US Legal Forms
New York Employers Statement of Wage Earnings Preceeding The Date of...

New York Employers Statement of Wage Earnings Preceeding The Date of Accident

Name: New York Employers Statement of Wage Earnings Preceeding The Date of Accident
Brand: US Legal Forms
Price: 59.00 USD
Rating: 4.59 (318 reviews)

Category:

New York Workers Compensation - Official

State:

New York

Control #:

NY-C-240

Format:

Instant download

This website is not affiliated with any governmental entity

Public form

Description

Employers Statement of Wage Earnings Preceeding The Date of Accident The New York Employers Statement of Wage Earnings Preceding The Date of Accident is a document used by employers in the state of New York to provide information on an employee's earnings prior to an accident occurring. This document is typically used for insurance purposes and contains data such as the employee's gross earnings, total deductions, net wages, and hours worked. There are two types of New York Employers Statement of Wage Earnings Preceding The Date of Accident: the NYS-45 and the NYS-50. The NYS-45 is used for employees in the private sector and includes information such as the employee's name, Social Security number, and wages earned for the previous quarter. The NYS-50 is used for public sector employees and provides similar information but also includes information on the employee's overtime wages.

The New York Employers Statement of Wage Earnings Preceding The Date of Accident is a document used by employers in the state of New York to provide information on an employee's earnings prior to an accident occurring. This document is typically used for insurance purposes and contains data such as the employee's gross earnings, total deductions, net wages, and hours worked. There are two types of New York Employers Statement of Wage Earnings Preceding The Date of Accident: the NYS-45 and the NYS-50. The NYS-45 is used for employees in the private sector and includes information such as the employee's name, Social Security number, and wages earned for the previous quarter. The NYS-50 is used for public sector employees and provides similar information but also includes information on the employee's overtime wages.

View Applicant Appraisal Form ??? Questions

View this form

View Applicant Appraisal Form ??? Questions to Applicant

View this form

View Checklist Regarding Matters that must be Disclosed to Prospective Franchisee

View this form

View Application and Loan Agreement for a Business Loan

View this form

View Interview Score Sheet

View this form

How to fill out New York Employers Statement Of Wage Earnings Preceeding The Date Of Accident?

US Legal Forms is the most straightforward and profitable way to find suitable legal templates. It’s the most extensive web-based library of business and personal legal documentation drafted and checked by legal professionals. Here, you can find printable and fillable templates that comply with national and local regulations - just like your New York Employers Statement of Wage Earnings Preceeding The Date of Accident.

Getting your template takes only a few simple steps. Users that already have an account with a valid subscription only need to log in to the web service and download the form on their device. Later, they can find it in their profile in the My Forms tab.

And here’s how you can get a professionally drafted New York Employers Statement of Wage Earnings Preceeding The Date of Accident if you are using US Legal Forms for the first time:

Read the form description or preview the document to guarantee you’ve found the one corresponding to your demands, or locate another one utilizing the search tab above.
Click Buy now when you’re certain about its compatibility with all the requirements, and choose the subscription plan you like most.
Register for an account with our service, sign in, and pay for your subscription using PayPal or you credit card.
Decide on the preferred file format for your New York Employers Statement of Wage Earnings Preceeding The Date of Accident and download it on your device with the appropriate button.

Once you save a template, you can reaccess it at any time - just find it in your profile, re-download it for printing and manual completion or upload it to an online editor to fill it out and sign more proficiently.

Take advantage of US Legal Forms, your trustworthy assistant in obtaining the corresponding official paperwork. Try it out!

Form Rating

4.59

Satisfied(318)

Form popularity

FAQ

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.

240 (617) EMPLOYER'S STATEMENT OF WAGE EARNINGS (Preceding the Date of Injury/Illness)

Under New York State law, you can file a claim two years from the date your injury or illness occurred, or two years from the time you should have known you suffered an injury or illness.

Timely Filing Within 48 hours of first treatment. After each follow-up visit scheduled when medically necessary but not more than 90 days apart. Within 120 days from the date of service.

The Board will calculate the rate of the award by looking at the injured worker's Average Weekly Wage. The rate the award is payable is two thirds of the worker's Average Weekly Wage. The lawyer must then add weeks of compensation to the award if there is a protracted healing period.

Going from and coming to work Normally, injuries incurred during regular commutes to and from work are not covered by workers' compensation as the time spent and act of commuting is not part of the scope and course of employment. This is called the going-and-coming rule.

After an injury or illness occurs, your employer must: Provide a workers' compensation claim form to you within one working day a work-related injury or illness is reported. Return a completed copy of the claim form to you within one working day of receipt.

More info

Claim Information - ALL COMMUNICATION SHOULD INCLUDE THESE NUMBERS. If you require assistance with completing these forms, please contact us.240: Employer's Statement of Wage Earnings Preceding Date of Accident. Employer's Statement of Wage Earnings Preceding Date of Accident. Give gross weekly earnings for the 52 weekly periods immediately preceding the date of accident. 2. To Employer: Making a false statement for the purpose of denying workers' compensation benefits may result in civil or criminal penalties. INSTRUCTIONS. Injured employee did not work sufficient time before alleged injury. What is the timeframe for the employer to complete the claim form? Accident-Fund premium. Only employers pay this premium.

New York Employers Statement of Wage Earnings Preceeding The Date of Accident

Description

Related forms

How to fill out New York Employers Statement Of Wage Earnings Preceeding The Date Of Accident?

Show more info

Form Rating

Form popularity

FAQ

How long does employee have to report injury in NY?

What is Form C 240?

What is the time limit for workers comp in NY?

What is the timely filing for workers compensation medical bills in New York?

How to calculate NYS workers comp settlement?

How long does an employee have to report an injury in NY State?

What is the coming and going rule for workers comp in NY?

What is the employer's responsibility when a worker is injured?

More info

Trusted and secure by over 3 million people of the world’s leading companies