How to Fill Out and Submit the NYS PESH 7 Complaint Form

The NYS PESH 7 complaint form is how a New York public employee reports a workplace safety or health hazard to the Department of Labor’s Public Employee Safety and Health Bureau. Download the PDF from the Department of Labor website,¹ fill in the worksite details and a specific description of the hazard, choose whether to keep your name confidential, sign it, and send it by email, online portal, fax, or mail to the PESH district office that covers the worksite.

Before You Use This Form

PESH 7 is for public-sector workers only. Labor Law Section 27-a covers employees of the state, counties, towns, villages, public authorities, and other governmental agencies or instrumentalities.² The Department of Labor adds school districts and both paid and volunteer fire departments to that list.³ A federal OSHA interpretation letter confirmed that state counsel considers volunteer firefighters covered as public employees.⁴

Private-sector workers in New York cannot use this form. Federal OSHA handles private workplaces, federal government workers, and postal employees.⁵

You do not have to file for yourself. The form says “employees or employee representatives” may use it,⁶ so a union safety officer can file on behalf of affected workers.

Filling Out Each Section of the Form

You can type into the PDF before printing and signing, or print it blank and complete it by hand. Incomplete forms get slowed down or sent back, so work through each field.

Establishment Name and Site Address

Enter the official name of the public employer and the full street address, city, state, and zip code of the worksite where the hazard exists. If the hazard is at a satellite location or a construction site rather than the main office, use that address, not the headquarters.

Hazard Description

This is the section that drives everything else. Describe the danger specifically: what it is, where it is within the building or site, and roughly how many employees are exposed. The form itself instructs you to “be specific and give details” and to include the physical location of the hazard.⁶

“Unsafe conditions in the basement” will not get you far. Something like “exposed electrical wiring on the west wall of the basement storage room, near the water heater, where three maintenance staff work daily” gives the inspector a specific place to look and a specific condition to evaluate.

Attach anything that illustrates the problem: photographs of the hazard, copies of internal safety reports, maintenance requests you submitted, or written correspondence with your supervisor about the issue. Attachments are not required, but they give the reviewing officer immediate context and can speed up the decision to schedule an inspection.

Prior Notification

The form asks whether you have already brought the condition to the attention of the employer or another government agency. Check the box that applies. You are not required to notify your employer before filing a PESH 7, but your answer helps the Bureau judge how responsive the employer has been.

Confidentiality Election

You pick one of two options: “Do NOT reveal complainant’s name to the employer,” or “Complainant’s name may be revealed to the employer.” Your choice applies for the duration of the investigation. The confidentiality option is backed by statute. Section 27-a(5)(a) requires the Department of Labor to withhold the complainant’s name and the names of individual employees from the employer when the person giving notice requests it.² The employer still receives a copy of the complaint itself, just without your identity attached.

Complainant Information and Signature

Fill in your name, contact information, and signature. The form must be signed. An unsigned complaint still gets reviewed, but signed complaints receive higher investigative priority under the Bureau’s scheduling system.

How to Submit the Completed Form

You have four ways to get the signed form to the Department of Labor:

Email. Scan or photograph the signed form and send it to ask.shnypesh@labor.ny.gov.
Online portal. The Department of Labor runs a DocuSign-based complaint portal accessible from the PESH page on the DOL website.³
Fax. Fax the signed form to the nearest Division of Safety and Health district office.
Mail. Send the signed form by postal mail to the nearest district office.

The form itself directs you to submit by email, fax, or mail to the nearest district office.⁶ File as soon as possible after noticing the hazard; the Department advises against delay. Keep a copy of the signed form for your records no matter which route you use.

PESH District Offices

Submit your complaint to the office responsible for the geographic area where the worksite sits:³

Albany: State Office Campus, Building 12, Room 158, Albany, NY 12226 — (518) 457-5508
Binghamton: 44 Hawley Street, 9th Floor, Binghamton, NY 13901-4409 — (607) 721-8211
Buffalo: 295 Main Street, Suite 905, Buffalo, NY 14203 — (716) 847-7133
Garden City: 400 Oak Street, Suite 102, Garden City, NY 11530 — (516) 228-3970
New York City: 55 Hanson Place, 12th Floor, Brooklyn, NY 12212 — (212) 775-3554
Rochester: 109 South Union Street, Room 402, Rochester, NY 14607 — (585) 258-4570
Syracuse: 450 South Salina Street, Room 202, Syracuse, NY 13202 — (315) 479-3212
Utica: 207 Genesee Street, Room 703A, Utica, NY 13501 — (315) 793-2258
White Plains: 120 Bloomingdale Road, Room 250, White Plains, NY 10605 — (914) 997-9514

If you are not sure which office covers your worksite, call any of these numbers and ask. Staff will route you to the right one.

What Happens After You File

The Bureau assigns every complaint a priority level, with imminent-danger reports at the top. When a complaint alleges imminent danger, meaning an employee faces serious injury or death from the condition, the statute requires that the inspection receive the “highest priority” and “shall be carried out immediately.”²

If the Bureau schedules an on-site inspection, the inspector arrives unannounced. A visit typically includes an opening conference, a walkaround of the worksite, employee interviews, and a closing conference with the employer. An authorized employee representative, often a union safety committee member, has the right to accompany the inspector on the walkaround. The statute says both an employer representative and an authorized employee representative “shall be given the opportunity to accompany the commissioner during an inspection.” If no formal representative exists, the inspector will consult directly with a reasonable number of employees about safety conditions. No employee loses wages for time spent accompanying the inspector.²

The inspector is not limited to the hazard you described. Once on site, the inspector may examine any area of the premises where there is reason to believe a violation exists.²

Not every complaint produces a physical visit. The Bureau may instead send the employer a written inquiry requiring a documented response showing corrective action. Either way, the Department provides a copy of the complaint to the employer, with your name removed if you elected confidentiality.

When an inspector does find a hazard, the Department issues a Notice of Violation and Order to Comply that identifies the violation and sets an abatement deadline. There is no upfront fine for most violations, but if the employer misses the abatement deadline, a penalty of up to $200 per calendar day accumulates until the employer complies.³

If Your Employer Retaliates

Retaliation for filing a PESH complaint is illegal. Section 27-a(10) prohibits any public employer from discharging, disciplining, or discriminating against an employee for reporting a safety concern or participating in a safety-related proceeding. If you believe your employer retaliated against you, you have 30 days from the date of the retaliatory action to file a separate discrimination complaint with the Department of Labor.² That 30-day window is firm. Miss it and you lose the right to pursue the claim through PESH.

If the state’s handling of your retaliation complaint falls short, you can file a Complaint About State Plan Administration (CASPA) with federal OSHA, alleging that the state plan failed to follow its own procedures. Federal OSHA does not investigate retaliation claims against state and local governments directly, but CASPA provides an oversight path for procedural failures.⁷

1
New York State Department of Labor. PESH Notice of Alleged Safety or Health Hazards
2
New York State Senate. New York Code LAB 27-a – Safety and Health Standards for Public Employees
3
New York State Department of Labor. Public Employee Safety and Health
4
Occupational Safety and Health Administration. OSHA Jurisdiction Over Volunteer Fire Fighters
5
Occupational Safety and Health Administration. New York State Plan
6
New York State Department of Labor. Notice of Alleged Safety or Health Hazards
7
Whistleblower Protection Program. Whistleblower Retaliation Rights in States and Territories Operating State Plans