New York · Workers' Compensation
New York workers' compensation forms
Every New York workers' comp form BlueHive has verified against the issuing agency. Download PDFs we host, or jump directly to the official source for the rest.
- Forms tracked
- 3
- PDFs hosted
- 1
- State
- NY
Filing workers’ comp forms in New York
Operational notes BlueHive coordinators rely on. For statute-level detail, see the compliance overview linked below.
- 1
Use the C-4 family (C-4, C-4.2, C-4.3) — every authorized provider must e-file via the WCB Medical Portal.
- 2
Initial C-4 is due within 48 hours of first treatment; progress C-4.2 every 90 days minimum.
- 3
Variance requests (MG-2) and treatment authorizations have separate clocks — check the Medical Treatment Guidelines.
New York forms at a glance
Quick reference for who completes each form and where it goes. Tap a form code for full detail.
| Form | Who fills out | Who signs | Where it goes | |
|---|---|---|---|---|
| C-4Doctor's Initial Report of Injury | Treating physician of record. NPs may sign C-4, C-4.2, and C-4.3 as authorized providers… | NPs may sign C-4, C-4.2, and C-4.3 as authorized providers under WCL… | C-4: within 48 hours of first treatment; C-4.2: 15-day report after first treatment, then… | Open |
| C-4.2Doctor's Progress Report | Treating physician of record. NPs may sign C-4, C-4.2, and C-4.3 as authorized providers… | NPs may sign C-4, C-4.2, and C-4.3 as authorized providers under WCL… | C-4: within 48 hours of first treatment; C-4.2: 15-day report after first treatment, then… | Open |
| C-4.3Doctor's Report of MMI / Permanent Impairment | Treating physician of record. NPs may sign C-4, C-4.2, and C-4.3 as authorized providers… | NPs may sign C-4, C-4.2, and C-4.3 as authorized providers under WCL… | C-4: within 48 hours of first treatment; C-4.2: 15-day report after first treatment, then… | Open |
All New York workers' comp forms
3 forms tracked. PDFs we host are downloadable; the rest deep-link to the issuing agency.
- Workers’ Comp Verified
C-4 — Doctor's Initial Report of Injury
New York Workers' Compensation Board (WCB)
Doctor's Initial Report of Injury (C-4) — state-prescribed clinician report used by the state workers’ comp agency.
View form Official source - Workers’ Comp Verified
C-4.2 — Doctor's Progress Report
New York Workers' Compensation Board (WCB)
Doctor's Progress Report (C-4.2) — state-prescribed clinician report used by the state workers’ comp agency.
View form Official source - Workers’ CompPDF hosted Verified
C-4.3 — Doctor's Report of MMI / Permanent Impairment
New York Workers' Compensation Board (WCB)
Doctor's Report of MMI / Permanent Impairment (C-4.3) — state-prescribed clinician report used by the state workers’ comp agency.
View form
Federal forms that also apply in New York
Federal forms providers in New York encounter alongside the state workers’ comp paperwork. Same data we publish on the federal pages.
- USCG MarinerCG-719K
Application for Merchant Mariner Medical Certificate
U.S. Coast Guard – National Maritime Center
View form - DOT / FMCSAMCSA-5875
Medical Examination Report Form (DOT)
Federal Motor Carrier Safety Administration (FMCSA)
View form - OSHA & SafetyOSHA 300
Log of Work-Related Injuries and Illnesses
Occupational Safety and Health Administration (OSHA)
View form
More states with forms
Bordering New York with forms
Important Legal Notice
The regulatory information presented on BlueHive Compliance Watch is provided for general informational purposes only and should not be construed as legal advice. While we strive to maintain accurate and up-to-date information, regulations can change rapidly and may be subject to interpretation.
You should always:
- Consult with qualified legal counsel before making compliance decisions
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- Review the full text of any regulation cited herein
- Consider jurisdiction-specific requirements that may apply to your organization
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