Web nys workers' compensation insurance coverage. The form, titled “employer’s first report of. Home address and phone number. Web it is the responsibility of the employer to submit the c2 form by documenting it in the payroll portal for you to receive an indexed carrier case number from the city of new york law. (print name of authorized representative or licensed agent of insurance carrier) title:. Date, time and location of injury. Web the c2, or an alternative report of injury document, must be completed within 10 days of the injury/illness or be subject to a penalty by the new york workers’. Occupational disease claim form continuation of pay excused absence medical treatment return to work (employee). On the ecomp site you can register for an account,. Volunteer worker who suffered injury/illness at or near the world trade center (ground zero) or the fresh kills landfill.
Web refer to this step by step process to file your claim. Home address and phone number. Web workers' compensation forms and worksheets. Web refer to this step by step process to file your claim. Occupational disease claim form continuation of pay excused absence medical treatment return to work (employee). Web ecomp submit forms online through the employees' compensation operations and management portal (ecomp). Web world trade center volunteer's claim for compensation. (print name of authorized representative or licensed agent of insurance carrier) title:. Volunteer worker who suffered injury/illness at or near the world trade center (ground zero) or the fresh kills landfill. Web the c2, or an alternative report of injury document, must be completed within 10 days of the injury/illness or be subject to a penalty by the new york workers’. Web date/hours of employment and wages.
