Should you have a Workers’ Compensation claim to report, first please click on Procedures document below to learn submission steps then access the form you need by clicking on the relevant link below.
- Claimant Packet Link to NYSWCB
- WC Claim Reporting Procedures
- C2 (ver 1-11) PDF Format - Employer’s Report of Work Related Injury/Illness
- C2 (ver 1-11) Excel Format - Employer’s Report of Work Related Injury/Illness
- C11 (ver 1-11) PDF Format - Employer’s Report of Injured Employee’s Change in Employment Status Resulting from Injury
- C11 (ver 1-11) Excel Format - Employer’s Report of Injured Employee’s Change in Employment Status Resulting from Injury
- C240 (ver 1-11) PDF Format - Employer’s Statement of Wage Earnings
- C240 (ver 1-11) Excel Format - Employer’s Statement of Wage Earnings
- C-107 PDF Format - Employer’s Request for Reimbursement
- Supervisor’s Accident Report – English
- Supervisor’s Accident Report – Spanish