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Cumulative Absence Reserve (CAR)
This is the formal name for your bank of “sick days.” You are credited with one CAR day on the 16 th of each month of the school year, for a total of 10 days for the full school year. If you are regularly appointed, you can accumulate up to 200 CAR...
Excessive Absences/Lateness
There is no specific number of absences that is automatically considered excessive. According to an arbitration award, facts and circumstances that must be considered include, but are not limited to, the employee’s attendance and work history...
Jury Duty
You are entitled to full pay for time spent on jury duty. Your jury duty time during the school year is classified as non-attendance days. Jury duty that causes you to miss per session time does not count as non-attendance; if you miss per session...
Educational Conference
Attendance at education conferences, meetings or conventions are treated as an excused absence with full pay and are not deducted from your CAR. Prior approval of the principal and superintendent are required.
Religious Observance
If you are going to be absent due to religious observance, you should give your principal sufficient notice so that he or she can hire a substitute teacher for you. Your school secretary has the appropriate form for you to fill out. In many instances...
Graduation
You may receive an excused absence to attend a graduation ceremony of a close family member. See the guidelines below: Pedagogues and paraprofessionals: One day with principal’s or supervisor’s permission to attend their graduation or that of a...
Chemical Inventory Form
Form and instructions from the DOE Science Safety Manual.
Chemical Removal Request Form
This form for Lab Specialists is taken from the DOE Science Safety Manual.
Disposition of Obsolete Equipment Form
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.
Hazardous Chemical Exposure Incident Report
Use this form to document a hazardous chemical exposure incident in your school. Parts I, II, and III of the form are included.
Facility-Wide Inventory of Mercury and Mercury-Containing Devices
Especially for Lab Specialists. Use Page 1 to document the presence of mercury in a science room.
Extended Session Grievance Form, Step 1
Extended Session Teacher/Student Ration Fact Sheet
Comprehensive Injury Report
This form details the nature of your injuries. It should be turned in to your principal within 24 hours of your accident or illness.
UFT Incident Report
Use this confidential form to notify the UFT School Safety Department if you have been the victim of an incident and/or injury. Or fill out the online incident report form.
OP 504: Request for Reimbursement for Loss or Damage to Personal Property
The DOE will reimburse you up to $500 per school year for stolen or destroyed property such as loss or damage to personal clothing and personal accessories. For reimbursement of eyeglasses damaged in assault cases, use form OP 505G.
OP 505: Request for Reimbursement of Medical Expenses
Once line-of-duty status has been approved, you can use this form to request reimbursement for out-of-pocket medical expenses to a maximum of $1,500.
UFT Workers' Compensation Intake Form
Workers’ compensation intake form for Paraprofessionals, School Nurses, Occupational and Physical Therapists:
C-2: Employer’s Report
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...
C-3: Employee’s Claim
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.
C-4: Physician’s Report
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.
C-11: Change of Employment Status
Change in employment status includes return to work, discontinuance of work, increase or decrease of regular hours of work and increase or reduction of wages.
C-257: Expense Reimbursement Form
Use this form to claim out-of-pocket expenses related to your injury or illness.
DB-450: Disability Claim
Complete this form to claim disability benefits only if your Workers’ Compensation claim has been rejected.
MD-1: Request for Medical Authorization
Here is the form for an attending doctor to obtain medical authorization:
WCD-23: Employee’s Notice of Injury
Complete this form and file it with your school payroll secretary within 10 days.
CAR Transfer Form
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.
OP 160: Leave of Absence Without Pay
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...
OP 255: Resumption of Service Report
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.
Chancellor's Regulation C-650: Sabbatical Leaves of Absence
This regulation sets forth the rules governing sabbatical leave of absence applicable to all pedagogical personnel.
OP 44: Application for Termination Pay for Pedagogues
Upon resignation, termination or retirement, pedagogues are entitled to receive half of their sick leave balance (up to 100 days).
FMLA: Request for Leave under the Family and Medical Leave Act
For pedagogues and administrative staff. You must provide acceptable certification by a physician or other health care provider for your own serious health condition or the serious health condition of a covered family member within fifteen (15)...
EB 1054: Health Benefits Report/Inquiry
Must be filed along with a FMLA request.