Workers’ Comp Complaint Form

You may use any method to report allegations of misconduct regarding the workers’ compensation system:

To file a complaint by mail, please write to us at:
New York State Offices of the Inspector General
Empire State Plaza, Agency Building 2, 16th Floor
Albany, New York 12223

Or fax your complaint to us at (518) 486-3745.

You may also file a complaint by calling our toll free hot line at 1 (800) 367-4448. This will connect you with trained staff who can discuss with you the specifics of your complaint.

Or, to file a complaint with the Office of the Workers’ Compensation Fraud Inspector General via this website, please complete the information below by providing as much information as possible.

Your name

Home address

Email

Home phone

Cell phone

Business phone

Recipient names(s)

Address

Date of birth

Type of injury

Date of injury

Location where injury occurred and entity’s name

Is subject currently working? If yes, where?

Business owner’s name

Business name

Business address

Number of employees

Complaint:

Your information is very important to us. Please explain your complaint below to assist us in gathering as much as possible. Please identify who is engaging in misconduct by including names, dates of birth, addresses, or any other identifying information, relative to your complaint. What state agencies or Departments of Social Services are involved (if any), what wrongdoing occurred, when, for how long, and if there are any witnesses that we may contact. Please be as detailed as possible.

Please note, we may have to contact you for additional information.

Complaint:

Workers’ Comp Complaint Form

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