Workers’ compensation intake form for Paraprofessionals, School Nurses, Occupational and Physical Therapists:

The employer is required to fill out this report within 10 days to notify the Workers’ Compensation Board of your work-related injury or illness. You should not participate in filling out this form. See the C-2: Employer's Report - Filing Procedure...

You must fill out this form to initiate your Workers’ Compensation claim. You should retain one copy, file a second with the Board, and provide a third to your legal representative.

Your doctor must fill out this form at regular intervals — usually every 4-6 weeks — during your convalescence. It is used to determine your level of benefits — so it is very important that your doctor fills it out carefully.

Use this form to claim out-of-pocket expenses related to your injury or illness.

Complete this form to claim disability benefits only if your Workers’ Compensation claim has been rejected.

Here is the form for an attending doctor to obtain medical authorization:

Complete this form and file it with your school payroll secretary within 10 days.

All pedagogues and paraprofessionals may use this form to donate sick time to a colleague. The recipient receives one day for every two days donated. Sick leave transfer rules are on page 2 of the form.

All pedagogical personnel may apply for a medical leave of absence without pay only when they have exhausted all of their Cumulative Absence Reserve (CAR) days. This application must be completed, signed and submitted to HR Connect for approval...

Upon an employee’s return from a leave of absence without pay, the payroll secretary must submit an OP 255 form to the Bureau of Salary Differentials and Status.

Pedagogues and paraprofessionals use this form to apply for a retirement leave of absence. For every two days in the employee’s sick bank, one day of terminal leave is granted. The form must be filed 30 days in advance of the leave. The leave can...

Upon resignation, termination or retirement, pedagogues are entitled to receive half of their sick leave balance (up to 100 days).

Print and complete the paraprofessional application only if you are not able to use the online enrollment form.

Print and complete the retired teachers’ application only if you are not able to use the online enrollment form.

UFT membership application for all DOE titles except paraprofessionals. Print, complete and submit this application form only if you are not able to use the UFT's online enrollment form.

Form and instructions from the DOE Science Safety Manual.

This form for Lab Specialists is taken from the DOE Science Safety Manual.

If there is equipment in your school that is unrepairable, not cost-effective to repair, educationally inappropriate, or a safety hazard, complete this form to have the equipment removed.

Use this form to document a hazardous chemical exposure incident in your school. Parts I, II, and III of the form are included.

This form is for payroll secretaries.

The following is a list of the most commonly prescribed drugs. It represents an abbreviated version of the drug list (formulary) that is at the core of our prescription drug benefit.

The Affordable Care Act requires group health plans to provide a Summary of Benefits and Coverage (SBC) to plan participants so they may better understand their coverage. In compliance with this law, the UFT Welfare Fund has completed an SBC...

This application form is to be used only by pedagogical personnel who have received a regular appointment.

Use this form to request employment verification for pension purposes.