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forms - NYSIF

Access frequently-used workers' compensation and disability benefits forms below. Many of the forms link directly to the Workers' Compensation Board website.

https://ww3.nysif.com/Home/FooterPages/Column1/Forms

Paid Family Leave - NYSIF

forms/Resources: The forms below are hosted by the state's Paid Family Leave website. Employee Notice of Paid Family Leave Payroll Deduction for 2025; Employer’s Application for Voluntary Coverage (No Employee Contribution) (PFL-135) Employer’s Application for Voluntary Coverage (Employee Contribution Required) (PFL-136)

https://ww3.nysif.com/Home/Employer/DBpolicyholder/AboutYourPoli...

Claimant Information Packet - NYSIF

Employers must give injured workers a Claimant Information Packet (available in several languages under Workers' Comp Claim forms - Employer) when filing claims. The packet includes: the claimant’s rights and responsibilities; pharmacy benefits information, and

https://ww3.nysif.com/Home/Employer/WCpolicyholder/AboutClaims/C...

Filing a Claim - NYSIF

To file a Paid Family Leave claim, an employee must complete NYSIF Form PFL-1, along with additional PFL forms for the type of leave being requested. See more details on our PFL claimant page. Your Part: PFL forms. All forms must be returned to the employee within three business days.

https://ww3.nysif.com/Home/Employer/DBpolicyholder/AboutClaims/D...

Employer's Role in Claims - NYSIF

Employers must file a report of work-related injury or illness with NYSIF immediately upon becoming aware of the injury or illness, and no later than 10 days after the employer’s knowledge of the injury or illness, in all cases where the injury/illness:. Has caused or will cause the employee’s loss of time from regular duties of one day beyond the workday or shift during which the incident ...

www.nysif.com/reportinjury

Policyholder Responsibilities - NYSIF

Policyholder responsibilities and options regarding NYSIF statutory and enriched disability benefits insurance.

www.nysif.com/DisabilityBenefits

PFL Form - Request for Family Care Leave - NYSIF

Complete your forms and attach the required documentation Complete the Request for Paid Family Leave (Form PFL-1). Fill out your section, make a copy, and give the form to your employer to fill out Part B.

https://ww3.nysif.com/-/media/Files/DISABILITY_BENEFITS/PDF/2023...

PFL Form - Request for Family Care Leave - NYSIF

Solicitud de Licencia Familiar Remunerada (Formulario NYSIF PFL-1) PARTE A INFORMACIÓN DEL EMPLEADO-(a completar por el empleado) 1.Nombre (nombre, inicial del segundo nombre, apellido)

https://ww3.nysif.com/-/media/Files/DISABILITY_BENEFITS/PDF/NYSI...

PFL Form - Request for Family Care Leave

Complete your forms and attach the required documentation Complete the Request for Paid Family Leave (Form PFL-1). Fill out your section, make a copy, and give the form to your employer to fill out Part B.

https://ww3.nysif.com/-/media/Files/DISABILITY_BENEFITS/PDF/2023...

PFL Form - Request for Family Care Leave

Solicitud de Licencia Familiar Remunerada (Formulario NYSIF PFL-1) PARTE A INFORMACIÓN DEL EMPLEADO -(a completar por el empleado) 1.Nombre (nombre, inicial del segundo nombre, apellido)

https://ww3.nysif.com/-/media/Files/DISABILITY_BENEFITS/PDF/NYSI...