Claimant Checklist

1. 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,” the employer’s name and the date of the accident are clearly listed in the center at the top of this document.
2. The carrier case number is also referred to as the "CC#," "NYSIF case number" or your “claim number.” The NYSIF case number is assigned 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.
3. The claimant should provide all medical providers with the NYSIF case number as soon as it is assigned. Your medical providers need to include the NYSIF case number on any correspondence.
4. While under medical treatment, the claimant is responsible for making sure all medical providers send updated medical reports to NYSIF.
5. When claimants are receiving WC medical and compensation benefits, their medical bills should be sent to NYSIF. Compensable injury treatment and medical services rendered are not to be processed through major medical insurance coverage or Medicare.
6. An Independent Medical Exam (IME) is arranged for you by NYSIF. IME’s are not scheduled all the time, but when they are, claimants must make every effort to attend the IME appointment as scheduled. If a claimant cannot appear for a scheduled IME appointment, call the IME doctor and your case manager for a new appointment.
7. 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 provider’s names and addresses where treatment was rendered and receipts for tolls and public transportation paid;
• Always include your name, your NYSIF case number and date of correspondence on everything you send to NYSIF.

8. Keep copies of ALL documents received from or mailed to NYSIF, including receipts for reimbursement.
9. If your phone numbers or addresses change, you need to advise both NYSIF and the Workers Compensation Board (WCB).