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Workers Compensation Claim Forms
C2 - Employer's Report of Work-Related Injury/Illness  eFROI - for electronic/online Reporting 

Workers' Compensation Incident Report Form 

Claimant Information Packet 

Manual de Información del Reclamante Claimant Information Packet (Spanish)


Notice to Post - NYSIF - Workers' Compensation Pharmacy Benefits Notification


C11 - Employer's Report of Injured Employee's Change in Employment Status Resulting from Injury

C107 - Employers Request for Reimbursement

C240 - Employer's Statement of Wage Earnings Preceding Date of Accident

C3.1 - Notice of Right to Select a Workers' Compensation Board Authorized Health Care Provider
 
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201-652-2015
 
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