New York State Workers' Compensation Board Forms

This form is used for filing a language access complaint in New York specifically for individuals who speak Urdu.

This type of document is used to file a request for assistance for an injured worker in New York.

This Form is used for requesting assistance by an injured worker in New York who speaks Haitian Creole.

This type of document is used for filing a compensation claim by World Trade Center volunteers in New York.

This Form is used for Polish-speaking volunteers at the World Trade Center in New York to file a claim for compensation.

This document is a claim form for volunteers at the World Trade Center in New York who are seeking compensation. It is available in Haitian Creole language.

This document is for Korean-speaking World Trade Center volunteers in New York who need to file a claim for compensation.

This form is used for volunteers at the World Trade Center in New York who want to file a claim for compensation. It is available in Yiddish.

This Form is used for obtaining a Waiver Agreement under Section 32 of the Workers' Compensation Law in New York. It is available in French.

This form is used for a settlement agreement in New York related to workers' compensation indemnity payments. It is available in French and specifically applies to Section 32 WCL indemnity-only settlements.

This Form is used for settling indemnity claims related to workers' compensation in New York. It is specifically designed for Urdu speakers.

This form is used for represented claimants in New York to document and agree upon findings and awards for a proposed conciliation decision. This particular version of the form is in French.

This document is for authorizing direct deposit of payments in New York.

This type of document is a sample of a Direct Deposit Authorization Form (Form DD-1). The specific document provided is the French version for use in New York.

This form is used for claimants in New York who need to provide a statement regarding no fault or personal injury. The form is available in French.

This form is used for registering participation in the World Trade Center rescue, recovery, and/or cleanup operations. It requires a sworn statement and is specific to New York. The document is available in Russian language.

This document is used for registering participation in World Trade Center rescue, recovery, and/or cleanup operations. It requires a sworn statement and is specific to New York.

This form is used for registering participation in the World Trade Center rescue, recovery, and/or cleanup operations. It requires a sworn statement and is specific to New York.

This form is used for registering participation in World Trade Center rescue, recovery, and/or cleanup operations in New York. It requires a sworn statement, and it is available in Urdu language.

This document is used for authorizing the release of medical information under the Health Insurance Portability and Accountability Act (HIPAA) in New York.

This document is used for registering participation in World Trade Center rescue, recovery, and/or cleanup operations in New York. It requires a sworn statement according to WCL 162. This version of the document is in Bengali.

This form is used for World Trade Center volunteers in New York to claim compensation.

This form is used to notify individuals in New York that they may be responsible for medical costs if their compensation claim is disallowed or if agreement pursuant to WCL 32 is approved.

This document is for World Trade Center volunteers who need to submit a claim for compensation in New York. It is available in French.

This Form is used to inform individuals in New York that they may be responsible for medical costs if their compensation claim is disallowed or if an agreement pursuant to WCL 32 is approved. The form is available in French.

This Form is used for filing an affidavit to claim death benefits in New York. This form is available in the French language.

This form is used to notify individuals in New York of their right to choose a healthcare provider authorized by the Workers' Compensation Board. It is available in both English and French.

This document is used to inform workers in New York of their right to choose a healthcare provider authorized by the Workers' Compensation Board. It is available in both English and Urdu.

This form is used for authorizing the release of limited health information in compliance with HIPAA regulations in New York. It is available in both English and Urdu languages.

This form is used for requesting a limited release of health information under HIPAA regulations in New York. It is available in both English and French languages.

This form is used for requesting a redetermination of extreme hardship for individuals residing in New York who are applying for immigration relief. The form is available in French.

This form is used to request a redetermination of extreme hardship in the case of a non-English speaking individual living in New York.