Employers Report Of Injured Employees Change In Employment Status Resulting From Injury {C-11} | Pdf Fpdf Doc Docx | New York

 New York   Workers Compensation 
Employers Report Of Injured Employees Change In Employment Status Resulting From Injury {C-11} | Pdf Fpdf Doc Docx | New York

Last updated: 9/14/2023

Employers Report Of Injured Employees Change In Employment Status Resulting From Injury {C-11}

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Description

C-11 - EMPLOYER'S REPORT OF INJURED EMPLOYEE'S CHANGE IN EMPLOYMENT STATUS RESULTING FROM INJURY. This report is to be filed directly with the Chair, Workers' Compensation Board as soon as the employment status of an injured employee, as reported on First Report of Injury, or on a previous Form C-11 or EC-11, is changed. Change in employment status includes return to work, discontinuance of work, increase or decrease of regular hours of work and increase or reduction of wages. A copy should also be sent to your insurer. www.FormsWorkflow.com

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