Workers’ Compensation Program

The HRSS Leaves Administration is responsible for administering the Workers’ Compensation Program with all work-related incident/injury reports and all leaves of absence due to a work-related injury 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.

Employee

We are so sorry you were involved in a work-related injury or illness. Here is what you need to do:

1. Seek medical treatment or first aid if needed. 
2. Immediately, you must notify your supervisor of the incident verbally when it occurs: what, when, where, and how you were injured, including who witnessed this incident. 
3. Within 24 hours of the 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; 
4. To receive treatment for a work-related injury, you must seek treatment from a NYS Workers Compensation Board Participating Physician​; 
5. If a healthcare 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 the Employee Self-Service Absence Management module in Peoplesoft. 
6. You must inform the HRSS Leaves Administration of your extended absence from work and also when you are ready to return to work from your extended absence.

Workers’ Compensation Process

Supervisor

When an employee reports a workplace injury or illness to you:

1. Ask the employee to complete the Employee’s Notice of Injury (WCD-23); 
2. Advise the employee to seek medical treatment or first aid if needed. 
3. Complete and sign Supervisor’s Report of Occupational Accident/Injury form 1615. 
4. If there are any witnesses, obtain a Witness Statement Form WCD-26 for their completion and submission. 
5. Complete authorization for the employee to seek an assessment with OHS if applicable. 
6. Submit completed Supervisor’s Report, Employee’s Report, Witness Statement(s), and OHS Report to LeavesWC@nychhc.org within 48 hours of the incident.

NYC Law Department and NYC Comptroller/Bureau of Accountancy/ Workers’ Compensation Direct Deposit 

Direct Deposit is available for the transmittal of workers’ compensation 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.

Forms

FAQs

Requesting a Leave of Absence as Workers Compensation

Employees absent from work due to a 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 HRSSLeaveAdministration@nychhc.org​ or through the Employee Self-Service Absence Management module in Peoplesoft.