eForm information
| Form ID | Form title | Who files | Where to file | When to file | Submittal options |
|---|---|---|---|---|---|
| RFA-2 | Request for Further Action by Insurer/Employer | Insurance carrier or Board-approved self-insured employer | Electronically filed with the Workers' Compensation Board, with PDF copy to claimant and claimant's representative, if any. | The form may be filed at any time after the assembly or indexing of a claim or after the Board has indicated that no further action (NFA) will be taken. |
|
Submitting via eCase
The new RFA-2 retained the original three request categories (Compensation, Medical, and Other). Each category will have applicable request reasons that have been revamped for clarity and to obtain more details to ensure efficient processing.
Based on the request reason selected, the eForm will present guided questions and fillable sections required to submit the eForm.
For example, when the request reason "Payments directed by the Board should be suspended pursuant to §300.23(b)" is selected, the user will see:
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Select "the decision that directed continuing payments."
- Selecting the Reference Documents button will display the eForms - Case Folder pop up window. Only applicable decisions will be listed or if the decision is not listed the user may select the "Decision not listed" check box. If there is no decisions, the user must "enter the filing date of the decision or the date of the hearing that directed payments."
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Select the most applicable option(s). Each option will have subsequent fields to complete.
- "Medical evidence finds no disability or fails to support ongoing disability"
- "No medical evidence of a disability produced in the past 90 days"
- "Failure to appear at one or more IMEs without good cause or sufficient excuse"
- "Claimant has voluntarily removed themselves from or is no longer attached to the labor market"
- "Claimant was directed in a Board decision to look for work and has not produced sufficient evidence"
- "Medical documentation of apportionment"
- "Claimant's disability is unrelated to established injury"
- "Claimant/beneficiary whereabouts are unknown"
- "Claimant did not produce documentation as directed in Board decision"
- Optional - a 500-character free form text box for additional information related to the request reason.
Once all questions and sections are complete, submit the eForm. See below for an in-depth breakdown of each step of the eForm.
eForm button in eCase
Once logged into eCase, and a case number is entered, users will see an eForm button.
eForm landing page
After selecting the eForm button, you will be taken to the eForm landing page shown below.
From here, you can start a new eForm, as well as view all drafted and submitted eForms.
The landing page contains eight columns:
- eForm
- Status (eForm statuses are Submitted, Rejected, and Draft)
- Last Saved Date
- User
- Submission ID
- Submission Date
- Document ID
- Medium (Displays how the eForm was submitted - WEB, API, FTP)
To start a new eForm, go to the Select a form to submit drop-down list and select RFA-2 - Request for Further Action by Insurer/Employer. Then select the Start eForm button.
Selecting a request reason
Once a new RFA-2 eForm is started, the page below will display on the screen. This page shows the request reasons. There are three categories of request reasons:
- Compensation
- Medical
- Other
Select a request reason, and then click Save & Continue.
Completing the Request Details page
After selecting a request reason, you will be prompted to fill in the request details on the Request Details page. See Request Reason Quick Guide below for important information on request reasons.
If the request reason selected requires a document to be referenced, only the appropriate documents that can be referenced will be available for selection in the pop-up that displays. Example: the request reason "Payments directed by the Board should be suspended pursuant to §300.23(b)" is selected and the user needs to "select the decision that directed continuing payments." Only decisions will be available for selection in the pop-up that displays.
