Form OC-110A Claimant's Authorization to Disclose Workers' Compensation Records - New York

Form OC-110A Claimant's Authorization to Disclose Workers' Compensation Records - New York

What Is Form OC-110A?

This is a legal form that was released by the New York State Workers' Compensation Board - a government authority operating within New York. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on December 1, 2017;
  • The latest edition provided by the New York State Workers' Compensation Board;
  • Easy to use and ready to print;
  • Available in Spanish;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form OC-110A by clicking the link below or browse more documents and templates provided by the New York State Workers' Compensation Board.

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Download Form OC-110A Claimant's Authorization to Disclose Workers' Compensation Records - New York

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