Electrical Employers Self Insurance Safety Plan (E.E.S.I.S.P.) FAQs

Immediately after the accident, report it to your foreman or supervisor who will then file a 24 Hour Report and ADR C2 with E.E.S.I.S.P. You will then receive a letter from from E.E.S.I.S.P. giving you a case number. If you do not receive this letter, contact your employer to make sure the accident report was filed.

Please note, medical bills or payment for lost time will be delayed or not paid without an accident report.

Contact MagnaComp at (888) 336-8773 and they will recommend doctors in your area. Please note, you must use a doctor in the MagnaComp network or payment of bills will be denied.

If you require immediate or emergency treatment following an injury, you may go to any hospital or walk-in clinic. If additional treatment is required, you must contact MagnaComp for a referral to an in-network provider.

If all forms have been filed correctly, you should receive your first check approximately 12-14 days after your first full day out of work.

The statutory portion of the benefit is two-thirds of your average weekly wage for the year prior to the date of your accident with a maximum of two-thirds of the New York State average weekly wage. Under most circumstances, you will also be entitled to a collectively bargained supplementary benefit up to a maximum of $155 per week. The supplementary benefit is subject to different criteria than the statutory benefit.

The inactive letter tells you that you are currently not losing time from work and that you are not under treatment for that claim. The claim has been closed, but if further treatment is needed, contact E.E.S.I.S.P. for information on how to reopen the claim.

To file a disability claim, for a non-work-related illness or injury, contact E.E.S.I.S.P. at (718) 591-2800 for a telephone interview. You must file a DB-450 form.

The DB-450 should be mailed to the Workers' Compensation Board if you become disabled and have been on unemployment for four (4) weeks or more prior to your disability. This form should be sent to:

Workers’ Compensation Board
Disability Benefits Bureau
100 Broadway – Menands
Albany NY 12241
(800) 353-3092

You should complete Part A of the form and your doctor will complete Part B of the form.

The DB-450 should be sent to E.E.S.I.S.P. when you become disabled due to a non-work-related illness or injury while employed, or if you become disabled prior to four (4) weeks of unemployment. This form is sent to:

E.E.S.I.S.P.
158-11 Harry Van Arsdale Jr. Avenue
Flushing, NY 11365.