File a Claim - Workers' Compensation Board 2025

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The document is an Employee Claim form (C-3) for applying for workers' compensation benefits in New York due to work-related injuries or illnesses. It requires the employee to provide personal information, details about their employer, job description, specifics of the injury or illness, and medical treatment received. The form also includes instructions on how to complete it and outlines the rights of injured workers regarding medical treatment and compensation.

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Click ‘Get Form’ to open it in the editor.
In Section A, enter your personal information including your name, date of birth, mailing address, and social security number. Ensure all details are accurate for processing.
Proceed to Section B and provide your employer's details. Include the name, address, and phone number of the employer at the time of injury.
In Section C, describe your job title and duties on the date of injury. Specify whether you were full-time or part-time and include your gross pay information.
Move to Section D to detail your injury or illness. Include the date and time of the incident, location, and a thorough description of how it occurred.
Complete Section E by indicating if you stopped working due to the injury and if you have returned to work. Provide relevant dates and employer information.
Finally, in Section F, document any medical treatment received for your injury. List healthcare providers and treatment dates as necessary.

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Versions	Form popularity	Fillable & printable
2022	4.9 Satisfied (47 Votes)
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2011	4.4 Satisfied (556 Votes)
2009	4.2 Satisfied (63 Votes)

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How do I get workers comp in NY?

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.

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

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.

How do I file a compensation claim?

If you want to take legal action to claim compensation for a personal injury, you will need to get advice from a solicitor specialising in these types of cases. This must be done as soon as possible as there are strict time limits on taking legal action.

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What is the statute of limitations for workers comp claims in NY?

New York law states that workers have up to two years to file a claim if they are suffering from a work-related illness or injury. For occupational hearing loss, workers have up to three months to report the injury and 90 days to file a workers compensation claim.

How long do you have to file a workers comp claim in NY?

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.

How long do you have to file a workers comp claim in New York?

Deadline for Filing a Workers Compensation Claim Under New York law, you must file your workers compensation claim within two years of the day you became injured.

How do I claim a work accident?

Your solicitor will base your accident at work claim on the following evidence: The accident at work was officially recorded in the company accident book. A record of medical treatment received afterwards. An independent medical assessment of your injuries. Photographs of the location and injury hazard.

How does workers comp work in NY?

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 workers lost time is equal to or less than one week.