Accident Reporting Policy

Employees

When an employee is involved in a work related accident resulting in injury or illness, the below listed procedures shall be followed:

1. Employees shall notify their supervisor immediately, or as soon as they are able. If this is not possible and a witness is on the scene, the witness can contact:

• The employee’s supervisor, if known;
• Department of Human Resources (585-245-5616); and the
• Department of Environmental Health and Safety (585-245-5663).

2. The University Police Department should be contacted only when an employee’s supervisor is not available or in extreme emergency cases. Failure to immediately report accidents resulting in injury or illness can compromise the employee’s occupational injury or illness claim, and can be a violation of this policy.
3. Regardless of the severity level, the Accident Report Form is to be completed in full by the injured employee for all injuries or illnesses. In instances where an employee is not capable of reporting an injury or illness, the employee’s supervisor will complete the form. All completed forms should be forwarded to Human Resources, Doty 318 where originals shall be kept on file. If medical attention is required or if the employee will miss time from work and the form cannot immediately be delivered to Human Resources, the supervisor should contact Human Resources at 585-245-5616.

*Note: Incomplete forms will be returned to the supervisor for further corrective action. Employees must report an injury or illness to the NYS Accident Reporting System (ARS) at 1-888-800-0029. The employee will be given an ARS incident number which they must record. In instances where an employee is not capable of calling ARS, the supervisor will make the call on their behalf and record the ARS incident number. The ARS Call Center is open 8:00 a.m. to 5:00 p.m. EST, Monday through Friday and the Call Center will be closed on State holidays. Callers will be able to leave a message after hours and on weekends/holidays. A Call Center Representative will return an employee’s call the next business day in order to report the injury or illness and obtain an ARS incident number. Calling the ARS Call Center remains the first step in expediting the workers’ compensation claims process.

4. Supervisors should ensure that corrective action for unsafe conditions or unsafe behaviors are either remedied as soon as possible or referred to the appropriate department for action. The Department of Environmental Health and Safety should be contacted for situations that require special attention.
5. If applicable, the employee will also be notified of their rights under the Family Medical Leave Act (FMLA). For more information, see Employee Rights and Responsibilities under the Family Medical Leave Act.
6. For absences from work five (5) days or more due to a work-related injury or illness, CSEA employees must charge the first (5) work days of their absence to sick or vacation accruals. The employee is then placed on the workers’ compensation payroll after the five (5) working days or seven (7) calendar days, whichever is greater. If the employee does not have any accruals to use, they will be placed on leave of absence without pay effective the first full day of absence (partial days do not count) and then on leave without pay. There is no way to avoid going on workers’ compensation payroll if an employee will be out of work for more than five (5) work days.
7. Employees represented by bargaining units other than CSEA should contact Human Resources for specifics on their workers’ compensation benefits.
8. Injured employees must provide medical documentation to support all absences related to the work-related injury or illness. 

It is the responsibility of the employee to obtain appropriate medical documentation. All medical documentation shall be submitted to the Department of Human Resources at SUNY Geneseo, Human Resources, Doty 318 Hall, Geneseo NY 14454. The doctor’s office may fax the information to 585-245-5998. Medical documentation will remain confidential and Human Resources will in turn notify the employee’s supervisor of their status. All medical documentation must be submitted on the Certification of Health Care Provider for Employee’s Serious Health Condition (WH380-E). 

9. Prior to returning to work, the Return to Work Form from the employee’s physician must be received by the Department of Human Resources at least 48 hours (during business days) prior to the employee’s anticipated return to work date. Human Resources is responsible for reviewing return to work certification. This form must be completed in full and reviewed by Human Resources 48 hours prior to the employee returning to work. If there are restrictions, they must be specific and state when they can be lifted.
10. Light duty may be considered when a person is considered 50% disabled or less, and full recovery is expected within 45-60 days. A Physical Capabilities form, which can be obtained from Human Resources, must also be completed by the employee’s physician.  Human Resources will discuss with the employee’s supervisor the restrictions to determine if light duty is possible. An employee may be required by the college to undergo a medical examination by a New York State Civil Service doctor at any time during their workers’ compensation leave.
11. It is critical that the employee remains in contact with the Human Resources office throughout their workers’ compensation leave.
12. The Department of Human Resources will post information related to occupational injury/illness, job safety, and health protection, and will maintain injury/illness records as required by the New York State Department of Labor. The Department of Human Resources will also assist in completing regulatory surveys involving injuries and illnesses.
13. The SUNY Geneseo Accident Report Form will be reviewed by the Department of Human Resources. Human Resources will forward copies of completed forms to the Department of Environmental Health and Safety for further review.
14. The Department of Human Resources is responsible for reviewing all return to work documentation (with or without restrictions/light duty). Human Resources will work in conjunction with the employee’s supervisor to coordinate the return to work. Every effort will be made to accommodate the employee’s return to work on light duty. However, in some instances, due to the nature of the job duties, this may not be feasible, and the return would be delayed until they are able to be released for full duty.
    1. The Department of Human Resources will transact in various employment and reporting systems all necessary transactions to affect a worker’s compensation leave without pay and report such to the New York State Insurance Fund.
    2. Human Resources will ensure that employees with illness or injury who have medical services or lost time have access to the Claimant Information Packet which includes information and forms. After hours, employees can print a Claimant Information Packet from the New York State Insurance Fund’s website.
    3. The Claimant Information Packet contains a Workers’ Compensation Temporary Prescription Services ID form. This form may be substituted for an incident number and presented to a participating Express Scripts pharmacy in order to receive a limited supply of a needed prescription. This form may only be used during times when the ARS Call Center is closed.
15. In the event of a work-related fatality or a hospitalization event involving two or more employees, the Department of Environmental Health and Safety will report within eight (8) hours the relevant information to the New York State Department of Labor, Division of Safety and Health. 

Forms

The following forms may be utilized for accidents involving employees:

• SUNY Geneseo Accident Report Form 
• Certification of Healthcare Provider Form (WH380-E)
• Return to Work Form
• Physical Capabilities Form

Students and Visitors

When a student or visitor is involved in an accident resulting in injury or illness, the following procedures shall be followed:

1. Dial 585-245-5222 or 911 for immediate response to the incident location by the University Police Department.
2. The responding University Police Officer shall:

• Determine if immediate medical attention is required;
• ensure the safety of all parties present;
• and complete Parts I and II of the Accident Report Form and submit for supervisory review and approval.

3. After supervisory review and approval of the completed Accident Report, the University Police Department shall maintain the original report forms for incidents involving students and visitors.  Electronic copies shall be forwarded to the College’s:

• Department of Environmental Health & Safety
• Controller’s Office

Notifications

The Controller’s Office shall make the following notifications as noted:

1. SUNY Counsel’s Office (for incidents involving serious injury or fatality);
2. The Dormitory Authority for incidents involving serious injury or fatality which occurred on or about a residence hall. Such reports may be mailed to:

                                  Director of Risk Management

                                 Dormitory Authority

                                 State of New York

                                 515 Broadway

                                 Albany, NY 12207-2964; or

*Note:  In the event that a serious injury or serious fire occurs at a campus residence hall, the Director of Risk Management at the Dormitory Authority shall be notified as soon as possible at (518) 257-3702.