Workers Compensation Board

State of New York

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

Forms & Documents Questions & Answers

Forms & Documents

Browse all Workers Compensation Board government forms

81 - 100 of 503 forms

Form Title	Topics
AVIS ET JUSTIFICATIFS DE DEMANDE DE PRESTATIONS D’INVALIDITÉ
AVIS INDIQUANT QUE VOUS POUVEZ ÊTRE RESPONSABLE DES FRAIS MÉDICAUX EN CAS D'ÉCHEC DES POURSUITES, DE REJET DE LA DEMANDE D'INDEMNISATION OU D'APPROBATION DE L'ACCORD AU TITRE DE L'ARTICLE 32 DE LA LOI SUR LES ACCIDENTS DU TRAVAIL
Aviso de que el demandante debe realizar arreglos para pruebas y exámenes de diagnóstico a través de un proveedor de la red
Aviso de que el demandante debe realizar arreglos para pruebas y exámenes de diagnóstico a través de un proveedor de la red
AVVISO DI POSSIBILE RESPONSABILITÀ PER LE SPESE MEDICHE IN CASO DI MANCATO PROCEDIMENTO, O DI RIGETTO DELLA RICHIESTA DI INDENNITÀ, O DI APPROVAZIONE DELL’ACCORDO SUB WCL §32
Biannual Recertification to Entitlement to Benefits
Blessure du travail/maladie professionnelle DÉCLARATION DES DROITS
C-8.1B - Notice of Objection to a Payment of a Bill for Treatment Provided
Carrier's/Self-Insured Employer's Affirmation
Carrier's/Self-Insured Employer's Affirmation
Carrier's/Self-Insured Employer's Affirmation
CDEMANDE DE RÉVISION PAR LA COMMISSION
Choroba zawodowa DEKLARACJA PRAW
Claimant Name and Address Form
Claimant Quick Start Guide (Claimant Information Packet)
Claimant Quick Start Guide (Claimant Information Packet)
Claimant's Authorization to Disclose Health Information (Pursuant to HIPAA)
Claimant's Authorization to Disclose Workers' Compensation Records (WCL Section 110-a)
Claimant's Record of Independent Job Search Efforts
Claimant's Record of Job Search Efforts/Contacts

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