New York Form WCB C-7, officially titled the Notice That Right to Compensation Is Controverted, is the document a workers’ compensation insurance carrier, self-insured employer, or special fund files with the New York State Workers’ Compensation Board to formally dispute an injured worker’s claim for benefits. The form is governed by Workers’ Compensation Law §25(2)(a) and must be filed within strict statutory deadlines or the carrier risks waiving defenses, paying the WCL §25(3)(e) penalty, and being ordered to start paying benefits.
The current revision of the Form C-7 PDF is dated 3-19 (March 2019), and the New York State Workers’ Compensation Board now requires most carriers to controvert through the eClaims EDI system using the FROI-04 transaction rather than the paper form. According to the Board’s most recent annual report, more than 140,000 claims are controverted each year in New York, and roughly 1 in 6 of those controversies is rejected for being late or incomplete, which is exactly why getting Form C-7 right matters.
Here is what you will learn in this guide:
- 📋 What Form C-7 does, who must file it, and how it interacts with the FROI-04 EDI transaction
- ⏰ The exact 18-day and 25-day deadlines under WCL §25(2)(a) and how to count them correctly
- ✍️ A line-by-line walkthrough of every box, code, and signature block on the C-7
- 👥 Three full filed-out examples covering carrier controversy, occupational disease, and independent contractor disputes
- ⚠️ The most common mistakes, the $300 penalty under WCL §25(3)(e), and how to avoid waiver of defenses
What Form C-7 Is and Who Must File It
Form C-7 is the New York State Workers’ Compensation Board’s official notice that a carrier or self-insured employer is denying liability for an injured worker’s claim. It tells the Board, the claimant, and the claimant’s attorney that the insurer will not voluntarily pay indemnity or medical benefits, and it identifies the specific legal grounds for the denial. The form is authorized by WCL §25(2)(a) and the Board’s regulation at 12 NYCRR §300.22.
The filer is never the injured worker. The proper filer is the workers’ compensation insurance carrier, a self-insured employer, the State Insurance Fund, a Special Fund (such as the Special Disability Fund), or the Uninsured Employers’ Fund when one of those entities chooses to dispute a claim. Defense attorneys often prepare the form, but the carrier remains legally responsible for the filing.
The form sits inside a larger framework of New York workers’ compensation forms. It is filed in response to a claim opened by a C-3 Employee Claim, it relies on facts gathered on the C-2F Employer’s Report of Work-Related Injury, and it is sometimes confused with the C-669 Notice to Chair of Carrier’s Action on Claim, which is filed when the carrier accepts and begins paying.
Per Subject No. 046-1216, carriers required to use eClaims must transmit a FROI-04 (Denial) through the EDI system instead of the paper C-7. The paper C-7 is still used by self-insured municipalities, certain special funds, and in limited backup situations described on the eClaims FAQ page.
Before You Start: Documents and Information You Need
Controverting a claim is a fact-intensive filing, and the C-7 must be supported by a clear paper trail. Before you open the form, gather every document below. Missing items are the leading reason controversies are rejected as legally insufficient under 12 NYCRR §300.22.
- WCB Case Number (also called the JCN, Jurisdiction Claim Number). Without it, the Board cannot match your filing to the open claim, and the C-7 will sit unindexed.
- Carrier Code (W-Number) and Insurer FEIN. The Board uses these to route the filing to the correct insurer record; a wrong W-Number routes the denial to another carrier.
- Date of Accident or Date of Disablement. For occupational disease, the date of disablement controls the WCL §28 statute of limitations.
- Date the carrier first had knowledge of the injury. This is the trigger for the 18-day clock under WCL §25(2)(a).
- Date the Board mailed the EC-84 indexing notice. This triggers the 25-day clock that runs in parallel with the 18-day clock.
- Completed C-2F Employer’s Report of Work-Related Injury. Attach it; the Board will treat a controversy as suspect if no employer report is on file.
- All medical reports in the C-4 series. These show whether causal relationship is even arguably supported.
- Witness statements, recorded statements, and surveillance. Anything you intend to rely on at the pre-hearing conference must be available.
- ISO/Index Bureau report. Useful when the defense involves a prior injury or apportionment under WCL §15(7).
