NEW YORK CITY PUBLIC SCHOOLS
DIVISION OF HUMAN RESOURCES
65 COURT STREET
BROOKLYN, NEW YORK 11201
PERSONNEL MEMORANDUM No. 16 1991-92
SUBJECT: WORKERS' COMPENSATION FOR ADMINISTRATIVE EMPLOYEES
The purpose of this circular is to clarify Workers' Compensation policy and procedure as it relates to all administrative employees including classroom paraprofessionals, family paraprofessionals and non-competitive employees. This circular supercedes the Accounting Memorandum on Workers' Compensation previously issued on January 18, 1990. This circular does not superceds or replace procedures'already in place for pedagogical employees applying for accident in the line of duty (Special Circular 32, 1989-90 and Special Circular 39, 1989-90).
I INTRODUCTION
Workeral Compensation Law
The Workers' Compensation Law exists to protect employees against loss of earning power if they are injured or become ill as a result of their employment. It provides cash benefits (wage replacement), medical benefits and rehabilitation services for all types of injuries, disabilities and illnesses.
In order to recover lost wages, employees may file for Workers' Compensation which is the only recourse available to administrative employees, including classroom and family paraprofessionals and non-competitive employees. When the law was enacted, the State Workers' Compensation Board was created to administer all related claims.
The Works' Compensation Division of the City of New York Law Department, as the administrator of the City/Board of Education se lf-insured program, files notice of employee injury or occupational illness as required by law and represents the City and the Board of Education at State Workers' Compensation Board hearings. The State Workers' Compensation Board should not be confused with the Workers' Compensation Division of the City of New York Law Department. The State Workers' Compensation Board is a State agency which resolves Workers' Compensation disputes between all employers and employees within the State. The Workers’ Compensation Division is part- of the City of New York Law Department and it represents the City and the Board of Education as a self-insurer and only processes claims of City/Board of Education employees.
Validity of Job Related Accident or Illness Claims,
The agency responsible for establishing the validity of a job related accident or illness claim and determining eligibility for compensation benefits is the Workers' Compensation Division of the City of New York Law Department, not the Board of Education.
New York City as Self-insurer
Workers' Compensation is the primary source of payment of medical and hospital bills so that even if an employee has medical coverage through the Board of Education, the bills for treatment relating to the injury incurred in the course Of employment must be paid through workers' Compensation.
RESPONSIBILITIES OF EMPLOYEE
The Workers' Compensation Law requires that an employee must notify his/her supervisor of an accident or assault. The City and the Board of Education require the employee to fill out forms which provide the supervisor with the information needed to prepare the report.
The employee is required to:
obtain first aid or medical treatment; inform a physician that injury or illness is work-related;
Notify his/her supervisor as soon as possible after the occurrence; and
complete, within 24 hours, and submit to his/her supervisor the following reports:
Employee’s Notice of Injury Form (WCD-23)
This report provides the employee's description of the accident and other related information
Comprehensive Accident Report (BA/UIC 9203)
This is an internal accident form used by the Board of Education to report incidents occurring on school premises involving students, teachers, and visitors to such areas.
The time frame for completion and submission is twenty-four hours from the time of injury and the report must be accompanied by the handwritten statements of at least two witnesses as well as a signed statement by the injured person.
Attending Doctor’s Report Form (C4/C48)
The employee must have this form completed by the physician at various stages during the period he/she is out of work. It must be completed within the first 48 hours after the accident and indicate the nature and extent of the injury and other information. The box labeled "initial" in the upper left hand corner of the form should be checked. The form should also be used when the employee returns to be re-examined Within 15 days after mailing the initial report and no later than 17 days after first treatment; during continuing treatment at intervals of 22 days or less; and for the "final" report upon termination of treatment. The boxes marked "progress" and "final" in the upper left hand corner of the form should be checked for this purpose.
Employees are advised to inform their physician prior to medical examination that their visit is related to a Workers' Compensation case.
