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New York Forms

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 624 State Forms found

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Employee Claim

 C-3.0 (6-22)

Self-Insurer’s Records Update Form

 SI Records Update Form (8/17)

NYS Workers' Compensation Board Affirmation For Death Benefits

 AFF-1 (1-24)

AGREED UPON FINDINGS AND AWARDS FOR PROPOSED CONCILIATION DECISION Represented Claimants Only

 C-312.5 (3-25)

ALTERNATIVE DISPUTE RESOLUTION PROGRAM FINAL DISPOSITION OF CLAIM

 ADR-2 (1-11)

REPORT OF WORK-RELATED INJURY OR OCCUPATIONAL DISEASE

 ADR-1 (6-22)

Alternative Dispute Resolution Program Modification of Previous Report

 ADR-1.1 (1-11)

APPLICATION FOR ACCEPTANCE OF INSURANCE FORM

 DB-850 (10-17)

APPLICATION FOR SELF-INSURANCE

 SI-1 (3/25)

Application For Self-Insurance Disability and Paid Family Leave Benefits Law

 DB-150 (3-25)

APPLICATION FOR A FEE BY CLAIMANT'S ATTORNEY OR LICENSED REPRESENTATIVE

 OC-400.1 (1-23)

CLAIMANT'S AUTHORIZATION TO DISCLOSE WORKERS' COMPENSATION RECORDS (Spanish)

 OC-110A (12-17)

BIANNUAL RECERTIFICATION TO ENTITLEMENT TO BENEFITS

 DD-2 (9-05)

CARRIER'S REPORT ON REHABILITATION

 Form R (8-05)

INSURER'S REQUEST FOR BENEFIT INCREASE REIMBURSEMENT UNDER SECTION 51 VOLUNTEER FIREFIGHTERS' & VOLUNTEER AMBULANCE WORKERS' BENEFIT LAWS

 VF/VAW-10 (12/21)
Disclaimer: These forms may not be the most recent version. New York may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on this site. Please check official sources.
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