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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/en/FooterPages/Column1/Forms

Essential Forms - NYSIF

Essential Forms C-240 Employer's Statement of Wage Earnings Preceding Date of Accident C-11 Employer's Report of Injured Employee's Change in Status C- ...

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

PFL Form - Request for Family Care Leave - NYSIF

number. Complete your forms and attach the required documentation. Complete the Request for Paid Family Leave Form PFL-1 .

https://ww3.nysif.com/-/media/Files/DISABILITY_BENEFITS/PDF/2024...

NYSIF Search

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/SearchResults?q=FORMS

Filing a Claim - NYSIF

Employers obtain Form DB-450 from this website with a valid NYSIF disability benefits policy number. Give this form to your employees to file a claim once ...

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

eSignature Forms - NYSIF

Oct 17 2017 ... NYSIF Expedites Electronic Submission for Commonly Used Forms ... The New York State Insurance Fund has decided to make its 10 most commonly-used ...

https://ww3.nysif.com/en/FooterPages/Column1/AboutNYSIF/NYSIF_Ne...

About Your Disability Benefits Claim - NYSIF

Your completed claim form should be submitted to your most recent employer or NYSIF within 30 days after you become sick or disabled. Mail completed NYSIF DB- ...

https://ww3.nysif.com/en/Claimant/DBClaimant/FilingAClaim

PFL Form - Request for Family Care Leave - NYSIF

to find out their Disability Benefits Paid Family Leave insurance company and policy number. Complete your forms and attach the required documentation. Complete ...

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

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 ...

https://ww3.nysif.com/en/Employer/WCpolicyholder/AboutClaims/Cla...

NYSIF Search

Results for FORMS. NYSIF PAYROLL REPORTING. Jul 29 2021 ... If you are unable to verify your payroll online you may obtain a paper form at ...

https://ww3.nysif.com/Home/SearchResults?&q=FORMS&count=10&offse...