Forms should be submitted by the employee to: New York City Law Department, Workers' Compensation Division, 175 Remsen Street, 3rd Floor, Brooklyn, New York 11201.
RESPONSIBILITIES OF SUPERVISORS, MANAGERS, EXECUTIVE DIRECTORS, COMMUNITY SUPERINTENDENTS, ET, AL,
Employer’s Report of Iniury (C2) and Employee’s Notice of Injury (WCD-23).
The organization head is first responsible to ensure that all job-related occupational injuries and illness are reported. As soon as the organization head becomes aware of the accident or assault, an Employer's Report of Injury (C-2) must be completed and submitted along with the Employee's Notice of injury (WCD23) which should have been completed by the employee. The Workers' Compensation Division of the City of New York Law Department, is mandated by law to file all C-2's with the State compensation Board within ten days from the date of accident or from the date of notice.
The C-2 is the Employer's Report of Injury which includes information on the accident, the injured employee,nature of the injury and other related information.
Where the employee is incapable of filling out the appropriate form, his/her supervisor will do so to the best of his/her ability.
Comprehensive Accident Report (BA/UIC9203).
For accidents/assaults of employees, the Comprehensive AccidentReport (BA/UIC9203) must be signed by both the Community Superintendent and the principal for community school districts and a manager/supervisor and/or the Executive Director (or equivalent) for employees of a central headquarters organization. The organization head may designate an appropriate individual to sign the Comprehensive Accident Report Form. In the case of an assault, the form must also reflect the Community Superintendent's or Executive Director's approval or disapproval of the assault claim.
Excused Absence With Pay (First Five Days)
A request for Excused Absence With Pay (Form P.D.19), accompanied by a copy of the C-2 Form, must be submitted by Community School Districts/Schools to the Division of Human Resources to cover the first five days of absence without charge to the emoloyee's leave balances. A physician's note is required if the absence exceeds three days. The requirement to submit the application to the Division of Human Resources does not apply to central headquarters operations which may approve the first five (5) days of absence in accordance with Personnel Memorandum #24, 1989-90.
Impact of Signing Forms
The Board of Education does not decide whether an injury or occupational illness claim in compensable. Anyone who wants to make a workers' compensation claim must be permitted to do so.The Workers' Compensation Division of the City of New York Law Department will decide whether or not to disapprove a case based our the information it receives from the Board of Superintent/Executive Director has no documentation for the facts as stated by the employee or believes that the claim is doubtful, he/she should attach a memorandum to the C-2 to provide the reason and all pertinent information. The word "alleged" should be used on that part of the C-2 where the accident is reported if the facts cannot be substantiated. If "alleged" is not used and there is no accompanying memorandum, the Workers' Compensation Division of the City of New York Law Department will have to accept the C-2 on its face and will not be able to later disapprove the case. Questionable assault claims must be investigated.
For information concerning the processing of assault claims,refer to Section IV of this circular.
IV PROCEDURES FOR SUBMISSION of FORMS
It is the responsibility of the organization head at the school/district or bureau level to handle the initial
processing and submission of forms for both accident and assault cases. The Employer's Report of Injury (C-2) must be filed by the Board of Education with the Workers' Compensation Division within 8 days after the occurrence or 8 days after the Board of Education receives notice, whichever is later. If some information requested on C-2 is not readily available, file the C-2 on time and follow-up with missing information. A chart outlining where forms should be submitted is included in the addendum to this circular.
Accidents
The original and two (2) copies of C-2 Form and the original Form WCD-23, are to be filed directly by the responsibility center with:
New York City Law Department
Workers' Compensation Division
175 Remsen Street, 3rd Floor
Brooklyn, New York 11201
One (1) copy each of Form WCD-23, Form C-2 and Form BA/UIC4203 is to be filed with the Board of Educationts:
Division of Business and Administration
Workers' Compensation Unit
65 Court Street, Room 1803
Brooklyn, New York 11201
Community School Districts and schools must submit an Application for Excused Absence Form (P.D.19) for the first five (5) work-days of excused absence with pay, with a copy of the C-2 form, to:
Bureau of Administrative Personnel
Related Staff Services Unit
65 Court Street, Room 504
Brooklyn, New York 11201
Central headquarters operations may approve the first five (5) days without submission of the P.D.19 Form to the Bureau of Administrative Personnel in accordance with Personnel Memorandum #24, 1989-90, which delegated this responsibility to line operations.
