Workers Compensation Board

State of New York

Official Website: https://www.wcb.ny.gov/

Forms & Documents

Browse all Workers Compensation Board government forms

201 - 220 of 503 forms

Form Title Topics
KONTESTASYON DEMANN POU REKONSIDERASYON/REVIZYON KOMISYON AN
Language Access Comment Form
Language Access Comment Form
Language Access Comment Form
Licensed Representative’s Full Disclosure of Conflict of Interest to Client
Limited Release of Health Information
Limited Release of Health Information (HIPAA)
Loss of Wage Earning Capacity Vocational Data Form
Loss of Wage Earning Capacity Vocational Data Form
Modulo DB-450.1, Dichiarazione del richiedente per incidente senza determinazione di colpa o lesioni personali
MODULO DI AUTORIZZAZIONE AL DEPOSITO DIRETTO
Modulo di reclamo sull’accessibilità linguistica
Modulo di reclamo sull’accessibilità linguistica
Notice and Proof of Claim for Disability Benefits
Notice of Election of a Municipal Corporation or other Political Subdivision of the State to Bring Executive Officers Under Coverage of WCL
Notice of Election of an Incorporated Religious, Charitable, Educational, or U.S. War Veterans Organization to Bring Executive Officers under the Coverage of the new York Workers' Compensation law
Notice of Election of a Not-for-Profit Corporation or Unincorporated Association to Exclude an Unsalaried Executive Officer from Coverage
Notice of Election of a Partnership, Limited Liability Partnership, Professional Limited Liability Partnership, Limited Liability Company, Professional Limited Liability Company or Sole Proprietorship to Bring Partners, Members or Self-Employed Persons Under the Coverage of the New York State Workers' Compensation Law
Notice of Election to Bring Sheltered Workshop Participants Under Coverage of WCL
Notice of Election to Exclude the Sole Shareholder Officer or Two Executive Officers of the Corporation from Compensation Coverage

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