eForm information
| Form ID | Form title | Who files | Where to file | When to file | Submittal options |
|---|---|---|---|---|---|
| RFA-2 | Request for Further Action by insurer/employer | Insurance carrier or Board-approved self-insured employer | Electronically filed with the Workers' Compensation Board, with PDF copy to claimant and claimant's representative, if any. | The form may be filed at any time after the assembly or indexing of a claim or after the Board has indicated that no further action (NFA) will be taken. |
|
Submitting via eCase
The new RFA-2 retained the original three request categories (Compensation, Medical, and Other). Each category will have applicable request reasons that have been revamped for clarity and to obtain more details to ensure efficient processing.
Based on the request reason selected, the eForm will present guided questions and fillable sections required to submit the eForm.
Submitting via API or XML file
- Registration Instructions
- Testing Requirements for API Submission - Under construction
- Testing Requirements for XML File Submission - Under construction
Requirements and examples
| File name | Description |
|---|---|
| DRAFT-EDI-RFA2-R1.0-Data-Requirements-and-Edits.xlsx | XML documentation/guidelines for RFA-2 XML data elements. This spreadsheet contains list of error codes, list of valid values, element requirements and element rules. |
| DRAFT-eFormsRfa2XmlTemplate.xml | XML template for the RFA-2 submission. This template contains the data elements for all submission reasons. It is recommended to review the API requirements and edits spreadsheet for the submission reason specific data element list. |
| DRAFT-eFormsRfa2.xsd | XML schema definition for RFA-2 XML data submission. API submitters are expected to use this schema definition to validate the data before sending XML submission via API. |
| DRAFT-Rfa2Sample.xml | XML layout example for RFA-2 submission of multiple request reason codes. |
FAQs
Under construction
More information
RFA-2 Payer Engagement Sessions April 2025
For more information or questions, please email eForms@wcb.ny.gov