WORKERS COMPENSATION

RE: INJURED/ILLNESS ON THE JOB

“WORKERS COMPENSATION”

 -You have the right to go to the hospital or doctor of your choice that handles NYS Workers Compensation. If treated at a medical emergency room, you can follow up with your personal physician or Health Works, whichever one you choose becomes your attending physician! *Very important*

 Inform the hospital or doctor/billing staff that your injury/illness occurred at your place of employment. Workers compensation cases are to be filed under the company’s compensation carrier, Corvel P.O. Box 2249 Syracuse New York 13220. If you receive any medical bills or have any questions concerning workers compensation, please contact myself.

 - Do, have your doctor complete the form provided by Xylem and return as soon as possible to plant, per contract, Article 22.08.

- Do, keep Xylem’s Personnel office updated as to all new medical information, (documentation) ex, doctors’ visits etc. Please keep a copy of all paperwork handed into personnel for your records.

• -If your injury/illness is a workers compensation case, pharmacy prescriptions are to be filled under the company’s compensation carrier, Corvel P.O. Box 2249 Syracuse New York 13220. Please inform your pharmacy that it is a workers compensation case, you do not pay a co pay. (It is against the law to fill a prescription under your BlueCross BlueShield prescription plan when it is a workers compensation case.)

 -If you are out of work 7 days or less, no benefits are paid for lost wages but your medical costs will be covered. Your eligibility for lost wages begins the 8th day. If your doctor does not permit you to return to work for 15 days or more your wage payments will be retroactive to day one. It usually takes several weeks before you receive any checks.

 -If you receive a C-3.1 form from the insurance carrier, our attorneys have recommended that our members not sign this form, disregard.

 -The Local has attorneys on retainer, we recommend you contact them.

 Sincerely and fraternally,

President/Compensation Agent   

      Dan Mangold (716) 310-5585