Copies of all completed forms should be kept in school or bureau files.
Assaults
In addition to the procedures listed above for accidents, additional documentation is needed to substantiate assault claims as follows:
Assault claims must be investigated at the local level and a recommendation made by the principal or supervisor to the Community Superintendent or Executive Director who will note approval or disapproval on the Comprehensive Accident Report (BA/UIC 9203).
Medical Bureau approval is required for all assault claims. A copy of the Comprehensive Accident Report (BA/UIC 9203), and a completed Form OP198 , accompanied by an Incident Report, must be submitted to:
Division of Human Resources
Medical Bureau
65 Court Street, Room 200
Brooklyn, New York 11201
This supporting documentation should include the supervisor's recommendation, a determination by the Superintendent or Executive Director, an incident report required by the Division of School Safety (prepared by a School security officer) and statements from witnesses, if any.
Referral of the employee to the Medical Bureau for examination is required when:
- There are claims of injuries to head, eyes, back, shoulder, elbow, knee or groin, or possible exposure to toxic fumes, particularly to asthmatics or-cardiacs.
- There are residual effects, even though no absence has occurred.
- Absence of any duration where the employee fails to consult A physician.
- The organization head believes an examination is warranted by the circumstances.
- The absence exceeds one week.
V OPTIONS FOR PAYMENT
Accidents
Employees who have filed an accident claim must select an option of payment to cover any time off after the first five work days of paid administrative leave.
Option I - Employee elects to use available sick/annual leave and receive full pay in lieu of Workers' Compensation pay after the first five (5) work days immediately following a job related injury or illness. Then, at some future date, the Board of Education (Workers' Compensation Unit) will be notified by the New York City Law Department to restore sick/annual leave used by the employee to the extent of any workers' Compensation Board reimbursement to the Board of Education. Approved restoration of time will be forwarded to the local responsibility center by the Division of Human Resources.
Option II Employee requests a leave of absence without pay after the first five (5) work days immediately following a job relatedinjury or illness. The employee will then receive payment from Workers’ Compensation at a rate lower than the regular rate of pay in accordance with Workers' Compensation guidelines. Please note that employees who select this option and retire on disability may not be entitled to a lump suma payment for unused leave.
Employees are entitled to all Workers' Compensation benefits after the first five (5) work days immediately following a job related accident or illness regardless of option selected for payment.
Assaults
Education family paraprofessionals and hourly non-competitive employees are assaulted on the job are contractually entitled to up to year full salary upon proper submission and approval of documentation after an investigation and determination has been completed by the Community Superintendent/Executive Director.
Annual administrative employees on the H Bank payroll are contractually entitled to up to eighteen (18) months full salary upon proper submission and approval of documentation after an investigation and determination has been completed by the Community Superintendent/Executive Director. A final decision is rendered by the Workers' Compensation Division of the New York City Law Department. This is pursuant to applicable collective bargaining agreements or Board of Education policy. Prevailing wage employees do not have this benefit. consult the Office of Labor Relations and Collective Bargaining about eligibility of specific titles for the assault benefit.
Service Reports For E and Z Bank Employees
School Secretaries and Payroll Secretaries are authorized to keep E and Z Bank employees on a regular payroll once the Medical Bureau has accepted and approved a case as an assault. Since hourly (E and Z Bank) employees are on positive pay, service reports should be submitted by the financial management center as part of the regular payroll to cover regularly scheduled hours for such employees. Service reports must be coded as administrative time and appropriate account codes should be included. Following this procedure will ensure that these employees will receive regular paychecks for the period of time they are unable to work.
