Fire Service Forms
ALL CLAIMS MUST BE FILED WITH THE COUNTY IN A TIMELY MANNER. FAILURE TO COMPLY WILL RESULT IN FINES. IN ADDITION, FILING A VF-2 FORM MORE THAN 10 DAYS LATE IS CONSIDERED A MISDEMEANOR. A fire department officer must sign all forms. Your Cortland County contact person for claims is Angie Wyatt. She may be contacted at 607 753-5048 (direct line) or fax info to (607) 756-3942.
Exact date of injury or death is extremely important. It is imperative that the injury report be filled out the same day that the injury occurred.
Under Part 801 of the State of New York Department of Labor Recording and Reporting Public Employees’ Occupational Injuries and Illnesses Section 801.9, Reporting of Fatalities or Multiple Hospitalization Accidents,
Within 8 hours after the occurrence of a firefighter accident which is fatal to one (1) or more firefighters or which results in inpatient hospitalization of two (2) or more firefighters, the Fire Chief or his/ her designee shall report the accident to the nearest office of the New York State Department of Labor, Division of Safety and Health, 450 South Salina Street, Syracuse, NY 13202, telephone area code (315)-479-3212.
Whether or not the accident is immediately reportable, if a firefighter dies of the effects of a fire department related accident within 6 months of that accident, the Fire Chief or his/her designee shall report to the Division of Safety and Health office, 315-479-3212, within 8 hours after learning of such death.
Each report required by this section shall relate to the circumstances of the accident, the number of fatalities or hospitalizations, and the extent of any injuries. The Fire Chief or his/her designee shall also provide to the Division of Safety and Health office any additional information and reports concerning the accident as the Department of Labor shall deem to be necessary.
If a fatality or serious incident occurs, the Fire Chief or his/her designee shall take appropriate measures to prevent the destruction or alteration of any evidence that would assist in investigating the fatality or serious accident.