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Subject Number 046-546 Workers’ Compensation Board Announces New Employer's First Report of Injury/Illness Form C-2F

Subject Numbers Regarding Health Provider Authorizations

May 16, 2013

On October 31, 2012, the New York State Workers' Compensation Board (Board) announced the publication of its NYS eClaims Requirement Tables and NYS Implementation Guide in furtherance of the Board’s implementation of eClaims in spring 2013. The Board continues to work closely with a broad range of stakeholders as the implementation of eClaims approaches.

The Board is introducing a new Form C-2F, Employer’s First Report of Work-Related Injury/Illness. This new form has been aligned with the IAIABC Claims Release 3.0 standard and the Board’s Element Requirement Table. The form will help a claim administrator collect the information required to file a first report of injury from the employer.

The implementation of eClaims is occurring in phases. Those employers covered by the first phase of implementation must begin reporting the information contained on the form C-2F to their claim administrator by June 17, 2013. This will enable accurate and timely reporting under eClaims. Those employers are not required to file the form C-2F with the Board if the claim administrator will be timely submitting the injury/illness information electronically to the Board on the employer’s behalf. Section §110 of the Workers’ Compensation Law allows a third-party designated by the employer to file the first report of injury/illness on behalf of the employer.

Those employers covered by a subsequent eClaims implementation phase are encouraged to begin using the form C-2F as soon as possible, but may continue to use the form C-2 until their claim administrator begins eClaims implementation. If an employer has questions about which form to complete, or needs assistance completing the form, it should contact its insurer who can advise on the best method to report the information.

In preparation for eClaims implementation, claim administrators are strongly urged to communicate with employers regarding the data collection and reporting requirements in support of the eClaims mandate. Claim administrators will be required to electronically file first and subsequent reports of injury (FROI/SROI) as indicated in the eClaims Requirement Tables. Therefore, it is essential that employers and related stakeholders understand the need to communicate reportable injury/illness events timely to enable electronic filing in compliance with statutory requirements.

Please note that the form C-2F will also be used by political subdivisions to report an injury/illness for volunteer ambulance workers and volunteer firefighters. Forms C-2, VAW-2, and VF-2 will become obsolete after all claim administrators have successfully transitioned to eClaims.

Claim administrators may find more information on the IAIABC Claims EDI Release 3.0 standard in the EDI Implementation Guide section of the IAIABC website at: Questions related to this announcement can be directed to: New York specific requirements, implementation schedule, and resources can be found on the eClaims section of the Board’s website:

Robert E. Beloten