Form C-11 Employer's Report of Injured Employee's Change in Employment Status Resulting From Injury - New York

What Is Form C-11?

This is a legal form that was released by the New York State Workers' Compensation Board - a government authority operating within New York. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is Form C-11?
A: Form C-11 is the Employer's Report of Injured Employee's Change in Employment Status Resulting From Injury.

Q: What is the purpose of Form C-11?
A: Form C-11 is used by employers in New York to report any change in an injured employee's employment status as a result of their injury.

Q: Who needs to fill out Form C-11?
A: Employers in New York need to fill out Form C-11 if an injured employee experiences a change in their employment status due to the injury.

Q: Is Form C-11 required for all workplace injuries?
A: No, Form C-11 is only required if there is a change in the injured employee's employment status as a result of their injury.

Q: What information is required on Form C-11?
A: Form C-11 requires information about the injured employee, the employer, the injury, and the change in employment status.

Q: Are there any deadlines for submitting Form C-11?
A: Yes, Form C-11 must be submitted within 10 days of the change in the injured employee's employment status.

Q: What should employers do with completed Form C-11?
A: Employers should keep a copy of the completed Form C-11 for their records and provide a copy to the injured employee as well.