Form I-15 Workers' Compensation Authorization - New York

What Is Form I-15?

This is a legal form that was released by the New York State Office of Victim Services - 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 I-15 Workers' Compensation Authorization?
A: Form I-15 is a form used in New York for authorizing the release of medical information related to a workers' compensation claim.

Q: Who uses Form I-15?
A: The injured worker and their healthcare provider(s) use Form I-15.

Q: What is the purpose of Form I-15?
A: Form I-15 authorizes the release of medical information for the purpose of supporting a workers' compensation claim.

Q: How can I obtain Form I-15?
A: Form I-15 can be obtained from the New York Workers' Compensation Board or from your employer's insurance carrier.

Q: Who should complete Form I-15?
A: The injured worker should complete Section A, and the healthcare provider should complete Section B of the form.

Q: What information is required on Form I-15?
A: Section A requires the injured worker's personal information, while Section B requires the healthcare provider's information and a description of the treatment provided.

Q: Do I need to provide authorization for every healthcare provider?
A: Yes, a separate Form I-15 is required for each healthcare provider that treated the injured worker.

Q: Is there a deadline for submitting Form I-15?
A: Yes, Form I-15 must be submitted within 45 days of the injured worker's first visit to the healthcare provider.

Q: What if I need to update or amend Form I-15?
A: If any information on the form needs to be updated or amended, a new Form I-15 should be completed and submitted.