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INSTRUCTIONS: Submit original to the Workers' Compensation Board and retain a copy for your records. Report any accident occurring on the job to your employer as soon as possible.Fill out and submit required paperwork to your employer. Claim For Continuance of Compensation Under the Federal Employees' Compensation Act ; CA-16. INSTRUCTIONS: For all requests, SECTION II, III or IV of this form must be fully completed, as applicable. Form nameVersion dateNotesAffidavit of Significant Financial Hardship (AS01)June 2018Legislative changesDisability Status Report (DS01)September 2012Employee's Claim Petition (EC04)June 2018Legislative changes If injured, you should (1) report your injury to your employer immediately; and (2) file a claim with the Commission no later than two years after the accident. Employer, employer's workers' compensation insurer. The employer must complete a First Report of Injury (FROI) form. 2. Who is eligible for Worker's Compensation Benefits?