Claims Kit

Penalties for Late Reporting WCL 110, 12 NYCRR 310.1

An employer who refuses or neglects to make a report or to keep records as required is guilty of a misdemeanor, punishable by a fine ofup to $1,000. The board or chair may impose a penalty of up to $2,500.00 upon an employer who refuses or neglects to make such report.

The report must be filed within 10 days after the occurrence of the accident.

Physician Selection WCL 13-a   325-8.1

The worker is free to choose any physician, chiropractor, podiatrist, or psychologist authorized to give medical care by the Chairman of the Workers' Compensation Board. 

All employees of an employer who has elected to utilize its workers' compensation insurance carrier's selected preferred provider organization must obtain initial treatment from the preferred provider organization. Any employee may seek treatment from outside of the preferred provider organization 30 days after his or her initial treatment from a preferred provider organization provider.

If for any reason during the period when medical treatment and care is required, the employee wishes to transfer his or her treatment and care to another authorized physician, he or she may do so, in accordance with rules prescribed by the chair.

The employer will have the right to transfer the care of an injured employee from the attending physician, whether chosen originally by the employee or by the employer, to another authorized physician (1) if the interest of the injured employee necessitates the transfer or (2) if the physician has not been authorized to treat injured employees under this act or (3) if he has not been authorized under this act to treat the particular injury or condition as provided by 13-b (2)

Reporting of Claim by Employer WCL 110 310.1

All injuries other than minor injuries must be reported to the Board and insurance carrier within 10 days. Failure to file within 10 days after the accident is a misdemeanor and punishable by a fine. In addition, the Board may impose a penalty of up to $2,500 

When completing Form C-2F, it is important to remember that statements may be legally binding. The employer should note on the form if they believe the claim to be questionable or fraudulent. The insurance carrier can be contacted for assistance with completing the form. Form C-2F can be filed by a third-party designated by the employer, however the employer is ultimately responsible for ensuring it is filed.

Filing Form C-2F is not necessarily an admission that you agree with the facts of a reported accident. It is a statement that an employee reported a work-related injury or illness to the employer.

Minor Injuries

The injury is minor if

• it requires two or fewer treatments by a person rendering first aid, and
• lost time amounts to less than one day beyond the end of the working shift on which the accident occurred.

For minor injuries, the employer may choose to pay for the first aid treatments directly. In this instance, the employer completes the Employer's First Report of Work-Related Injury/Illness (Form C-2F), but does not send it to the Board or the insurance carrier. Instead, the employer maintains the form in their files for the statutory 18-year period (WCL 110). Form C-2F is available from the insurance carrier, or any Board office.

Board Rule 300.37 calls for employers to distribute a "Claimant Information Packet" to workers at the time of their injury or illness.

The Board has incorporated those items in a document which, when combined with Form C-3, Employee's Claim, and Form C-3.3, Limited Release of Health Information (HIPAA), constitutes the Claimant Information Packet. Employers can comply with Board Rule 300.37 by distributing the Packet to their workers when they become aware of any injury or work-related illness.

Injured On The Job Pamphlet

While not mentioned in Board Rule 300.37, the Board's Injured on the Job pamphlet was also revised. This document, directed toward claimants, has long been used by workers' compensation stakeholders. It contains helpful details about accessing benefits and the claimant's rights within the New York workers' compensation system. Employers and carriers may distribute the Injured on the Job pamphlet to workers in addition to the mandatory Claimant Information Packet.

Employer's statement of wage earnings Form C-240

Posting Requirements  WCL 51

Every employer must post in a conspicuous place a notice, (Form C-105)  Notice of Compliance - Workers' Compensation Law,  that the employer has obtained workers' compensation coverage for their employees. The C-105 form informs employees that their employer is in compliance with the Workers' Compensation Law and of their rights and obligations if they suffer a work related injury or occupational disease. For employers who own or operate horse-drawn or automotive vehicles the notice prescribed by the Board to be posted is the C-105.1 form.

Forms C-105 and C-105.1 are not available online.

Employers obtain the C-105 or C-105.1 forms from the insurance carrier that provides coverage.

Carriers, their licensed agents, and Self-Insured Employers may email the Board at Certificates@wcb.ny.gov to obtain controlled forms not available on the website.

An employer who fails to post the C-105 conspicuously about the employer's place of business will be fined up to $250.