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What forms do I need to file for Workers' Compensation?

You need to complete a Comprehensive Injury Report and return it to your principal within 24 hours. Make sure to tell the person attending to you that your injury or illness is work-related. Your doctor must complete an OP 198 Absence form, which you should file with your payroll secretary as soon as possible along with any doctor's notes, and file a C-4 Physician’s Report with the Workers’ Compensation Board. You’ll also need to complete a C-3 Employee Claim form, with the assistance of your doctor if necessary, and file it with the Workers’ Compensation Board as soon as possible but within two years of the injury. If necessary, you may also need to file a leave of absence form via SOLAS. It is the responsibility of the employer to submit the C2 form by documenting it in the Payroll Portal for you to receive an indexed carrier case number from the City of New York Law Department the insurance carrier for Workers’ Compensation recipients.

Find copies of these forms on our Workers' Compensation web page »