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Employer's Report of Work-Related Injury/Illness
(EC-2) Adobe Format

This EC-2 form uses Adobe Reader to render the form.   Adobe Reader® 9 or later, is recommended to support the additional functionality in this form. The latest version of Adobe Reader® Link to External Website is available as a free download from Adobe's web site.

For more information regarding how to use the save data, load data and other features of this form, please review Web Submission of Claim Forms - Adobe Format.

Instructions for Completion adobe pdf

Workers' Compensation Law Section 110 adobe pdf

PLEASE READ if you are using a Mac™ or Google Chrome™ or Firefox 19.0™ before selecting CONTINUE!