Reasonable Accomodation Request
Reasonable Accomodation Appeal
While a 3 Physician Board is required to apply for an RA, many members have been having problems where their doctors opinion is opposite of that of the Department. If you are having trouble with the 3 Man Board, or getting a RA position call the Local ASAP!
Worker's Compensation Forms
Most of the time, these forms are completed by your Comp lawyer. You should be keeping track of your medical travel expenses and incidentals on your own for reimbursement. All medical appointments are paid for by Comp when they file a C-4. You MUST NOT use your union prescription plan for medications. ALL MEDICATIONS TO TREAT YOUR LINE OF DUTY INJURY MUST GO THROUGH COMP!! Go to your local pharmacy and ask them for a Worker's Comp form. You need your date if injury and the claim numbers. The carrier is:
NYC Law Department
350 Jay Street
Brooklyn NY 11201
Your claim representative changes from time to time:
If your last name is beween A-K call
Abrahim 718-222-2169 Fax Number: 718-222-2391.
If your last name is beween L-Z call
Tanisha Meyers 718-222-2158.
If you are having a problem getting them to call you, call Eric Shenk 718-222-2157, and if still unsuccessful, call the Division Chief, John Sweeney 718-222-2101. If that does not get you a resolution, contact Jack Schaefer for guidance. Call the union for her number.
- C257 Medical & Travel Expenses
- C 27 Reopen a Claim
- C 3 File a Comp Claim
- C 430s Statement Of Worker's Comp Rights
- MD-1 Filed When Comp Ignores Your Dr's Request For Authorizations For Tx
- MD-3 Filed When Your Dr's Request For Tx Is Denied by the FDNY or Law Dept
Visit the Worker's Comp Site for more information and other links
Worker's Comp Prescriptions should all be put through your comp! DO NOT USE YOUR UNION PRESCRIPTION PLAN UNLESS YOUR CASE WAS CONTROVERTED, CLOSED or Comp refuses to approve them! Go to your pharmacy, ask for a Worker's Comp application. If you prefer to use a mail order system, you can use the INJURED WORKERS PHARMACY. They handle all Comp billing for prescriptions. Just call 1-888-321-7945. As of June 2005, the Law Dept is giving us a hard time paying the bills of the IWP, so if they refuse to assist you, try Workers Comp RX 1-888-226-6779.
Public Employee Safety and Health Citations
Forms and Documents
- Assault on EMS MOS Data Collection form for downloading (in order to fax or mail).
- FDNY Medical Documentation Form
- Bio Agent Summary
- Hazmat Exposure Form
- Millenium Gas Mask
- PICA Prescription Drug Program
- NEW DC37 Stepping Prescription Program Effective December 1, 2004
- Protocol For Responses to Assignments Involving Unknown Substances
- Small Pox Vaccine FAQ
- Bullet Proof Vests Authorized Vendors