Nys ehs 2026

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The document is an 'Agency Request for Medical Examination' form (EHS-707) used to request medical evaluations for employees. It includes sections for the requester’s information, employee details, legal authority for the request, and various reasons for the examination such as involuntary leave, ADA compliance, or workers' compensation. The form emphasizes the need for supporting documentation and provides contact information for scheduling.

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Click ‘Get Form’ to open the Agency Request for Medical Examination (EHS-707) in the editor.
Begin by filling in the 'PERSON REQUESTING EXAMINATION' section. Enter your printed name, signature, title, date of request, phone number, fax number, agency name and address, agency code, division, and preferred service location.
Next, provide details about the employee concerning whom the examination is requested. Fill in their name, Social Security number, date of birth, street address, city, state, zip code, and title.
Indicate the legal authority for the request by selecting from options such as Involuntary Leave or Workers’ Compensation. Ensure to attach any necessary explanations as required by Section 2620 of the State Personnel Management Manual.
Finally, review all entered information for accuracy before submitting. Use our platform’s features to save or share your completed form easily.

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Versions	Form popularity	Fillable & printable
2019	4.8 Satisfied (67 Votes)
2006	4.3 Satisfied (49 Votes)

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How do I contact the New York State Department of Health?

1-800-663-6114 - Complaints/Inquiries (Monday-Friday 9:00 a.m - 5:00 p.m.)

What is the purpose of the essential health benefits?

Essential health benefits ensure that health plans cover care that patients need. EHB requirements ensure that everyone in the individual and small group health insurance markets has access to comprehensive coverage that actually covers the services they need.

What is the NYS Essential health Plan?

The Essential Plan: Has no deductible, so the plan starts paying for your health care right away. Covers comprehensive benefits, including dental and vision, inpatient and outpatient hospital care, prescription drugs and more. Covers free preventive care like routine exams and screenings.

What is the rule of 3 in NYS civil service?

New York State Civil Service Law requires that an appointing authority must select from the top 3 candidates willing to accept an appointment. Some examples: Three scores of 100 (choice of 3 candidates)

What is the New York State Public Employee safety and health Act?

Every employer shall: (1) furnish to each of its employees, employment and a place of employment which are free from recognized hazards that are causing or are likely to cause death or serious physical harm to its employees and which will provide reasonable and adequate protection to the lives, safety or health of its

nys ehs

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What is the essential benefits plan?

Essential Benefits Plans (EBP) are a type of health insurance plan designed to cover all necessary health services a person might need. These plans are typically mandated to include a base level of coverage to ensure that individuals have access to comprehensive healthcare services.