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Firms and workers file Form SS-8 to request a determination of the status of a worker for purposes of federal employment taxes and income tax withholding. Claim No. The Employee can return to regular work.Giving the completed form to your employer opens your workers' compensation case. Instructions to the Health Care Provider: Please complete this form after every medical visit. Form nameVersion dateNotesAffidavit of Significant Financial Hardship (AS01)June 2018Legislative changesDisability Status Report (DS01)September 2012Employee's Claim Petition (EC04)June 2018Legislative changes State of New York – Workers' Compensation Board. Instructions for Completing Form C-2F. Form nameVersion dateNotesAffidavit of Significant Financial Hardship (AS01)June 2018Legislative changesDisability Status Report (DS01)September 2012Employee's Claim Petition (EC04)June 2018Legislative changes The forms listed below are the official New Hampshire State Forms. This includes citizens and noncitizens.