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Form A-9B 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 (Bengali)
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 Bengali. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is Form A-9B?
A: Form A-9B is a notice that informs individuals that they may be responsible for medical costs in certain situations.
Q: When would I be responsible for medical costs?
A: You may be responsible for medical costs if you fail to prosecute your claim, if your compensation claim is disallowed, or if an agreement pursuant to WCL 32 is approved.
Q: Who is this form applicable to?
A: This form is applicable to individuals in New York.
Q: What is WCL 32?
A: WCL 32 refers to Section 32 of the New York Workers' Compensation Law which pertains to lump sum settlements.
Q: Is this form available in Bengali?
A: Yes, this form is available in Bengali for individuals who prefer that language.
Form Details:
- Released on January 1, 2007;
- 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;
Download a fillable version of Form A-9B by clicking the link below or browse more documents and templates provided by the New York State Workers' Compensation Board.
