Instructions for Completing Employee Claim (Form C-3) Please complete this form and send it to the Workers' Compensation Board centralized mailing address listed at the end of these …

Employer Quarterly Report (Form C-3) includes the total and taxable wage amounts paid in a quarter. Wages List (Form C-4) includes the employee names, Social Security numbers and …

Fill out this form to apply for workers' compensation benefits because of a work injury or work-related illness. Required items are indicated by an *

File a C-3 employee claim form online, complete as many fields with as much detail as you can and submit. No other documents are necessary to file a C-3 and you don’t need to establish …

the injured employee is expected to be off work 5 days or more, attach wage verification form (D-8). Gross earnings will include overtime, bonuses, and other remuneration, but will not include …

If your injury was the result of the use or operation of a licensed motor vehicle: If you filed a Department of Motor Vehicles Form MV-104 (Report of Motor Vehicle Accident), please …

2020年12月8日 · The easiest way to get started on a workers’ compensation claim in New York is to file a C-3 form, which allows you to report your workplace injury. This form is available for …

2024年10月25日 · Before you can receive workers’ compensation benefits in New York, you must complete the Employee Claim form, also known as the C-3 form. This step is separate from …

2022年12月2日 · Wage totals on Form C-3 are calculated from employee data entered on Form C-4, which must be completed first. The user must enter ALL employee data on Form C-4. If …

2023年9月12日 · A C-3 form is an employee claim for workers’ compensation. It is the first step in applying for workers’ compensation benefits. A C-3 form contains seven (7) sections, each of …