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Claimant Checklist
Print
Claimant Checklist
After a claim is filed, the first document a claimant receives from NYSIF is
Form DP-G1, "Personal Privacy Protection Law Notification"
(PDF file).The carrier case number, employer’s name and the date of the accident are clearly listed in the center at the top of this document.
Carrier case number is also referred to as the CC#,
NYSIF
case number or claim number.
NYSIF
assigns a case number when a claim is filed. Claimants should always use their
NYSIF
case number when contacting
NYSIF
. All correspondence should include your name, the date of correspondence and the
NYSIF
case number.
The claimant should provide all medical providers with the
NYSIF
case number as soon as it is assigned.
Medical bills for claimants receiving WC medical and compensation benefits should be sent to
NYSIF
. Compensable injury treatment and medical services are not to be processed through major medical insurance coverage or Medicare.
The claimant is responsible for making sure all medical providers send updated medical reports to
NYSIF
.
If an Independent Medical Exam (IME) is arranged for you by
NYSIF
, you must make every effort to attend the appointment as scheduled. If a claimant cannot appear for a scheduled
IME
, call the
IME
doctor and your
case manager
for a new appointment.
When claimants submit reimbursement requests to
NYSIF
for:
Prescription and durable medical equipment,
they must include a copy of the prescription from the prescribing doctor and the purchase receipt;
Transportation and mileage,
they must include dates of the medical appointments, the medical providers' names and addresses where treatment were rendered, and receipts for tolls and public transportation;
Always include your name, your
NYSIF
case number and date of correspondence on everything you send to
NYSIF
.
Keep copies of ALL documents received from, or mailed to,
NYSIF
including receipts for reimbursement.
If your phone numbers or addresses change, you need to advise both
NYSIF
and the Workers Compensation Board (WCB).
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