IMPORTANT INFORMATION ON FILING A CLAIM

You must give notice to your employer within 30 days from your injury stating when, where and how you were injured.

You must have medical evidence documenting your work injury/illness. You should seek medical attention from a qualified medical expert authorized by the NYS Workers’ Compensation Board as soon as possible. Be sure to give the history of your injury/illness to your doctor along with the name and address of your employer. Confirm with your doctor that reports will be filed with the NYS Workers’ Compensation Board and your employer or its insurance carrier. The doctor should not bill you or your private insurance for the treatment of your work related injury.

File C-3 EMPLOYEE CLAIM FORM with the Board as soon as possible, but no later than 2 years from the date of your injury/illness.

FORMS C-3 and C-3.3 can be found on the NYS Workers’ Compensation Board website www.wcb.ny.gov

File FORM C-3.3 along with your C-3 if you have a prior history of injury to the same body part or if you had a similar illness.

You must remain under the care of your doctor at intervals of no greater than 90 days during any period of time out of work due to your work injury/illness.

If you move or change your telephone number you should notify the Workers’ Compensation Board and the insurance carrier immediately.

Any and all work activity following the injury/illness, including but not limited to self-employment, work performed on or off the books, work for pay, barter or no pay must be disclosed to NYS WCB and insurance carrier immediately. Concealing work activity of any kind while collecting or claiming workers’ compensation benefits constitutes fraud, and will in most instances result in serious civil and/or criminal penalties.

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