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

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 Haitian Creole. 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 for claimants to authorize the disclosure of workers' compensation records in New York.

Q: Who uses Form OC-110A?
A: Claimants in New York who want to give permission for the release of their workers' compensation records.

Q: What is the purpose of Form OC-110A?
A: The purpose of Form OC-110A is to allow claimants to authorize the disclosure of their workers' compensation records.

Q: Is Form OC-110A specific to a particular language?
A: Yes, Form OC-110A is available in Haitian Creole for those who prefer to use that language.

Q: What should I do with Form OC-110A once completed?
A: Once you have completed Form OC-110A, you should submit it to the appropriate authority or organization.

Q: Are there any fees associated with Form OC-110A?
A: There may be fees associated with submitting Form OC-110A. It is best to check with the relevant authority or organization.

Q: Can I use Form OC-110A if I am not in New York?
A: No, Form OC-110A is specifically for use in New York.

Q: Can someone else sign Form OC-110A on my behalf?
A: No, Form OC-110A must be signed by the claimant themselves.

Q: What information do I need to provide on Form OC-110A?
A: You will need to provide your personal information, details of your workers' compensation claim, and authorize the release of your records.