- Wage statement (Form C-240) if AWW is contested. Disputing average weekly wage requires payroll backup.
- Defense counsel’s notice of appearance, if represented. Without it, hearing notices go only to the carrier.
Where to Get the Form and How to Access It
The official, current version of Form C-7 lives on the New York State Workers’ Compensation Board’s forms page. You can pull the fillable C-7 PDF directly, and you should always download a fresh copy because the Board occasionally republishes the form with updated bar codes that route filings through the imaging system. Using a years-old copy of the form is one of the simplest ways to have a controversy bounced back as unindexable.
If you are an EDI trading partner, you do not download the paper form at all. Instead, you build a FROI-04 transaction following the New York EDI Implementation Guide, which maps each C-7 data element to an IAIABC field. The transaction is sent through your EDI vendor or in-house translator to the Board’s gateway, and you receive a TA (transaction accepted) or TR (transaction rejected) acknowledgment within minutes.
For carriers that qualify for Web Upload (lower-volume filers), the Board offers a browser-based portal accessible from the eClaims home page. Web Upload accepts the same FROI-04 data but lets you key it into a form rather than transmit a flat file.
Self-insured municipalities, certain special funds, and pro se employers without an EDI partner may still file the paper C-7 by mail or by upload through the Board’s secure document upload tool. Whichever channel you use, the filing date is the date the Board receives a complete, indexable filing, not the date you put it in the mail.
Step-by-Step: How to Fill Out Form WCB C-7 Line by Line
The C-7 is a single-page form with a header, four lettered sections (A through D), and a signature block. Each field below gets its own walkthrough with an example entry, a nuance, a common mistake and consequence, and a misconception to clear up. Sample entries are italicized throughout so you can tell them apart from instructions.
Header: WCB Case Number
The header asks for the WCB Case Number, also called the JCN. In plain English, this is the unique number the Board assigns when it indexes the claim. To answer it, copy the number exactly as it appears on the EC-84 indexing notice, including any leading zeros, and place it in the top right of the form. Maria Lopez’s adjuster writes G2845139 in the WCB Case Number box.
A common nuance arises when the C-7 is filed before indexing — in that situation, leave the WCB Case Number blank and write “Pre-index” in the margin so the Board’s imaging system routes it to the matching claim once the EC-84 issues. The most common mistake here is entering the carrier’s internal claim number instead of the WCB number, and the consequence is that the filing is rejected at intake and the 18-day clock keeps running. The misconception worth correcting: filers often think the JCN and the carrier claim number are the same — they are not, and only the JCN belongs in this box.
Header: Date of Accident / Date of Disablement
This field asks the date the worker was hurt for a traumatic injury, or the date the worker first lost time for an occupational disease. Enter it in MM/DD/YYYY format. For Marcus Reed, who slipped on a loading dock on March 14, 2026, the adjuster writes 03/14/2026.
For an occupational disease, the nuance is that the date of disablement under WCL §37 is not the date of exposure; it is usually the date the worker stopped work or first sought treatment. The common mistake is entering the date the carrier learned of the injury rather than the date the injury occurred, and the consequence is that the WCL §28 two-year statute defense becomes harder to compute. A frequent misconception is that “date of accident” means the date the C-3 was filed — it does not.
Header: Carrier Case Number
The Board still wants the carrier’s internal claim number for cross-reference, even though it is not the JCN. Enter the number your claims system generated when the loss was reported. Liberty Mutual writes WC-2026-NY-008842 here.
The nuance is that some TPAs use both an internal claim number and a client claim number; enter the one you will use on every subsequent filing so the Board can thread the file. The mistake is leaving this blank when a number exists, which causes the carrier’s later filings (C-669, C-8/8.6) to land in different folders. The misconception is that the carrier number replaces the JCN — both numbers belong on the form, in their own boxes.
Section A: Identifying Information — Claimant
Section A asks for the injured worker’s full legal name, address, Social Security number, date of birth, gender, and phone number. Enter the name as it appears on the C-3, write the SSN with dashes (123-45-6789), and use MM/DD/YYYY for date of birth. Aisha Bennett, 412 Crown St., Brooklyn, NY 11225, SSN 142-58-7791, DOB 06/22/1989.
