Contrary to popular belief, not every work related sickness or accident must be reported through Workers’ Compensation, and in fact, we do not recommend reporting every incident because the carrier will assign a monetary reserve that will negatively affect your policy premium. Accident frequency can negatively impact a client’s EMR (experience modification rating). Under NYS WC law, a company is not required to report an accident that involves less than two (2) days of lost time not including the accident date and does not involve more than two (2) doctor visits.
Non-reported injuries should be monitored though, since an injury can worsen and may turn into a reportable WC claim, or a doctor may require it become a WC claim. If you do not report a claim, always document and keep an internal file of the incident in case the injury escalates/changes and need to report down the road.
NYS also provides a first aid option to employers for non-reportable accidents:
According to the NY State Insurance Fund website, “The first aid option allows employers to avoid having the claim impact their claims history by paying for medical services rendered for accidents that are not-reportable. The policyholder should advise NYSIF, the claimant and medical providers to send medical bills to the policyholder for prompt payment.”
If the policyholder chooses the first aid option, but the injury escalates to a lost time case, or more than two medical treatments are rendered, the policyholder must file an Employer’s Report of Work-Related Injury/Illness with NYSIF and the WCB immediately.”
Should an employer decide they would like to pay the first aid expenses at a reduced worker’s compensation rate, books are available for purchase:
NYS Hospital Fee Schedule & NY Work Comp Medical Fee Schedule each cost less than $200 each – note you must get both & renew the purchase every few years. These come with a CD and a designated person from your office would need to create a login to gain access to the codes in order to reduce the medical fees accordingly. It is not difficult, but can be time consuming.
I hope this information is helpful.
Nicole Pancaldo – Danzi, ACSR