Skip to Content

Workers' Compensation Board

Give yourself extra time to arrive at our Garden City office Monday due to traffic changes for the presidential debate at nearby Hofstra University. For traffic restrictions, http://bit.ly/2dpaZST.

Language Assistance: (877) 632-4996 | Español | Русский | Polski | 中文 | Italiano | Kreyòl ayisyen | 한국어

Mapped Documents

The six mapped documents are current Board forms C-2, VF-2, VAW-2, C-669, C-7 and C-8/8.6 with the IAIABC data element numbers listed in the existing fields. These Board forms will be replaced with FROI/SROI upon implementation of eClaims.

PDFs adobe pdf

  • C-2 (Employer's Report of Work-Related Injury/Illness)
  • C-7 (Notice That Right to Compensation is Controverted)
  • C-8/8.6 (Notice That Payment of Compensation Has Been Stopped or Modified)
  • C-669 (Notice to Chair of Carrier's Action on Claim for Benefits)
  • VAW-2 (Political Subdivision's Report of Injury to Volunteer Ambulance Worker)
  • VF-2 (Political Subdivision's Report of Injury to Volunteer Firefighter)