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External Workers' Compensation Process for OOS Employees in New York

New York

In the event of an on-the-job injury or illness occurring in the State of New York, please follow the below steps in order.

  • Step 1: Report the injury or illness to your supervisor immediately. Seek medical treatment from a list of providers approved by the Workers’ Compensation Board in New York State. You can search for an approved provider here Healthcare Provider Search

  • Step 2:  Document your injury as soon as possible by choosing one of the following options: 
    • If you work for an agency that reports an injury, illness or near miss using the Workday system, logon to Workday. Select Report a Safety Incident within the Workday Safety application. 
    • If your agency has not established an injury, illness or near miss reporting process or you are unaware of the process, please click on this hyperlink. Select Submit a New Risk Management Request, fill-in the fields on the form and select  Out-of-State Safety Incident Report under the Type of Request drop down menu, then submit the form.

  • Step 3: Please complete the State of New York online C3 Form immediately and send a copy to DAS Risk Management. 
  • Step 4:  File a claim with the appropriate insurance carrier. https://www.zurichna.com/claims Your claim will be managed by Zurich, our out of state insurance provider.  You should expect a call from Zurich after the claim is filed. Please work with Zurich and provide them with any needed information during the life of your claim. 
For more information see https://www.wcb.ny.gov/content/main/Workers/lp_workers-comp.jsp

For any questions or concerns please reach out to DAS Risk Management 

Mailing address:
     PO Box 12009
     Salem, Oregon 97309
 
Phone: 503-373-7475
Fax: 503-373-7337​