At Metropolitan Risk, our best practice clients understand the critical importance of getting employee injuries into the workers compensation system. Each injury that goes undetected or unreported costs the employer up to 39% more for the same exact injury if unreported for more than 4 weeks. This is why Day of Injury protocol can be such a powerful tool if your goal is to lower the high cost of employee injuries.  Recently timeliness has become even more imperative as failure to comply with timely injury reporting not only drives your workers compensation costs up, it will now be a fineable offense through the eyes of the NY State Workers Compensation Board.

From Then to Now

In June of 2013, the eClaims for First Report of Injury (eFROI) was initiated which required all New York State Insurance Fund policyholders to report electronically all “First Report of Injuries” In addition, an expectation that all carriers not just the NYSIF will move to this electronic reporting platform. This eFROI mandate was went into effect on April 23rd, 2014. As a part of this mandate, effective May 23rd, 2014, all employers are required to use Form C-2F, which replaced Form C-2.

As of October 1st, 2015, the Board announced strict enforcement of  timely reporting ; assessing all available statutory penalties to EMPLOYERS for non-compliance in reporting claims.Fines range from $1,000 to $2,500 for late reporting of workplace injuries.  

What Should You Do About This?

Minor Incidents (Internal Incidents Only):

For all incidents that have resulted in a minor injury that only requires first aide of 2 or less treatments and/or lost time of not more than one day beyond the day or shift when the injury had taken place, you MUST complete Form C2-F which is a formal notice of incident. This form does NOT get submitted to the carrier or the NY State Workers Compensation Board. It must be kept in an internal file for no less than 18 years, love that, UGH! If you are a client of Metropolitan Risk it should be attached to the incident record in our portal for safe keeping, please retain your own copy for your internal records. This should be submitted to Metropolitan Risk within 24 hours of the incident.

Filing A Formal Claim:

If your employee has been injured, reported the incident to someone on your staff AND it DOES NOT fit the criteria of a MINOR INCIDENT (see above) you must complete and file a C2-F and submit to your workers compensation carrier of record. Please supply Metropolitan Risk a copy so we don’t keep pinging reminders at you that it needs to be done.

Please note if you are insured with the New York State Insurance Fund you must report the claim electronically by clicking HERE as they do not accept paper forms.

If you neglect to report the CLAIM via the C2-F Form or the NYSIF’s (eFROI)  within 10 days, the New York State Workers Compensation Board may be sending unwitting employers penalties for late reports per the aforementioned change of policy on October 1st , 2015.

New York State has secure procedures in place that allows them to track just how timely you are reporting claims. They have the power to issue a $1,000 fine or a $2,500 penalty directly to your company which maybe the policyholder of record if you neglect to report the claims within 10 days.  We are curious as to how this will be enforced as quite often the employers are not the first to know of a worker’s injury. Thus we recommend that a notice be placed inside each worker’s pay slip advising them that all workplace injuries MUST be reported within 10 days of the injury to be considered and leave it at that. Just to reinforce it. We are not certain how the State will rule when an employee reports an injury. We have inquiries into the State and will issue an advisory to clear some of these ambiguities up.

So, what should you do about all of this? Best practice firms in any industry will make sure to report all incidents to us within 24 hours. We will then guide you when we think it should be reported up to the carrier so as not to trigger a potential fine and reserve your rights as a policyholder.  As of October 1st, 2015 it’s not only a requirement of your workers’ compensation policy, but also the law in New York State.

Coming Soon: The Easiest Way to Report Claims:

We expect to have our mobile app deployed soon, which lets all stakeholders know an employee was potentially injured so our team and yours can jump on the incident. It will also guide you to the nearest medical center. You may even have an account right within the app.

We are also changing our incident reporting procedures for all client HR point people at the client level. You will be reporting the incidents directly into our website which is built to match the C2-F. Once complete you hit a button, the C2-F form will print for your 18 year record. Should we have to report this incident to the carrier we have all the info in our system and can report for you directly so you will be in compliance.

As of this writing we are still building the back end of the system. Until this is deployed, you will be responsible for reporting to the carrier directly as only you have the payroll records, etc.

We hope you find this notice helpful as we are continually working to make your lives more efficient. Any suggestions or recommendations are always welcomed. Thank in you in advance for your cooperation with these new changes in the rules and regulations with respect to NY Workers Compensation Insurance. Just want to be sure all our clients are up to date with the latest and greatest.

To download the C2-F Form directly, click here.

 

Kind regards,

Lisa Schorfheide

(914) 357-8444

lisas@metropolitanrisk.com

Claims Advocacy Supervisor &

Your Metropolitan Risk Claims Advocacy Team