Workers’ Compensation Claim Kit – New York

Who will handle your claims?
The New Jersey Regional Claim Office will handle your New York claims, located at:

305 Madison Ave.
P.O. Box 1973
Morristown, NJ 07962

Phone (888) 890-1500
Diane Parrish, Regional Director

How to Report Workers’ Compensation Claims?

To report via the Internet: Log on to the Crum & Forster website at Use your assigned User ID and Password. If you do not have a current User ID, please contact your local Crum & Forster Claims or Marketing resource.

To report e-mail:
To report via fax: 1-877-622-6218
To report claims via telephone: 1-800-690-5520

(7 day/24 hour toll free reporting line for all states)

  • In the event of a serious or fatal injury, notify the local claim office immediately by telephone.

What forms and pamphlets does the employer need to be aware of?

Click on this link for the New York Forms:

Posting Notice (C-105)
Prominently display the notice where each employee is likely to see the notice on a regular basis. The New York posting notices are available on the Crum & Forster website.

nsation-claims/C-2F / Employer’s First Report of Injury

If you report the claim via the Internet or by telephone, you do not need to fill out this form. If you report the claim via fax or by e-mail, complete this form, and fax or e-mail it to Crum & Forster at the fax number or e-mail address provided above.

C-2F Form (1.14)

C-240 / Employer’s Wage Statement
File this form with the carrier, claimant, and claimant’s representative when the claimant is losing time from work. Read the instructions for more specifics on when to file the form.

C-240 Revised 6.2017

C-11 / Employer’s Report of Injured Employee’s Change in Employment Status Resulting from Injury
File this form with the carrier when there is a change in employment status resulting from the Workers Compensation injury.

C-11 Form June 2017

A Guide to the New York State Workers Compensation System

NY WC 12-2011 Employer Handbook

The NY Workers Compensation Reform bill was signed into law on March 13, 2007. The following material changes were included in the bill:

  • Statutory benefit caps on permanent partial benefits will apply to accidents or occupational diseases occurring on or after 3/13/2007. PPD findings previously resulted in automatic lifetime awards.
  • Insurance carriers may mandate the use of network providers for diagnostic testing and lab work. This applies to MRI, x-ray examinations and any other radiological examinations or tests.
  • Pre-hearing conferences are required on all controverted claims within 45 days of a notice of denial.
  • The second injury fund was abolished.
  • Pharmacy generic substitution is required by pharmacy unless treating physician specifically indicates otherwise.
  • Carriers are permitted to contract with a pharmacy network and require claimants to use participating pharmacies.
  • Pre-approval required over $1000 for specialist consultations, surgical operations, and physiotherapeutic or occupational therapy procedures.
  • The injured worker is permitted to select any board approved physician.

New York Payor Compliance
Effective in 2016, New York began assessing penalties for failure to comply with section 110, which requires insurance carriers and other claims payors to file a First Report of Injury with the NY WCB within 18 days after the disability event or within 10 days after the employer received notice of the disability event, whichever period is greater.
For this reason, it is imperative that the insured report work related injuries as soon as they have knowledge of the incident.

What is the Waiting Period for Lost Wages in New York?
The waiting period is 7 days. However, the employee would need to be out of work for 14 days in order to collect the first 7 days of compensation retroactively.

What is the Choice of Physician Rule in New York?
Currently in New York, an employer can recommend a provider for treatment and provide a network of providers. Utilization of the network or providers are purely voluntary, a full list of authorized health care providers is available from the Workers’ Compensation Board and the employee may select or change their provider at any time without jeopardizing their medical or indemnity benefits. The employer must provide the employee information on his/hers right to choose via the attached XC3.1 form.

NY-C-3.1 3.04

Preferred Provider Organization Network (PPO)
Crum & Forster has a PPO network available. Follow the instructions below to access the PPO Network:

Logon to the website at:

  • Search by Provider Address, Name or Region
  • Select the Distance, Provider Type and Specialty
  • Results can then be exported to a directory or excel.
  • You can obtain a Map List or text message by selecting a specific provider

Where should all medical bills be sent?

Crum & Forster
PO Box 14801
Lexington, KY 40512

Important Websites

New York Workers Compensation Board –

Multi-State Information-