Medical Only Claims

Minor employee injuries that result in no more than one lost work shift and two treatments by a doctor are classified as "Section 110" claims. The ABC Trust requires its members to self pay Section 110 medical bills so the claim won’t be counted against the employer’s experience modifier and the Trust reduces its claims administration expenses.

When a minor employee or first aid type injury has been reported you must:

1. Submit a request to the attending physician asking the physician to bill your company directly. SEE SAMPLE TEXT FOR SUCH A LETTER (Word).

2. Complete an "Employers Report of Work-Related Accident/Occupational Disease," (commonly called a C2 form). Do not send the C2 form to ABC Compensation Trust c/o Reller Risk Management, just keep it at your office.

3. When the medical bill arrives, mark it ABC Compensation Trust and send it to ABC Compensation Trust c/o Reller Risk Management. They will review the bill to see if the charges adhere to the NYS medical fee schedule for workers’ compensation injuries.

   Mailing address:

   ABC Compensation Trust
   c/o Reller Risk Management
   6315 Fly Road
   East Syracuse, NY 13057

   Contacts:

   Ms. Stanne Russell, (315) 671-4189 x 4189

   Ms. Liz Santaferra, (315) 671-4190 x 4190

4. Pay the medical provider according to the corrected billing you receive from ABC Compensation Trust.

5. Should the injury worsen and require additional medical treatment and absence from work, complete a letter of explanation along with the C2 form to ABC Compensation Trust. SEE SAMPLE TEXT FOR SUCH A LETTER (Word).

Following Procedures

It is important to follow these procedures exactly. If ABC Compensation Trust receives a bill, they will pay it and follow-up with you for the C2 form. You will not be able to reimburse ABC Compensation Trust and erase the claim.

Please call Ms. Stanne Russell (ext 4189) or Liz Santaferra (ext 4190) with any questions regarding these procedures.