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New York State
Workers' Compensation Board
OFFICE OF THE CHAIRMAN
328 State Street  Schenectady, New York 12305
Subject No. 046-85

To:  Insurance Carriers and Self-Insurers Providing Benefits Under the Workers' Compensation Law, Volunteer Firefighters' Benefit Law, and the Volunteer Ambulance Workers' Benefit Law; Attorneys and Licensed Representatives Practicing Before the Board; Authorized Health Providers

Phase Out of Color Requirement and Hole-Punching for Prescribed Board Forms

Supersedes Subject No. 046-59 Printing of Prescribed Board Forms, dated July 19, 1999

Date:  February 9, 1999

The Workers' Compensation Board is in the process of instituting an Electronic Case Folder (ECF) system in all of its offices. Forms and papers received by the Board are being scanned at a central facility, with the scanned images of these documents assembled electronically into a case file for use by Board employees and parties of interest on the claim.

Color Requirement   Currently, the Board requires a number of prescribed reporting forms to be printed on colored paper, e.g., Form C-7 (tan), Form C-4 (pink), for easy identification in the case folder. However, with the advent of the Electronic Case Folder, colored paper is no longer necessary for identification purposes; moreover, scanning of such paper is sometimes difficult and the image is occasionally unsatisfactory.

Accordingly, effective April 1, 1999, the Board will begin accepting most prescribed forms under the Workers' Compensation, Volunteer Ambulance Workers' and Volunteer Firefighters' Benefit Laws on white paper. Please note, however, that the following forms are not affected by this change and must still be filed on the colored paper indicated:

  • C-251, Carrier's Request for Reimbursement of Compensation Payments Under Sec. 15-8 (Canary)
  • C-251.1, Carrier's Request for Reimbursement of Medical Expenses Under Sec. 15-8 (Pink)
  • C-251.2, Carrier's Request for Reimbursement of Compensation Payments Under Section 14-6, Concurrent Employment (Blue)
  • ADR-1, Alternative Dispute Resolution Program Report of Injury (Green)
  • ADR-1.1, Modification of Previous Report (Green)
  • ADR-2, Alternative Dispute Resolution Program Final Disposition on Settlement of Claim (Green)
  • All forms under the Disability Benefits Law

Carriers, self-insurers, attorneys and licensed representatives with large supplies of forms on colored paper may use these supplies until December 31, 1999. After that date only white forms, except as noted above, will be accepted.

Health providers who obtain Form C-4 and other medical reports from the Board should place their orders in the usual manner as their supplies run out. Because of the expected immediate demand, we ask that you do not discard any existing pink forms at this time. New orders will be filled with white forms as they become available.

Hole Punching   A number of prescribed Board forms require two holes to be punched at the top of the form to facilitate filing in the Board's case folders. As a result of the Electronic Case Folder, this requirement is also being eliminated effective April 1, 1999. Forms filed on or after that date do not have to be punched.

Thank you for your cooperation.

 

Robert R. Snashall
Chairman