The nuance is that if the claimant uses a different name on medical records than on the C-3, list the C-3 name here and add an alias note at the bottom of the form so the Board can match medical evidence. The common mistake is transposing two SSN digits, which causes the Board’s matching algorithm to open a duplicate claim and the controversy to be filed against the wrong file. The misconception: filers sometimes leave the SSN blank under privacy concerns — the Board legally needs it under WCL §110-a.
Section A: Identifying Information — Employer
Right under the claimant block, enter the legal name of the employer (not the trade name), the employer’s full street address, and the employer’s FEIN. Hudson Valley Logistics, Inc., 88 Industrial Pkwy., Newburgh, NY 12550, FEIN 14-2298471.
The nuance is that staffing-agency cases require both the staffing agency and the host employer to be named, with the agency listed in Section A and the host employer noted at the bottom. A common mistake is using the d/b/a instead of the corporate name, which leads to a misindexed employer and complications when the carrier later seeks reimbursement from the Special Disability Fund. The misconception is that the FEIN is optional — it drives the Board’s employer database match.
Section A: Identifying Information — Carrier / Self-Insured Employer
Enter the carrier’s full legal name, the W-Number (Carrier Code) assigned by the Board, the carrier’s FEIN, and the address where Board correspondence should be sent. State Insurance Fund, W-Number W819000, FEIN 14-6013200, 199 Church St., New York, NY 10007.
The nuance is that third-party administrators must list the carrier of record in this block and put the TPA’s contact information in the signature block, not here. The mistake is using the parent company’s W-Number when the policy is written by a subsidiary; the consequence is that hearing notices route to the wrong inbox and a default may be entered. The misconception: filers often think any carrier code works — only the W-Number on the policy in force on the date of accident is correct.
Section B: Date the Carrier First Had Knowledge
Section B asks the date the carrier first had knowledge of the injury. This is the date that starts the 18-day clock under WCL §25(2)(a). Enter MM/DD/YYYY and be honest — the Board cross-checks this against the C-2F and the EDI FROI-00 already on file. 03/16/2026.
The nuance is that “knowledge” can come from the employer’s report, an ER visit notification, an attorney’s letter of representation, or a direct call from the worker; the earliest of those dates is what belongs here. The mistake is entering the date the file was assigned to the adjuster, which is usually later than actual knowledge; the consequence is that an investigator will challenge the date and the Board may treat the controversy as untimely. A persistent misconception is that knowledge means “completed investigation” — it does not; it means first notice of an alleged work injury.
Section B: Date the Notice of Indexing Was Received
Right next to the knowledge date, the form asks the date the Board’s notice of indexing (Form EC-84) was received. This triggers the parallel 25-day clock. Enter MM/DD/YYYY using the date stamped on the envelope or the EDI ACK date. 03/22/2026.
The nuance is that EDI carriers typically receive electronic indexing through an SROI-AP or the Board’s claim activity report, and the electronic receipt date governs. The mistake is using the EC-84’s print date rather than the receipt date, which can shave days off a defense. The misconception is that the 18-day and 25-day clocks are alternatives — they run in parallel, and you must beat whichever expires first.
Section C: Grounds for Controversy (Checkboxes)
Section C is the heart of the form. It lists the legal grounds the carrier is asserting, with checkboxes for each. You must check every box that applies and provide a brief factual statement supporting each one. The grounds include: not an employee, no employer-employee relationship, not in the course of employment, no accident, no causal relationship, no notice under WCL §18, late filing under WCL §28, intoxication under WCL §10, willful intent to injure, and “other.” For Marcus Reed’s claim, the adjuster checks “no causal relationship” and “no accident as defined by §2(7),” then writes: “Claimant’s MRI dated 03/20/2026 shows pre-existing degenerative changes; no objective evidence of acute injury.”
The nuance is that the Board treats unchecked grounds as waived at the pre-hearing conference under 12 NYCRR §300.38; you cannot raise a defense at the hearing that you did not flag here. The most common mistake is checking only “no causal relationship” when the real defense is “not in the course of employment,” which leads to the broader defense being lost. The misconception is that you can simply check “other” and explain later — the Board requires specificity, and a vague “other” is treated as no defense at all.
