UFT Incident and Injury Reporting Guidelines
Oh no! You've been injured on the job!
These are Chris Verdone's step-by-step instructions on how to report an incident or injury for both the DOE and UFT:
Comprehensive Injury Report - Print this form, complete and submit to your payroll secretary and principal ASAP.
Payroll Secretary Responsibilities - Details a payroll secretary's role when a pedagogue applies for a LODI (Line of Duty Injury); please note the OP 200 Form is no longer used.
Levitt Letter - NYC legal arbitration that the Union secured that specifically states NYC DOE teachers and pedagogues are NOT eligible for Workers' Compensation. If pedagogues see a medical provider for a work-related injury, they are NOT to fill out Workers' Compensation paperwork. They are only responsible for their co-pays. If there are issues, let me know.
OP 505 Form - If a member's LODI is approved by the DOE Medical Bureau, they fill this out, attach all medical receipts, and submit everything on the DOE HR Connect Portal. Members can be reimbursed up to $1500 for out-of-pocket medical expenses, including co-pays.
OP 504 Form - Members can be reimbursed up to $500 for any items damaged or stolen as long as they have receipts. Submit everything on the DOE HR Connect Portal.
DOE Written Statement Form (SAMPLE) - Official DOE incident report that is handwritten by the member and entered into OORS (Online Occurrence Reporting System). Request a copy of the OORS report.