You can complete a select group of claim forms and submit them online to the Workers' Compensation Board. For a list of forms which may be submitted online, please refer to the "List of Available Forms".
If you submit a form online, DO NOT mail a duplicate paper form to the Board.
The Workers' Compensation law requires you to maintain records of certain forms. After submitting your completed form, an Adobe PDF (see Minimum Technical Requirements) version of the form will display in your browser. You can print the PDF or save a copy to your computer. A printed copy should also be sent to all parties of interest as indicated on the form.
Some claim forms require you to obtain a user ID and password. This is to prevent unauthorized submission of claim forms for an open case.
Each organization requesting to submit online claim forms that require a user ID and password must designate an administrator from within their organization. Please read Web Submission of Claim Forms Administrator's Responsibilities for more detailed information.
These forms may be viewed and reprinted for a period of up to 30 days from the date of submission using the 'search for' function available on the Online Forms Submission page. After 30 days, if you need the form you can contact the WCB Office handling the case to request a copy, or it can be printed from the case folder if you have access to eCase.
If you have problems submitting forms or questions please direct them to the ITS Enterprise Service Desk.
Forms may be submitted 24 hours a day. However, there are times when the application may not be available. Please review the Board's On-line Services Availability information. Select the Claims Web Forms Submissions link at the bottom for information specific to this application. If you are experiencing problems with this application you should check these web pages before contacting the ITS Enterprise Service Desk.
*Only Health Care Providers that have been authorized by the Board to treat workers' compensation injuries are eligible to submit C-4 forms via the web. If you are not an authorized Health Care Provider and would like to become one, complete and submit Health Providers Application for Authorization Under the Workers' Compensation Law MR/IME-1