Section C: Factual Statement Supporting Each Ground
Below the checkboxes, the form provides space for a brief narrative. In plain English, this is your one-paragraph explanation of why each checked ground applies. Keep it factual, dated, and tied to evidence. “On 03/14/2026, claimant reported a back injury at work; however, surveillance dated 03/13/2026 (one day before the alleged accident) shows claimant moving furniture at his residence, and his initial ER record at Newburgh Memorial dated 03/15/2026 attributes onset to home activity.”
The nuance is that the Board’s law judges read this narrative before the hearing, and a tight, evidence-anchored statement frames the case in your favor. The mistake is dumping legal conclusions (“claim is fraudulent”) without facts, which judges discount. The misconception is that the narrative is just a placeholder — it is a pleading, and inconsistent narratives between the C-7 and the FROI-04 will be used against the carrier on cross-examination.
Section D: Information About Wages, Dependents, and Coverage
Section D asks supporting facts the Board needs even when the carrier is denying the claim: average weekly wage as known, number of dependents, policy number, and policy effective dates. AWW $1,142.86; dependents 2; policy WC-NY-7741128; effective 01/01/2026 to 12/31/2026.
The nuance is that providing AWW does not waive your right to contest it later; the Board simply needs a working number for any provisional rate calculation. The mistake is leaving Section D blank because “we are denying anyway” — the Board treats blanks as incomplete and may reject the filing under 12 NYCRR §300.22. The misconception is that policy info is optional on a controverted claim — it is required so the Board can confirm coverage existed on the date of accident.
Signature Block
The signature block requires the printed name, title, signature, date, and phone number of the carrier representative or attorney filing the C-7. Sign in ink (or with a compliant electronic signature) and date it the day the form is transmitted. Jordan Patel, Senior Claims Examiner, Liberty Mutual, signed 04/01/2026, (212) 555-0173.
The nuance is that an attorney signing on behalf of the carrier should attach a notice of appearance the same day; otherwise hearing notices may bypass counsel. The mistake is dating the signature earlier than the actual filing date, which creates a discrepancy with the Board’s date stamp. The misconception is that an unsigned C-7 is curable later — it is not; the Board treats unsigned controversies as never filed for WCL §25(2)(a) timeliness.
Three Filled-Out Examples Using Real Scenarios
Below are three of the most common controversy fact patterns, each followed through the entire C-7 by a named filer. Tables show what each adjuster enters in the major sections.
Example 1: Carlos — “Not in the Course of Employment”
Carlos Mendoza is a delivery driver who claims he hurt his shoulder unloading a truck on 02/10/2026. Surveillance shows the injury actually happened during a personal stop at a hardware store, off route. The carrier (Travelers) controverts on course-of-employment grounds.
| Form Section | What Carlos’s Adjuster Enters |
|---|---|
| WCB Case Number | G2901188 |
| Date of Accident | 02/10/2026 |
| Carrier Case Number | TRV-NY-2026-44219 |
| Section A — Claimant | Carlos Mendoza, 1410 Westchester Ave., Bronx, NY 10472 |
| Section A — Employer | Empire Parcel Services, Inc., FEIN 13-4477219 |
| Section A — Carrier | Travelers Indemnity Co., W-Number W260000 |
| Section B — Knowledge Date | 02/12/2026 |
| Section B — Indexing Receipt | 02/19/2026 |
| Section C — Grounds | Checked: “not in the course of employment”; “no accident under §2(7)” |
| Section C — Narrative | “GPS data and surveillance show claimant deviated from route to a personal errand at 14:18 on 02/10/2026; injury occurred during deviation.” |
| Section D — AWW | $1,284.00; 1 dependent; policy WC-TR-9921115 |
| Signature | Priya Shah, Claims Examiner, 03/02/2026 |
Example 2: Janet — Occupational Disease, Late §28 Filing
Janet O’Connor, a hospital sterilization tech, filed a C-3 in 2026 alleging chemical-induced asthma with a date of disablement of 04/01/2023. The C-3 came in 04/15/2026, beyond the WCL §28 two-year window. The carrier (NYSIF) controverts on §28.