| Request reason (RR) | Use for | Conditions for display | Requires certification | Link to resources | Reason abbreviation (API/XML) | RR medical provider name field value in eCase | Image example |
|---|---|---|---|---|---|---|---|
| Payments directed by the Board should be suspended pursuant to §300.23(b) |
Medical evidence finds no disability or fails to support ongoing disability No medical evidence of a disability produced in the past 90 days Failure to appear at one or more IMEs without good cause or sufficient excuse Claimant has voluntarily removed themselves from or is no longer attached to the labor market Claimant was directed in a Board decision to look for work and has not produced sufficient evidence Medical documentation of apportionment Claimant's disability is unrelated to established injury Claimant/beneficiary whereabouts are unknown Claimant did not produce documentation as directed in Board decision |
Always displays | This reason requires certification when the following occurs:
|
Workers' Compensation Benefits | CPD | suspend | |
| Payments directed by the Board should be reduced pursuant to §300.23(b) |
Medical evidence finds a change in disability Average weekly wage (AWW) set without prejudice and continuing payments are at a tentative rate Medical documentation of apportionment |
Always displays | Yes | Workers' Compensation Benefits | CPR | reduce | |
| Insurer requests to apply overpayment to ongoing payments | Always displays | Yes | CPI | ovrpay | |||
| Payments should begin or be modified based on reduced earnings | Will not display for volunteer firefighter/ambulance worker cases | Yes | Workers' Compensation Benefits | CPS | re |
| Request reason (RR) | Use for | Conditions for display | Requires certification | Link to resources | Reason abbreviation (API/XML) | RR medical provider name field value in eCase | Image example |
|---|---|---|---|---|---|---|---|
| Claimant is at maximum medical improvement and a medical report on permanency has been filed | Always displays | No | Guidelines for Determining Permanent Impairment and Loss of Wage Earning Capacity Overview | MCI | mmi | ||
| Opioid weaning under Non-Acute Pain Guidelines | Always displays | Yes only if claimant is represented | New York Medical Treatment Guidelines | MOW | opioid | ||
| Insurer requests apportionment finding for medical treatment | Always displays | Yes | Glossary Description: A proportionate division of all or part of the benefit costs in a case between two or more injury claims for the same claimant, based on an evaluation of the relative contribution that the injuries have made to the claimant's permanent disability. Apportionment can also occur in a case when a claimant has one injury claim but has other injuries unrelated to their injury claim due to a prior injury outside of work. | MIA | apport |
| Request reason (RR) | Use for | Conditions for display | Requires certification | Link to resources | Reason abbreviation (API/XML) | RR medical provider name field value in eCase | Image example |
|---|---|---|---|---|---|---|---|
| Employer is requesting reimbursement | Will not display for volunteer firefighter/ambulance worker cases | Yes | Glossary Description: A request by an employer for reimbursement for wages paid to an employee for a period during which the employee was eligible to receive workers' compensation or disability benefits. | OER | reimb | ||
| Insurer raising labor market attachment | Always displays | No | Labor Market Attachment | OIL | lma | ||
| Request disqualification pursuant to §114-a | Always displays | No | ORD | 114a | |||
| Insurer seeks desk review of Special Funds Group (SFG) reimbursement decision Form C-251.6R | Always displays | No | Procedural Updates on Special Funds Group Reimbursement and Establishment of Section 15(8) Claims | OID | 251.6r | ||
| Claimant has discontinued or settled a lawsuit pertaining to the accident/injury of this claim | Always displays | Yes | Glossary Description: Lawsuits against equipment manufacturers, facility owners and other non-employer parties whose products or services contributed to the occurrence of an accident. Under the Workers' Compensation Law, a compensation claim is a worker's sole remedy against the employer, but lawsuits may be initiated against third parties for contributory negligence, product defects, etc. | OCD | 3pa | ||
| Insurer withdraws appeal | Always displays | No | Appeals | OIW | rb89 | ||
| Unresolved issues related to a death case |
Further action requested on a death case Spouse remarried Beneficiary reaches 18, 23, or 25 (25 only applicable to Volunteer Ambulance and Volunteer Fire cases) Beneficiary is no longer a student Beneficiary is a student Beneficiary cannot be located Beneficiary has passed away Other Issue |
Always displays | Yes | Death Claims | OUI | death | |
| Additional Proposed Findings | Use For | Conditions for Display | Requires Certification | Link to Resources | Abbreviation (API/XML) | Medical Provider Name field value in eCase | Image Example |
| Establish case (ANCR/ODNCR) | Always displays | Yes | pf | ||||
| Establish average weekly wage (AWW) | Will not display for volunteer firefighter/ambulance worker cases | Yes | pf | ||||
| Award lost wage benefits not in dispute | Always displays | Yes | pf |
In the example below, the request reason "Claimant is at maximum medical improvement and a medical report on permanency has been filed" was selected. Next, you will complete the information fields required. Select Save & Continue when you are finished.
Submission Progress panel
The Submission Progress panel allows you to keep track of the eForm's progress as you complete each step.
Saving a draft
You can save a draft or exit at any point while filling out the eForm. When you select Exit, the message window below displays on the screen. If you select "Confirm," you are acknowledging that the progress on the current step you are on will be lost and a draft with all previously completed information will be saved.
Adding another request reason
Multiple reasons can be submitted on an RFA-2 eForm. You may add another request reason once the first request reason has been completed. After saving the request details, a prompt will appear asking if you want to add another request reason. Select Yes to add an additional request reason.
Editing a request reason
To edit request details, select the pencil icon shown on the Submission Progress panel.
Note: You must click the Save & Continue button in order for the pencil icon to appear next to a step in the eForm.
Deleting a request reason
If a request reason was selected in error, select the trash can icon displayed in the Submission Progress panel. This will delete the request reason and return you to the list of reasons.
Upon selecting this icon, you will be prompted to confirm deletion of the record.
Select Delete.
Additional Proposed Findings page
The Additional Proposed Findings page allows you to add findings that are not in dispute or select no additional proposed findings. The options to select are No additional proposed findings, Establish case (ANCR/ODNCR), Establish average weekly wage (AWW), or Award lost wage benefits not in dispute.
