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Form A-9 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 (Italian)
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 Italian. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is Form A-9?
A: Form A-9 is a notice that informs individuals in New York about their potential responsibility for medical costs in certain situations.
Q: What situations could result in responsibility for medical costs?
A: Failure to prosecute, disallowed compensation claim, or approval of an agreement pursuant to WCL 32 could result in responsibility for medical costs.
Q: Who should receive Form A-9?
A: Any individual in New York who may be responsible for medical costs should receive Form A-9.
Q: Is this form specifically for Italian speakers?
A: Yes, Form A-9 is available in Italian language for Italian speakers in New York.
Form Details:
- Released on November 1, 2021;
- 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;
Download a fillable version of Form A-9 by clicking the link below or browse more documents and templates provided by the New York State Workers' Compensation Board.
