- City of New York Workers’ Compensation Claim Initiation Employee Statement – WCS-110
- City of New York Workers’ Compensation Claim Initiation Witness Statement – WCS-120
- City of New York Workers’ Compensation Claim Initiation Supervisor’s/Agency - “Report of Injury” – WCS-100 [this is a double-sided 2-page document]
- City of New York Workers’ Compensation Claim Initiation Accident Description Codes
- Form DP2002 – Election of Rate of Charge against Annual and/or Sick Leave Balances for Absence due to Injury Sustained in the Performance of Official Duties
- SH900.2 - Injury and Illness Incident Report (for NYPD use)
This form is one of the first forms that must be filled out when a recordable work-related injury or illness has occurred – According to 12 NYCRR Part 801, PESH recordkeeping rule, this form must be kept on file for 5 years following the year to which it pertains. - C3/3.3 Workers’ Compensation Board – Employee’s Claim