Form C-22 Application for Approval of Non-schedule Adjustment - New York

What Is Form C-22?

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-22?
A: Form C-22 is an application for approval of non-schedule adjustment in New York.

Q: What is a non-schedule adjustment?
A: A non-schedule adjustment is a change to an existing schedule in Workers' Compensation cases.

Q: Who needs to file Form C-22?
A: Individuals or their attorneys who want to request a non-schedule adjustment need to file Form C-22.

Q: What information is required on Form C-22?
A: Form C-22 requires information about the injured worker, the employer, the insurance carrier, and the details of the requested non-schedule adjustment.

Q: What is the purpose of filing Form C-22?
A: The purpose of filing Form C-22 is to request approval for a non-schedule adjustment in Workers' Compensation cases.

Q: Is there a fee for filing Form C-22?
A: There is no fee for filing Form C-22.

Q: Are there any additional documents required to be submitted with Form C-22?
A: Yes, supporting medical documentation should be submitted along with Form C-22.

Q: What happens after Form C-22 is filed?
A: After Form C-22 is filed, a hearing may be scheduled to review the request for non-schedule adjustment.

Q: Can I appeal if my non-schedule adjustment request is denied?
A: Yes, you can appeal a denial of a non-schedule adjustment request by filing an appeal with the Workers' Compensation Board.