Release-of Checks
Under no circumstances, with the exception of a documented and approved assault, should payroll checks be released to employees who have no sick/annual leave balances. In the case of an assault, a Medical Bureau approval is required prior to the releasing of payroll checks to the employee.
VI RECURRENCE OF INJURY INCURRED FROM WORK_RELATED ACCIDENT OR ASSAULT
I f the recurrence of a job related injury or illness happens while an employee is off duty, he/she must get medical attention from aphysician. The doctor must complete Form C-27 and submit it
directly to the New York State Workers' Compensation Board, 180 Livingston Street, Brooklyn, New York 11201. A copy of the form should be sent to the New York City Law Department, Workers' Compensation Division, 175 Remsen Street, 3rd Floor, Brooklyn, New York 11201. Also, a letter must be submitted by the responsibility center to the Board of Education Workers' Compensation Unit, 65 Court Street, Room 1803, Brooklyn, New York 11201 stating that the case is to be re-opened indicating the original accident date.
If the recurrence of a job related injury or illness happens while an employee is on duty, it is considered a new case when there in another incident. All necessary forms are to be completed and filed with the appropriate offices as if the injury were occurring for the first time. For assault claims, any resubmission alleging an on the job recurrence must be sent to the Medical Bureau for approval.
VII BENEFITS
Purpose/compensation
The primary purpose of the law is to immediately replace lost wages and provide medical care to employees for job-related injury or illness. The compensation amount is determined by the State Workers' Compensation Board subject to certain maximums.
Certain categories of employees may be entitled to additional benefits for assault claims pursuant to collective bargaining agreement.
Continuation of Health Benefits
If an employee is removed from payroll and will be receiving Workers* Compensation Benefits, the Health and Welfare Unit of the Board of Education should be notified in order to continue health insurance.
Medical Bills
All medical bills relating to a job related injury or illness are to be forwarded by the employee to the New York City Law Department, Workers' Compensation Division, 175 Remsen Street, 3rd Floor, Brooklyn, New York 11201.
If any school or office of the Board of Education receives any documents from the Workers' Compensation Board or medical bills, they must be sent immediately to the New York City Law Department, Workers' Compensation Division, 175 Remsen Street, 3rd Floor, Brooklyn, New York 11201.
VIII RETURN TO WORK
- Return to work From Accident/Illuess/Assault
When an employee returns to duty from a job related injury or illness, the Board of Education Workers' Compensation Unit is to be notified immediately by the payroll secretary or timekeeper.
If the need is identified, the Medical Bureau will examine employees for fitness to return to duty after clearance is provided by Workers' Compensation physicians.
- End Of Full Pay Entitlement For Assault
There is no provision to extend the full pay entitlement beyond eighteen (18) months for administrative employees and one (1) year for education and family paraprofessionals and hourly noncompetitive employees. In either case, if the employee is not able to return to work, he/she must provide medical documentation and then select Option I or Option 2 for payment, as outlined in section V of this circular. Under no circumstances should checks be released to an employee until a selection is made. If Option I is selected, checks may then be released only for the purpose of exhausting unused leave balances.
IX INQUIRES
Inquiries concerning sections of this circular should be directed to:
General Questions, Forms,Procedures
Workers' Compensation Unit
65 Court Street, Room 1803
Brooklyn, New York 11201
(1-718-935-2213)
Medical Bureau
65 Court Street, Room 200
Brooklyn, NewYork 11201
(1-718-935-2726)
Labor Relations
Office of Labor Relations
110 Livingston Street, Room 912
Brooklyn, New York 11201
(1-718-935-2612)
Adminintrative Personnel
Related Staff Services
65 Court Street, Room 504
Brooklyn, New York 11201
(1-718-935-3679)
Health and Welfare
65 Court Street,Room 502
Brooklyn, New York 11201
(1-718-935-2312)
Your cooperation in complying with the provisions of this circular is greatly appreciated.
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