PDF
Word
Form A-9H Notice That You May Be Responsible for Medical Costs in the Event of Failure to Prosecute, or if Compensation Claim Is Disallowed, or if Agreement Pursuant to Wcl 32 Is Approved - New York (English / Haitian Creole)
What Is Form A-9H?
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 A-9H?
A: Form A-9H is a notice that informs you that you may be responsible for medical costs in certain situations.
Q: When am I responsible for medical costs?
A: You may be responsible for medical costs if your compensation claim is disallowed, if you fail to prosecute your claim, or if an agreement pursuant to WCL 32 is approved.
Q: What is WCL 32?
A: WCL 32 refers to Section 32 of the New York Workers' Compensation Law.
Q: In which languages is Form A-9H available?
A: Form A-9H is available in both English and Haitian Creole.
Form Details:
- Released on October 1, 2012;
- The latest edition provided by the New York State Workers' Compensation Board;
- Easy to use and ready to print;
- Available in Haitian Creole;
- Quick to customize;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a printable version of Form A-9H by clicking the link below or browse more documents and templates provided by the New York State Workers' Compensation Board.
Download Form A-9H Notice That You May Be Responsible for Medical Costs in the Event of Failure to Prosecute, or if Compensation Claim Is Disallowed, or if Agreement Pursuant to Wcl 32 Is Approved - New York (English / Haitian Creole)
1
2
