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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
What Is Form A-9?
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 A-9?
A: Form A-9 is a notice that informs you that you may be responsible for medical costs under certain circumstances.
Q: When am I responsible for medical costs according to Form A-9?
A: You may be responsible for medical costs if there is a failure to prosecute your compensation claim, if your compensation claim is disallowed, or if an agreement pursuant to WCL 32 is approved.
Q: What does WCL 32 refer to?
A: WCL 32 refers to a section of the New York Workers' Compensation Law.
Q: What should I do if I receive Form A-9?
A: If you receive Form A-9, you should carefully review it and seek legal advice if needed to understand your potential responsibilities for medical costs.
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;
- Fill out the form in our online filing application.
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.