| Form Section | What Janet’s Adjuster Enters |
|---|---|
| WCB Case Number | G2935442 |
| Date of Disablement | 04/01/2023 |
| Carrier Case Number | SIF-OD-2026-00781 |
| Section A — Claimant | Janet O’Connor, 27 Maple Dr., Albany, NY 12203 |
| Section A — Employer | St. Mary’s Regional Hospital, FEIN 14-1399208 |
| Section A — Carrier | NYS Insurance Fund, W-Number W819000 |
| Section B — Knowledge Date | 04/16/2026 |
| Section B — Indexing Receipt | 04/22/2026 |
| Section C — Grounds | Checked: “claim filed beyond §28 statute of limitations”; “no causal relationship” |
| Section C — Narrative | “Date of disablement is 04/01/2023; C-3 filed 04/15/2026, more than two years after disablement and more than two years after claimant knew or should have known of work-relatedness.” |
| Section D — AWW | $1,055.00; 0 dependents; policy WC-SIF-2023-9981 |
| Signature | Daniel Kim, Senior Examiner, 05/05/2026 |
Example 3: Aisha — Independent Contractor Defense
Aisha Bennett claims she fell while cleaning a private home she was hired to clean through a referral app. The “employer” (HomeShine LLC) maintains she was an independent contractor. The carrier (Hartford) controverts on employer-employee relationship under WCL §2(4).
| Form Section | What Aisha’s Adjuster Enters |
|---|---|
| WCB Case Number | G2948019 |
| Date of Accident | 03/03/2026 |
| Carrier Case Number | HFD-NY-2026-22118 |
| Section A — Claimant | Aisha Bennett, 412 Crown St., Brooklyn, NY 11225 |
| Section A — Employer | HomeShine LLC, FEIN 84-2298110 |
| Section A — Carrier | Hartford Underwriters Ins. Co., W-Number W124000 |
| Section B — Knowledge Date | 03/05/2026 |
| Section B — Indexing Receipt | 03/12/2026 |
| Section C — Grounds | Checked: “no employer-employee relationship”; “claimant is an independent contractor” |
| Section C — Narrative | “Claimant signed a Platform Services Agreement dated 11/14/2025 designating her as an independent contractor; she set her own hours, used her own supplies, served other clients, and received 1099-NEC for 2025.” |
| Section D — AWW | Not applicable — no employment relationship; policy WC-HFD-2026-7740 |
| Signature | Renee Alvarez, Claims Counsel, 03/24/2026 |
How to File the Completed Form
Filing channel matters because the date the Board receives a complete, indexable filing controls timeliness, not the date the form is signed. Pick the right channel for your filer profile and keep proof.
eClaims EDI (FROI-04). Required for most carriers per Subject No. 046-1216. Transmit through your EDI vendor to the Board’s gateway; the TA acknowledgment is your proof of filing. There is no fee. Processing is typically same-day. Save the TA in your claim file — without it, you cannot prove timeliness.
Web Upload. For approved lower-volume filers; access through the eClaims portal. Key the FROI-04 fields into the browser form, click submit, and download the confirmation page as a PDF. No fee, same-day processing.
Secure Document Upload. For paper C-7 filers (self-insured municipalities, certain special funds, pro se employers), use the WCB Document Upload tool. Accepted file types are PDF, TIFF, and JPG up to 5 MB. The system returns a transaction ID as your proof of filing; print or save it. No fee, processed within one business day.
U.S. Mail. Last resort. Mail the signed paper C-7 to NYS Workers’ Compensation Board, PO Box 5205, Binghamton, NY 13902-5205. Use certified mail with return receipt as your proof of filing. No fee. Processing time can run 7 to 14 days, which is dangerous given the 18-day controversy clock.
In Person. You may walk a paper C-7 into any WCB district office during business hours and obtain a date stamp on a copy as your proof of filing. No fee, same-day filing date.
What Happens After You File
Once the Board accepts the C-7 (or FROI-04), it sets the case for a pre-hearing conference (PHC) under 12 NYCRR §300.38. The PHC is typically held within 60 days of indexing and is the carrier’s first real opportunity to lay out its defenses to a workers’ compensation law judge. Defenses not listed on the C-7 are generally deemed waived at the PHC.
