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Workers' Compensation

Employee Accident and Investigation Report
(To Report a Work Related Injury or Illness)

Call the Accident Reporting System (ARS) at (888)-800-0029 to report a work related injury or illness as soon as possible. Write down the incident number the operator gives you.
Complete the State Workers' Compensation Accident and Incident Report (ARS) Form as soon as possible and send it to:
Lorraine Berry
Human Resource Services
390 Administration Building
Stony Brook University
Stony Brook, NY 11794-0751
Pay attention to the following:
- Be specific when stating (Box 19) what you were doing at the time of the injury and what part or parts of your body were injured.
- It is very important to indicate if you received medical treatment (Box 15). If you do not seek medical treatment at the time of the injury, but do so at a later date, notify Time and Attendance immediately. If you are losing time from work due to your injury, Time and Attendance must be notified. You must provide ongoing medical documentation to your department during your absence.
- Time and Attendance must be notified when you are losing time from work and when you return (Box 14).
- You and your supervisor must sign this report. This report is needed to process your Workers' Compensation claim.
- Personal Health Insurance cannot be used for Workers' Compensation claims.

All fees for medical treatment must be billed to:: State Insurance Fund
Policy Number: 24096-0
8 Corporate Center Drive
3^rd Floor
Melville, NY 11747-3166