Skip to Content

Workers’ Compensation Board

Search menu

WCB Information Related to Novel Coronavirus (COVID-19)

Language Assistance: (877) 632-4996 |

Language Access Policy | Español | Русский | Polski | 中文 | Italiano | Kreyòl ayisyen | 한국어 | বাঙালি

Subject Number 046-909 Form Submission Guidelines

Board Bulletins and Subject Numbers

Date: January 4, 2017

To improve customer service for all stakeholders and to reduce system costs, the Workers’ Compensation Board has the following guidelines on submitting forms and other documents.

Avoid Duplicate Filing of Forms

The Board asks that you refrain from submitting forms more than once or in multiple formats. The quality of customer service diminishes when resources must be dedicated to sorting through duplicate forms to resolve an issue. Duplicate filings increase the amount of time required to respond to a customer request for further action or a status update on a pending request.

Duplicate submissions may be deemed to be raising or continuing an issue without reasonable grounds, will never result in higher fees being granted and may subject the sender to penalties under Workers’ Compensation Law § 114-a(3).

Choose a Submission Method that Works for You

There are multiple methods you can use to submit forms. The Chair has designated the following methods for submitting Board forms. Choose only one method for each form:

If you are faxing or mailing a form, ensure that you are using the most recent version of the form from the Board’s website. If, occasionally, you must send a corrected version of the form or document, please indicate on the top of the form that it is a corrected version of a form already submitted, including the date of the original (i.e., Corrected Version – Original Dated MM-DD-YYYY).

Consider Using Online Web Forms or Web Upload Link

The most frequently submitted forms are available for online submission on the Board’s website. You are encouraged to use these online web forms to maximize legibility and minimize filing turnaround times. Forms submitted electronically are routed automatically to the proper case folder, bypassing the scanning process. Forms submitted online appear in eCase the following business day.

Online web forms currently available are listed in the table below. They are available at: http://www.wcb.ny.gov/content/ebiz/WEBForms/webform_allForms.jsp

Form Number Injured Worker Employer Medical Provider Insurer/TPA Legal Representative
C-3 X
C-4, C-4.2, C-4.3 X
EC-4AMR X
EC-4NARR X
C-8.1 Part A X
C-8.1 Part B X
C-11 X
C-240 X
OT/PT-4 X
PH-16.2 X X X
RFA-1W X
RFA-1LC X
RFA-2 X
VDF-1 X

You can use the Board’s Web Upload Link to submit any form not available as an online web form. Documents submitted using the Web Upload Link are viewable in eCase faster than documents submitted by mail, email or fax. The transmission is more secure than either fax or email and the image quality is better. When the upload is successful, you will receive a confirmation email that notifies you that the image was uploaded. You can also generate a report listing the documents and when each was uploaded.

Verify Board Receipt of Forms

You can verify the Board’s receipt of a form in several ways:

If you have questions with the electronic submission of forms, or experience difficulty, please contact the ITS Enterprise Service Desk at (800) 694-1323. For assistance with forms submitted through the Web Upload Link, please contact usa.nywcb.helpdesk@xerox.com.

Kenneth J. Munnelly
Chair