C-258 2026

See details

4.2 out of 5

49 votes

The document is a form (C-258) for claimants to record their job search efforts and demonstrate attachment to the labor market as required by the New York State Workers' Compensation Board. It outlines various ways to show job search activities, including participation in job-location services, independent job searches, vocational rehabilitation programs, and full-time education. The form requires detailed information about each effort and emphasizes the importance of supporting documentation. Claimants are advised to consult with legal representatives before submission, as insufficient efforts may lead to benefit suspension.

Here's how it works

01. Edit your c 258 form online

Type text, add images, blackout confidential details, add comments, highlights and more.

02. Sign it in a few clicks

Draw your signature, type it, upload its image, or use your mobile device as a signature pad.

03. Share your form with others

Send c 258 1 form via email, link, or fax. You can also download it, export it or print it out.

How to use or fill out C-258 with DocHub

Ease of Setup

DocHub User Ratings on G2

Ease of Use

DocHub User Ratings on G2

Click ‘Get Form’ to open the C-258 in our editor.
Begin by entering your last name, first name, middle initial, WCB case number, and the period for which you are reporting your job search efforts.
In Section 1, provide details of any participation in job-location services. Include the location, name of the program or service, and dates along with activity/results.
For Section 2, if you conducted an independent job search, check the box and ensure to complete Form C-258.1 as well.
In Section 3, document any participation in vocational rehabilitation programs. Fill in the date(s) of contact, name of the career center or program, and attach supporting documentation.
Finally, in Section 4, if attending an accredited institution, provide enrollment dates and attach proof of enrollment.

Start using our platform today to easily fill out your C-258 form for free!

See more C-258 versions

We've got more versions of the C-258 form. Select the right C-258 version from the list and start editing it straight away!

Versions	Form popularity	Fillable & printable
2019	4.2 Satisfied (49 Votes)
2010	4.2 Satisfied (51 Votes)

be ready to get more

Complete this form in 5 minutes or less

Get form

Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

What is the compensation rate for mileage?

Self-employed and business: 70 cents/mile. Charities: 14 cents/mile. Medical: 21 cents/mile. Moving (military only): 21 cents/mile.

How much does NYS workers comp pay for mileage?

To continue to receive ongoing lost-wage benefits, a temporarily, partially disabled claimant is obligated to demonstrate labor market attachment. A claimant is considered to be attached to the labor market if that claimant is found to be making reasonable efforts to obtain gainful employment that is consistent with

Is mileage included in workers compensation?

In some states, such as California, injured workers can get reimbursed for any miles driven to and from a doctors appointment, pharmacy, or other reasonably necessary treatment for their injuries.

How much does NYS reimburse for mileage?

New York business mileage reimbursement rates Tax YearBusiness rateCharitable rate 2023 $0.655 $0.14 2022 (Jul 1 to Dec 31) $0.625 $0.14 2022 (Jan 1 to Jun 30) $0.585 $0.14 2021 $0.56 $0.143 more rows

What does it mean to be attached to the labor market?

Email to the Boards centralized email address, wcbclaimsfiling@wcb.ny.gov; Mail to the Boards centralized mailing address, P.O. Box 5205, Binghamton, NY 13902-5205; or. Fax to the Boards centralized fax number, (877) 533-0337.

c 258 1

C-258.1 Spanish C 258.1 7 17 C-257 C258 form C-257 form NYS Workers' Compensation forms C 2 C-3 form Workers comp NYS Workers comp C-4.3 form

Security and compliance

At DocHub, your data security is our priority. We follow HIPAA, SOC2, GDPR, and other standards, so you can work on your documents with confidence.

Learn more

Related forms

be ready to get more

Complete this form in 5 minutes or less

Get form

Does workers comp pay for mileage in NY?

The rate for personal vehicle mileage on or after January 1, 2025, is 70 cents per mile. In those instances where injured workers are entitled to reimbursement for travel expenses, insurers will reimburse injured workers for travel in accordance with this rate.

C-258 2026

Here's how it works

How to use or fill out C-258 with DocHub

See more C-258 versions

Complete this form in 5 minutes or less

Got questions?

What is the compensation rate for mileage?

How much does NYS workers comp pay for mileage?

Is mileage included in workers compensation?

How much does NYS reimburse for mileage?

What does it mean to be attached to the labor market?

Security and compliance

Complete this form in 5 minutes or less

People also ask

Does workers comp pay for mileage in NY?

c258 1

Try more PDF tools