When the box is checked for any of these options, the eForm will have information for that additional proposed finding. For example, if Establish case (ANCR/ODNCR) is selected, the user will enter the required data fields.
If there are no additional proposed findings, select No additional proposed findings at the top of this section.
Supporting Documentation page
The Supporting Documentation page allows you to reference documents from the case folder or upload supporting documentation for the eForm. Please refer to the Required Document Matrix (MS Excel) for more information on required documentation.
Certification page
Certification may be required for a request reason/additional proposed findings. It is the responsibility of the submitter to serve all parties, including any official Board eForm submission.
Note: The certification date cannot be the current date when selecting the second option.
Attestation page
To submit the eForm, you must accept the Attestation. First, select Accept, and then enter the required information for who the RFA-2 is submitted on behalf of and the submitter information.
Review and Submit page
Prior to submitting the eForm, you will have a chance to review a draft of your submission. Click the Back button to edit the eForm or delete a request reason.
Select Submit to finish the submission.
Upon submission, the system automatically generates a PDF and places it in the case folder. You will be able to view/print/download the PDF from the eForms landing page and via eCase. You can also view submitted eForm details, including submitted status, on the eForms landing page.
Submitting via API or XML file
- Registration Instructions
- Testing Requirements for API Submission
- Testing Requirements for XML File Submission
Requirements and examples
| File name | Description |
|---|---|
| RFA-2-XML-Data-Requirements-and-Edits.xlsx | XML documentation/guidelines for RFA-2 XML data elements. This spreadsheet contains list of error codes, list of valid values, element requirements and element rules. |
| Rfa2MultiReason.xml | XML layout example for RFA-2 submission of multiple request reason codes. |
| Rfa2SingleReasonMia.xml | XML layout example for RFA-2 submission of request reason code MIA (Insurer requests apportionment finding for medical treatment). |
| Rfa2SampleCpi.xml | XML layout example for RFA-2 submission of request reason code CPI (Insurer requests to apply overpayment to ongoing payments). |
| eFormsRfa2XMLAckTemplate.xml | XML acknowledgement template for RFA-2. After processing the API submission the acceptance and rejection of the transaction will be returned back to the sender. |
| eFormsRfa2XmlTemplate.xml | XML template for the RFA-2 submission. This template contains the data elements for all submission reasons. It is recommended to review the API requirements and edits spreadsheet for the submission reason specific data element list. |
| eFormsRfa2.xsd | XML schema definition for RFA-2 XML data submission. API submitters are expected to use this schema definition to validate the data before sending XML submission via API. |
| Required-Document-Matrix.xlsx | This document will assist you in determining if supporting documentation will be needed (referenced or submitted) when submitting the RFA-2. |
| Submitted-RFA-2-Sample-1.pdf | This is a sample of a generated RFA-2 after it was submitted to the Board for when payments directed by the Board should be suspended pursuant to §300.23(b). |
| Submitted-RFA-2-Sample-2.pdf | This is a sample of a generated RFA-2 where there are multiple reasons for the form submission, including additional proposed findings. Certification section displays second option. |
| Submitted-RFA-2-Sample-3.pdf | This is a sample of a generated RFA-2 where there are multiple reasons for the form submission, including additional proposed findings. Certification section displays first option. |
FAQs
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Will the eForm option automatically be available beginning March 20, 2026, or is there a separate step that an eCase user may need to take to ensure they have this access?
It will automatically be available on March 20th. Users will need to perform a successful case search in eCase with case details displayed, before the eForm button appears.
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Why don't I see the eForm button?
If you are a carrier attorney granted view only access, the eForm button will not display. Only attorney's who were placed on notice by the carrier's eCase administrator will have the ability to file an RFA-2.
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Is there an opt-out option (e.g., submitting by U.S. mail)?
No, you must submit electronically starting on March 20, 2026. After this date, the Board will not accept or act on any paper RFA-2 forms submitted by insurers/employers.
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Is there an option to download the completed RFA-2 eForm?
Yes, you can download or print a PDF of the completed eForm. Submitted eForms are placed in the case folder and can be viewed from the eForms landing page using the Submission ID hyperlink. The hyperlink will open the PDF.
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Does a copy of the eForm automatically get sent to the required parties (e.g., claimant attorney, claimant)?
No, a copy of the completed RFA-2 eForm is not automatically sent to the required parties. It is the responsibility of the insurer or their representative to download and print the completed eForms and serve all parties the RFA-2 and any uploaded documents following the same methods currently being used to serve all parties.
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Is there any way to fix mistakes on the RFA-2 eForm after it is submitted?
