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  • Froi 02 Form In Ny

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State of New York Workers ' Compensation Board First Report of Injury Report Type (MTC) 02Change This paper contains information that has been provided electronically to the Board. Do not serve a.

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Date of AccidentWeekly Maximum Total / PartialJuly 1, 2021 - June 30, 2022$1,063.05 / $1,063.05July 1, 2020 - June 30, 2021$966.78 / $966.78July 1, 2019 - June 30, 2020$934.11 / $934.11July 1, 2018 - June 30, 2019$904.74 / $904.7416 more rows

There are three ways you can file a claim for workers' compensation in New York State: Visit our claims page. Call 877-632-4996 to speak with a New York State Board representative. Complete and file the C-3 Employee Claim form.

Or fax your complaint to us at (518) 486-3745. You may also file a complaint by calling our toll free hot line at 1 (800) 367-4448. This will connect you with trained staff who can discuss with you the specifics of your complaint.

Notify Your Supervisor of Your Injury Written notification should be provided to your employer as soon as possible, but within 30 days. If you fail to notify your employer, within 30 days after the date of injury, you may lose your rights to workers' compensation benefits.

Upon approval for a workers' compensation claim, you will receive payments from the insurer every two weeks. Every 45 days, your doctor will submit a progress report to the Board. If 12 weeks pass, and you are still recovering, the insurance carrier will consider whether rehabilitation treatment is necessary.

When to File. You must notify your employer within 30 days, but it is best to do so as soon as possible. If 30 days pass and you have not notified your employer, you may lose your rights to workers' compensation benefits.

There is a statutory waiting period of seven calendar days for workers' compensation benefits. NYSIF must begin payments within 18 days after the onset of disability. Subsequent benefits are paid bi-weekly. Compensation is not payable if an injured worker's lost time is equal to or less than one week.

Every employer in New York must provide workers' compensation insurance for their employees....There are three ways for New York employers to purchase a workers' compensation insurance policy: You can buy a policy from a private insurance company. ... You can buy a policy from the state fund. ... You can apply for self-insurance.

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© Copyright 1997-2025
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Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232