Form C-4.3 Doctor's Report of Mmi / Permanent Partial Impairment - New York

Form C-4.3 Doctor's Report of Mmi / Permanent Partial Impairment - New York

What Is Form C-4.3?

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-4.3?
A: Form C-4.3 is the Doctor's Report of MMI/Permanent Partial Impairment in New York.

Q: What does MMI stand for?
A: MMI stands for Maximum Medical Improvement.

Q: What is Permanent Partial Impairment?
A: Permanent Partial Impairment refers to a lasting physical or mental impairment that affects a person's ability to carry out daily activities.

Q: Who needs to fill out Form C-4.3?
A: The doctor treating the individual who sustained a work-related injury or illness needs to fill out Form C-4.3.

Q: What information is required on Form C-4.3?
A: Form C-4.3 requires the doctor to provide details about the individual's medical condition, treatment, and assessment of permanent impairment.

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Form Details:

  • Released on May 1, 2022;
  • 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;
  • Fill out the form in our online filing application.

Download a fillable version of Form C-4.3 by clicking the link below or browse more documents and templates provided by the New York State Workers' Compensation Board.

Download Form C-4.3 Doctor's Report of Mmi / Permanent Partial Impairment - New York

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