Get Ny Oc-400 2021-2026

The NY OC-400 form is a crucial document for individuals seeking representation in workers' compensation cases in New York. This guide will provide clear, step-by-step instructions on how to accurately complete this form online, ensuring that you understand each component and its relevance to your claim.

Follow the steps to complete your NY OC-400 form with ease.

1. Press the ‘Get Form’ button to obtain the document and open it for editing.
2. In the top section, indicate which type of notice you are submitting by selecting one of the available options, such as 'Notice of Retainer and Appearance' or 'Notice of Substitution and Appearance'.
3. Fill in the date of injury or illness, along with the Paid Family Leave start date or the complaint date, as applicable. This information is vital for processing your claim.
4. Provide your name, WCB case number, and Social Security number. Ensure all entries are correct to avoid delays.
5. Specify the language needed for interpretation at the hearing, if applicable.
6. Complete your address and details regarding the claimant, employer, insurer, and attorney or representative. This will require accurate information for all parties involved.
7. In section A, as the claimant, confirm that you have retained the specified attorney or representative by checking the appropriate box. If this is a substitution, provide the name of the former attorney.
8. Sign and date the form in blue ink where indicated, ensuring your signature is legible.
9. Section B must be filled out by the attorney or representative. They will confirm their agreement to represent you and provide their signature and date.
10. If applicable, complete section C regarding substitution only. This includes serving notice on the former attorney and providing necessary details.
11. In section D, if necessary, request copies of medical reports to be transmitted to your representative.
12. Section E requires the attorney or representative to certify that the notice has been transmitted to the required parties.
13. Review all filled sections for accuracy. Once complete, you can choose to save changes, download, print, or share the form as required.

Submit your completed NY OC-400 form online to ensure prompt processing of your workers' compensation claim.