No, once the RFA-2 is submitted, no other changes can be made. However, the form can be saved and edited as a work in progress before submission.
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How does an insurer/employer withdraw an RFA-2 that was submitted?
You cannot cancel the RFA once it's been submitted, but you can send correspondence to the Board and parties of interest stating that you withdraw the RFA-2 that was filed.
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Can supporting documentation be attached after the RFA-2 is filed?
No, the attachments must be filed with the original RFA-2 before it is submitted. For attachments after submission, submit the documentation with correspondence relating it to the RFA-2. Do not file a second RFA-2.
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Is supporting documentation required for every RFA-2 submission?
Use the Required Document Matrix file (MS Excel) from the Requirements and examples section above to assist you in determining if supporting documentation will be needed (referenced or uploaded).
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Can multiple insurer/employer users access and update eForm drafts on the landing page?
There can only be one draft per WCB case number. Only one person can work in a WCB case number at a time. One user can start an eForm, save a draft, and another user can resume that draft and save or submit it.
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What if my request reason is not included on the RFA-2 eForm?
First, consider whether the Board needs a request on that topic. For example, any of the following will trigger Claims action without the need for an RFA-2 or correspondence: Section 32 waiver agreement, Stipulation (Form C-300.5), and Agreed Upon Proposed Decision Findings (Form C-312.5). Sending unnecessary requests will cause delays.
For issues that do not result in an automated Board action, the insurer/employer may submit correspondence. Do NOT file an RFA-2 using a request reason that does not apply.
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How do I request to cancel a duplicate case?
Submit an online claims inquiry and select "Cancel/combine case".
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How do I request cross-examination of the claimant's health provider?
Most situations are covered by a request reason and you can include the cross-examination request in the free text box. The insurer can submit correspondence for any other cross-examination requests not covered in the RFA-2.
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How do I request Section 44 apportionment?
Correspondence may be submitted to raise this issue.
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How do I request a hearing to address reimbursement from another carrier that has not complied with a direction by the Board?
Correspondence may be submitted to raise this issue.
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How do I request to suspend payments when selecting reason 'Request disqualification pursuant to §114-a'?
In the free form text box state that you are requesting to suspend payments in addition to listing the documentation/evidence to be produced.
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My reason for requesting suspension of payments is not listed. How do I request to suspend payments?
First, consider if the Board requires a request for that topic. If the suspension reason is not listed, a Subsequent Report of Injury (SROI) with supporting evidence may be appropriate in lieu of an RFA-2. These are some examples when a SROI should be filed per 12 NYCRR 300.23 (a) & (b): proof of incarceration upon conviction of a felony, evidence of claimant's return to work, and death of a claimant. Additional information on how to file a SROI can be found on the eClaims page.
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Where do I enter free text in the request reason?
The free text option is within the Request Details step (if available for that request reason).
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How can I attach evidence?
On the RFA-2 eForm, select the appropriate request reason. Documents can be selected from the case file or uploaded from the user's device within that request reason.
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How can I check the status of a previously submitted RFA-2?
If required, status on a previously submitted RFA-2 may be checked by submitting an online claims inquiry and selecting "Request for Further Action (Form RFA-2) status." Please give the Board at least 30 days before submitting an inquiry.
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How do I document an overpayment?
If you are requesting that an overpayment credit be applied to continuing payments then select reason 'Insurer requests to apply overpayment to ongoing payments'.
If there are no continuing payments, submit correspondence to the Board with the overpayment amount, supporting documentation, and details of how the overpayment was created.
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How do I request that cases be set to travel?
If you are submitting an RFA-2 you can include this request in the additional information free form text field, or correspondence may be submitted for this request.
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When a schedule loss of use is at issue, how do I raise sufficiency/credibility of the treating physician's opinion as noted on an EC-81.7?
In lieu of depositions on permanency, the carrier/employer may raise an argument regarding the sufficiency and credibility of the claimant's permanency opinion. Written arguments on the issue must be received by the Board within seventy-five (75) days of the EC-81.7. An RFA-2 is not necessary.
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What if the claimant refuses to sign a release for medical or case records?
You may submit correspondence to raise this issue and reference/attach supporting documentation. Detailed guidance on this topic can be found on the Use of the C-3.3 in Controverted and Non-Controverted Claims page.
More information
Need help or have feedback? Email OnBoard@wcb.ny.gov. Please include the following in your correspondence, where applicable:
- User ID
- R#, W#, T#
- Request reason(s)
- Field or XML data element name
- Details of issue
- Screen shot
Additional resources
RFA-2 technical outreach webinar – July 2025: Video / Slides
RFA-2 Payer Engagement Sessions April 2025
Technical support
For technical assistance, please email WCBTechnicalSupport@wcb.ny.gov.