Both sides then exchange a pre-hearing conference statement (PH-16.2) identifying witnesses, exhibits, and lay and medical issues. The judge issues a stipulation order or refers the case for trial on the controverted issues. If the judge finds the controversy was untimely or frivolous, the carrier can be assessed a $300 penalty under WCL §25(3)(e) and ordered to begin paying benefits while defenses proceed.
If you win the controversy, the Board issues a Notice of Decision disallowing the claim. If you lose, the Board issues an award of indemnity and medical benefits, often retroactive to the date of disability. Either side may seek administrative review by a panel of three Board members within 30 days under WCL §23.
Mistakes to Avoid When Filling Out the Form
Each error below has cost real carriers real money. The consequence is what the Board, a law judge, or an appellate panel typically does when the mistake appears.
- Missing the 18-day deadline from first knowledge. Consequence: presumption of compensability and a $300 penalty under WCL §25(3)(e).
- Missing the 25-day deadline from indexing. Consequence: waiver of all defenses except lack of jurisdiction.
- Checking only one ground when several apply. Consequence: unchecked defenses are waived at the PHC.
- Using a vague “other” without specifics. Consequence: defense is treated as no defense and stricken.
- Entering the carrier’s claim number in the WCB Case Number box. Consequence: filing is unindexable and considered not filed.
- Wrong W-Number. Consequence: hearing notices route to the wrong carrier and a default may be entered.
- Leaving Section D blank. Consequence: the Board rejects the filing as incomplete under 12 NYCRR §300.22.
- Filing the paper C-7 when EDI is required. Consequence: the Board treats the FROI-04 as not filed and the controversy as untimely.
- Unsigned C-7. Consequence: deemed not filed for timeliness purposes.
- Inconsistent narratives between the C-7 and the FROI-04. Consequence: cross-examination ammunition for claimant’s counsel.
- Failing to attach the C-2F or medical evidence. Consequence: judge may find the controversy unsupported and order benefits.
- Using a stale revision of the form. Consequence: imaging system rejects the bar code and the filing is returned.
Do’s and Don’ts
Do’s
- Do download a fresh copy of the C-7 PDF for every filing because revision dates change and the bar code matters.
- Do docket both the 18-day and 25-day clocks the moment a claim is reported, because whichever expires first controls.
- Do check every applicable ground in Section C, because unchecked grounds are waived at the PHC.
- Do save the EDI TA acknowledgment or the Document Upload transaction ID, because it is your only proof of filing date.
- Do attach a notice of appearance the same day defense counsel signs the C-7, so hearings notices route to counsel.
- Do match the AWW in Section D to the wage statement on file, because mismatched numbers invite a §32 credibility challenge.
Don’ts
- Don’t wait for the investigation to finish before controverting, because the 18-day clock runs from first knowledge, not from completed investigation.
- Don’t use the d/b/a name in the employer block, because the Board’s matching engine keys on the legal name and FEIN.
- Don’t controvert on “fraud” without specific facts, because vague allegations are stricken under 12 NYCRR §300.38.
- Don’t leave the SSN blank, because WCL §110-a authorizes its collection and the Board needs it to match medicals.
- Don’t sign and date the C-7 before you actually file it, because a date discrepancy with the Board stamp undercuts timeliness.
- Don’t rely on U.S. mail for a controversy due in three days, because the Board’s filing date is receipt, not postmark.
Pros and Cons of Filing on Your Own vs. With Help
Pros of Filing Pro Se (Carrier Adjuster Without Defense Counsel)
- Lower cost because you avoid hourly defense counsel fees on routine controversies.
- Faster turnaround because the adjuster controls the calendar without external coordination.
- Direct knowledge of the file, since the adjuster already has the C-2F, medicals, and recorded statement.
- Simpler internal authority chain, since claims handling stays in-house.
- Adequate for clear-cut cases, like obvious independent-contractor defenses or unambiguous §28 bars.
Cons of Filing Pro Se
- Higher waiver risk because adjusters may miss less-obvious defenses such as apportionment under §15(7).
- Weaker narrative drafting, since defense counsel are trained to write Section C narratives that survive PHC scrutiny.
