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No one knows the long-term health effects of COVID-19 exposure, so it’s essential that you protect your right to medical care and wage replacement through New York’s workers’ compensation system. Future benefits for you and your family could hinge on steps you take in the coming weeks.

The state’s workers compensation system requires employer notification within 30 days of the incident or exposure, so NYSNA is encouraging all exposed members to notify their employer. (While the board may accept a different standard for COVID-19 illness down the road, at this time it is imperative that members notify their employer as soon as possible.)

We have set up this easy-to-use form to help you protect yourself and your family. By submitting this form, you will officially notify your employer of your exposure. A copy of your email will be sent to you for your records.
Your Contact Info







Exposure Information


For H+H facilities, scroll down to "NYC Health + Hospitals" and find your facility there. If your facility is not listed, contact data@nysna.org for help.

Best approximate estimate.

Best approximate estimate.

Best approximate estimate. Leave blank of exposure continues

If applicable

If applicable

List all units where you believe you were exposed to the virus.