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

This is a legal form that was released by the New York State Workers' Compensation Board - a government authority operating within New York.

The document is provided in Polish. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is Form OC-110A?
A: Form OC-110A is a document used in New York to authorize the disclosure of workers' compensation records.

Q: Who is the claimant in Form OC-110A?
A: The claimant is the person who is seeking workers' compensation benefits.

Q: Why is authorization needed to disclose workers' compensation records?
A: Authorization is needed to ensure that the claimant's privacy rights are protected when their records are shared with others.

Q: Is Form OC-110A available in Polish?
A: Yes, Form OC-110A is available in Polish to cater to individuals who prefer or require the Polish language.

Q: What information does Form OC-110A require?
A: Form OC-110A requires the claimant to provide their personal information, the names of entities authorized to receive the information, and the purpose of disclosure.

Q: Can Form OC-110A be used for other states or countries?
A: No, Form OC-110A is specific to New York and cannot be used for other states or countries.

Q: Is there a fee associated with submitting Form OC-110A?
A: No, there is usually no fee required to submit Form OC-110A for authorization.

Q: How long does it take to process Form OC-110A?
A: The processing time for Form OC-110A may vary, but it typically takes a few weeks to receive a response.

Q: What should I do if I need assistance with Form OC-110A?
A: If you need assistance with Form OC-110A, you can contact the Workers' Compensation Board or seek help from a legal professional.