- Limited PHC presence, since adjusters are not authorized to argue motions or examine witnesses in person.
- Penalty exposure under WCL §25(3)(e) if the controversy is later found frivolous.
- Appellate exposure, because preserving issues for §23 Board review and Third Department appeal is a counsel-driven skill.
C-7 vs. C-669 vs. FROI-04: Choosing the Right Filing
| Filing | When to Use It |
|---|---|
| Form C-7 (paper) | Used by self-insured municipalities and special funds denying a claim, where eClaims EDI is not mandated under Subject No. 046-1216. |
| FROI-04 (EDI) | Mandatory electronic equivalent of the C-7 for most carriers; transmitted through the eClaims gateway using the IAIABC standard. |
| Form C-669 | Used when the carrier is accepting liability and beginning payments, or filing the corresponding SROI-IP. |
| Form C-7.1 | Carrier’s claim for §14(6) reimbursement; not a controversy form. |
| Form C-240 | Wage statement supporting AWW; attaches to the C-7 when AWW is contested. |
FAQs
Is Form C-7 the right form to deny a workers’ compensation claim in New York?
Yes. Form C-7 is the New York State Workers’ Compensation Board’s official notice that a carrier or self-insured employer is denying liability under WCL §25(2)(a).
Can the injured worker file Form C-7?
No. The form is filed only by the carrier, self-insured employer, the State Insurance Fund, or a special fund. Workers file the C-3 instead.
Is paper Form C-7 still accepted if my carrier uses eClaims?
No. Carriers required to file by EDI must submit a FROI-04 transaction; paper C-7s from those carriers are treated as not filed.
Yes or no — does the 18-day clock run from the date of accident?
No. It runs from the date the carrier first had knowledge of the alleged injury under WCL §25(2)(a), which can be earlier or later than the accident date.
Do I write the carrier claim number in the WCB Case Number box?
No. That box is only for the JCN assigned by the Board on the EC-84 indexing notice; the carrier number goes in its own field.
In Section C, can I check “other” without specifying a ground?
No. Vague “other” entries are treated as no defense at all under 12 NYCRR §300.38 and are stricken at the PHC.
Do I have to provide AWW in Section D if I am denying the whole claim?
Yes. The Board needs a working AWW for any provisional award; providing it does not waive your right to contest it later.
Can I add new defenses at the pre-hearing conference?
No. Defenses not listed on the C-7 or the FROI-04 are generally waived at the PHC absent good cause.
Is there a filing fee for Form C-7?
No. The Workers’ Compensation Board does not charge a fee to file Form C-7 or the FROI-04 through any channel.
Can an unsigned C-7 be cured later?
No. The Board treats unsigned controversies as never filed for timeliness, so missing the signature can cost every defense.
Does filing Form C-7 stop medical treatment authorization?
Yes. Once the claim is controverted, the carrier is not obligated to authorize non-emergency treatment until the controversy is resolved, subject to the Medical Treatment Guidelines.
Is the $300 penalty under WCL §25(3)(e) the only exposure for a late controversy?
No. The carrier may also be ordered to start paying indemnity and medicals while the case proceeds, and may face additional penalties under WCL §114-a for frivolous filings.
Can I file Form C-7 before the Board indexes the claim?
Yes. You may file pre-index, but you must mark the WCB Case Number box “Pre-index” so the Board’s imaging system can match it once the EC-84 issues.
Does an attorney’s letter of representation count as carrier knowledge?
Yes. A letter of representation is one of the events that triggers carrier knowledge and starts the 18-day clock under WCL §25(2)(a).
Related reading
- How to Fill Out New York Form C-3 (w/Examples) + FAQs
- How to Fill Out New York Form C-4.2 (w/Examples) + FAQs
- How to Fill Out New York Form C-4 (w/Examples) + FAQs
- How to Fill Out New York Form RFA-2 (w/Examples) + FAQs
- How to Fill Out New York Form WCB C-300.5 (w/Examples) + FAQs
- How to Fill Out New York WCB Insurance Coverage Statement + FAQs
- How to Fill Out California WCAB DWC-AD 1 (w/Examples) + FAQs