All New York Workers Compensation forms

Workers Compensation - Arbitration

• Notice of Withdrawal of Request for Arbitration for Workers' Compensation NY-HP4-WC

Workers Compensation - Attorneys Fees

• Application for a Fee by Claimant's Attorney or Representative for Workers' Compensation NY-OC-400-WC

Workers Compensation - Claims

• Checklists - Worker's Compensation Claims US-04076BG

Workers Compensation - Conferences

• Prehearing Conference Statement for Workers' Compensation NY-PH-16-WC

Workers Compensation - Discovery

• Requests for Production of Documents to Carrier US-01367
• Claimant's First Set of Requests for Production US-01366
• Claimant's First Set of Interrogatories to Employer and Carrier US-01365

Workers Compensation - Employers

• Employer's Report Of Work Related Accident for Workers' Compensation NY-C-2-WC

Workers Compensation - Firefighters or Ambulance Workers

• VF-VAW Adjustment for Workers' Compensation NY-VF-VAW-10-WC

Workers Compensation - Firemen

• Notice of Volunteer Firefighters' Injury or Death for Workers' Compensation NY-VF-1-WC

Workers Compensation - Injury and Claims

• Notice of Work-Related Injury and Claim for Worker's Compensation US-01495BG

Workers Compensation - Injury Reports

• Report of Injury by Employee to Employer to be Filed with Worker's Compensation Agency of State US-01494BG

Workers Compensation - Insurance

• Agreement of Employee Service Provider to Maintain Workers Compensation Insurance US-01625BG

Workers Compensation - Official - Claims

• Claim For Compensation And Notice of Commencement of Third Party Action NY-C-121-WC
• Volunteer Ambulance Workers Claim For Benefits NY-VAW-3-WC
• Employee Claim for Compensation NY-C-3-WC

Workers Compensation - Official - Death Claims

• Claim For Compensation In Death Case NY-C-62-WC

Workers Compensation - Official - Disability

• Notice And Proof of Claim For Disability Benefits NY-DB-450-WC

Workers Compensation - Official - Employers

• Employers Report of Injured Employees Change In Employment Status Resulting From Injury NY-C-11-WC

Workers Compensation - Official - Firemen

• Volunteer Firefighters Claim For Benefits NY-VF-3-WC

Workers Compensation - Official - Issues

• Pre-Hearing Conference Statement NY-PH-16.2-WC
• Statement of Unresolved Issues-Special Part For Expedited Hearings NY-C-300-34-WC

Workers Compensation - Official - Notices

• Notice To Liable Political Subdivision Or Unaffiliated Ambulance Service NY-VAW-1-WC

Workers Compensation - Official - Rehabilitation

• Carrier's Report on Rehabilitation NY-R-WC

Workers Compensation - Official - Stipulations

• Stipulation NY-C-300.5-WC

Workers Compensation - Questionnaires

• Workers Compensation Questionnaire US-Q1038

Workers Compensation - Reimbursements

• Carrier's Request For Reimbursement for Workers' Compensation NY-C-251-WC
• Notice of Claim for Reimbursement for Workers' Compensation NY-C-250-WC

Workers Compensation - Requests

• Carrier's - Employer's Request for Further Action NY-RFA-2-WC
• Claimant's Request for Further Action NY-RFA-1-WC

Workers Compensation - Reviews

• Cover Sheet Rebuttal for Board Review for Workers' Compensation NY-RB-89.1-WC
• Cover Sheet Application for Board Review for Workers' Compensation NY-RB-89-WC

Workers Compensation - Settlements

• Section 32 Settlement Agreement - Claimant Release NY-C-32.1-WC
• Settlement Agreement - Section 32 WCL NY-C-32-WC

Workers Compensation - Wages

• Employer's Statement Of Wage Earnings for Workers' Compensation NY-C-240-WC