NY WCB C-3 2019 free printable template

C-3 Employee Claim State of New York - Workers Compensation Board Fill out this form to apply for workers compensation benefits because of a work injury RU ZRUN UHODWHG LOOQHVV 7 SH RU print neatly. If you were treated by a doctor indicate the name s and address es of the doctor s whom provided care and complete and file Form C-3. Have you had another injury to the same body part or a similar illness If yes provide the names and addresses of the doctor s who treated If yes were you...

How to fill out NY WCB C-3

How to fill out NY WCB C-3

1. Obtain the NY WCB C-3 form from the New York State Workers' Compensation Board website or your employer.
2. Fill in your personal information including your name, address, social security number, and date of birth.
3. Provide details about your employer, including their name, address, and contact information.
4. Describe the injury or illness, including when and where it occurred and how it happened.
5. Indicate the nature of the injury or illness and any medical treatment you have received.
6. Sign and date the form to certify that the information you have provided is accurate.

Who needs NY WCB C-3?

1. Anyone who has suffered a work-related injury or illness in New York and seeks to file a claim for workers' compensation benefits needs to complete the NY WCB C-3 form.

Instructions and Help about NY WCB C-3

Music this is workers comp matters hosted by attorney Alan s peers the only legal talk Network program that focuses entirely on the people and the law in workers compensation cases nationally recognized trial attorney expert and author Alan S Pierce is a leader committed to making a difference when workers comp matters Music welcome to legal talk Network this is Alan Pearce host of workers comp matters I'm an attorney at Pearce Pearson napolitana in Salem, and we're bringing you another edition of workers comps matters with guest Michael Grubber before we get into topic with Michael we want to thank our sponsor case pacer practice management software dedicated to the busy trial attorney to learn more go to case pacer dot-com and our other sponsor we'd like to thank is P I now find a local qualified private investigator anywhere in the United States visit p I know com to learn more today's guest is Michael Grubber Michael is a partner, and I'm going to take a deep breath in the law firm of Pasternak telco Ziegler Walsh Stanton and Romano LLP in New York City and other satellite offices I believe Michael is a partner in their Brooklyn office Michael is a graduate of Michigan State he earned his JD degree from the University of Denver College of Law he's been a worker's comp lawyer for over 20 years in addition to litigating workers comp claims he oversees the workers' compensation appellate division practice at the firm, and he has been a member and leader in a variety of local and national Bar Association's and professional groups most recently he just completed a very successful term as president of Willing which is the workers' injury law and advocacy group so with that having been said I'd like to welcome Michael to workers comp matters welcome thank you very much Alan it is a pleasure to be here all right, so you practice in New York, and I've been reading online a variety of posts about some recent somewhat controversial changes that are being proposed to the workers comp statute in New York and I know you and you affirm representing the interests of injured workers have taken a pretty vocal stand why don't you give our listeners an overview of what's been proposed and the status of these possible changes so in New York as many states do a variety of types of benefits that are available injured workers one of the benefits we have here in New York is for extremity injuries to arms letting way down to the fingers from the toes, and we have what are called schedule loss of use awards for permanent injuries to those extremities for injuries to the extremities these are types of awards that you can get regardless of whether you miss a day from work in New York for injuries to your neck your back your head you ask me out of work in order to get any monetary benefits but for any injury to an extremity that results in a permanent injury you are entitled to a monetary award now the value of the extremity for lack of a better way to put it is...

People Also Ask about

What is the New York Workers Compensation Benefit?

Compensation Rates An injured employee is entitled to a compensation rate equal to two-thirds of the average weekly wage (AWW) in New York State for the 52-week period immediately prior to the date of accident. The rate is subject to prescribed maximums and degree of disability.

How long do you have to file a workers comp claim in NYS?

When to File. You must notify your employer within 30 days, but it is best to do so as soon as possible. If 30 days pass and you have not notified your employer, you may lose your rights to workers' compensation benefits.

What is the statute of limitations for workers comp claims in NY?

New York law states that workers have up to two years to file a claim if they are suffering from a work-related illness or injury. For occupational hearing loss, workers have up to three months to report the injury and 90 days to file a workers' compensation claim.

How do I file a workers comp claim in NYC?

Call: 866-396-8314. A Board representative will take your information and complete the C-3 form. Submit a paper C-3 form.

How long does an employer have to file a workers comp claim New York?

Your employer must notify their insurance carrier within 10 days of the injury or illness if you require medical treatment beyond first aid or have lost at least one day from work other than the date the injury or illness occurred.

How do I check the status of my workers compensation claim in NY?

If you filed a claim and were assigned a number, you can call (646)264-3000 for information about your claim. If you are a U.S. Department of Labor employee, please call (816)502-0301 for claim status information.

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What is NY WCB C-3?

NY WCB C-3 is a form used to report an employee's claim for workers' compensation benefits in New York.

Who is required to file NY WCB C-3?

The employer or any authorized representative is required to file the NY WCB C-3 form when an employee sustains a work-related injury.

How to fill out NY WCB C-3?

To fill out the NY WCB C-3, you need to provide information about the injured employee, details regarding the injury, incident date, and any medical treatment received.

What is the purpose of NY WCB C-3?

The purpose of the NY WCB C-3 is to officially document and submit an employee's claim for compensation due to a work-related injury or illness.

What information must be reported on NY WCB C-3?

The information required on NY WCB C-3 includes the employee's personal information, details about the injury, the date and location of the incident, and information regarding medical treatment.