

Things to remember after the accident:

  • Keep HR and the State Insurance Fund updated with medical information, address changes, lost time and return to work.
  • Keep your supervisor informed.
  • Attend hearings, if necessary, and submit to medical examinations when requested.
  • Submit satisfactory medical documentation.
  • Contact HR before returning to work, follow return to work procedures.

Meg Tremblay

  • PHONE: 607-777-2193
  • FAX: 607-777-4947

Supervisor's Role:

  • Assist employee in getting immediate treatment when necessary.
  • Assist employee in completing the accident report and calling ARS.

Other Information:

  • Accident must be directly associated with work activities.
  • Our insurance carrier for worker's compensation (work related accidents) is:

                                New York State Insurance Fund (NYSIF)

                             Phone: (607) 741-3900      Fax: (607) 741-3918

                                           Billing should addressed to:
                                                               NYSIF
                                                         PO Box 66699
                                                     Albany, NY 12206

Additional Notes:

  • Facilities Management is notified by Environmental Health & Safety of any accident that involves campus grounds; they in turn inspect the area and take appropriate action to alleviate the situation.
  • IF YOU HAVE ANY QUESTIONS REGARDING THE PROCEDURES TO BE FOLLOWED you should contact Human Resources Office located on the second floor, Couper Administration (AD-244).

Forms

  • You may obtain accident report forms from your supervisor, your department secretary, the Human Resources office or on our  

FAQ's