PDF
Word
Form C-4.3 Doctor's Report of Mmi / Permanent Partial Impairment - New York
What Is Form C-4.3?
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.
FAQ
Q: What is Form C-4.3?A: Form C-4.3 is the Doctor's Report of MMI/Permanent Partial Impairment in New York.
Q: What does MMI stand for?A: MMI stands for Maximum Medical Improvement.
Q: What is Permanent Partial Impairment?A: Permanent Partial Impairment refers to a lasting physical or mental impairment that affects a person's ability to carry out daily activities.
Q: Who needs to fill out Form C-4.3?A: The doctor treating the individual who sustained a work-related injury or illness needs to fill out Form C-4.3.
Q: What information is required on Form C-4.3?A: Form C-4.3 requires the doctor to provide details about the individual's medical condition, treatment, and assessment of permanent impairment.
Form Details:
- Released on May 1, 2022;
- The latest edition provided by the New York State Workers' Compensation Board;
- Easy to use and ready to print;
- Quick to customize;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a fillable version of Form C-4.3 by clicking the link below or browse more documents and templates provided by the New York State Workers' Compensation Board.
Download Form C-4.3 Doctor's Report of Mmi / Permanent Partial Impairment - New York
1
2
3
4
5
6
7
