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This version of the form is not currently in use and is provided for reference only. Download this version of
Form RFA-1W
for the current year.
Form RFA-1W Request for Assistance by Injured Worker - New York
What Is Form RFA-1W?
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 RFA-1W?
A: Form RFA-1W is the Request for Assistance by Injured Worker in New York.
Q: Who can use Form RFA-1W?
A: Form RFA-1W can be used by injured workers in New York.
Q: What is the purpose of Form RFA-1W?
A: The purpose of Form RFA-1W is to request assistance as an injured worker in New York.
Q: Is there a fee for submitting Form RFA-1W?
A: No, there is no fee for submitting Form RFA-1W.
Q: What information is required on Form RFA-1W?
A: Form RFA-1W requires information such as the injured worker's personal details, details of the injury, and medical treatment received.
Q: What is the deadline for submitting Form RFA-1W?
A: The deadline for submitting Form RFA-1W may vary, so it is best to check with the relevant authorities in New York.
Q: What can I expect after submitting Form RFA-1W?
A: After submitting Form RFA-1W, you can expect the relevant authorities to review your request and provide assistance if eligible.
Q: Can I appeal a decision made on Form RFA-1W?
A: Yes, you have the right to appeal a decision made on Form RFA-1W in New York.
Form Details:
- Released on April 1, 2017;
- The latest edition provided by the New York State Workers' Compensation Board;
- Easy to use and ready to print;
- Available in Spanish;
- Quick to customize;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a fillable version of Form RFA-1W by clicking the link below or browse more documents and templates provided by the New York State Workers' Compensation Board.
Download Form RFA-1W Request for Assistance by Injured Worker - New York
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