Form DB-450 Notice and Proof of Claim for Disability Benefits - New York (Haitian Creole)

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 Haitian Creole. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is the DB-450 form?
A: The DB-450 form is a Notice and Proof of Claim for Disability Benefits specifically designed for residents of New York.

Q: Who can use the DB-450 form?
A: Residents of New York who are seeking disability benefits can use the DB-450 form.

Q: What does the DB-450 form include?
A: The DB-450 form includes a notice of representation, a section for the claimant's personal information, as well as a medical provider information section.

Q: Can I fill out the DB-450 form in Haitian Creole?
A: Yes, the DB-450 form is available in Haitian Creole for those who prefer to fill it out in that language.

Q: What should I do after filling out the DB-450 form?
A: After filling out the DB-450 form, you should submit it to the appropriate office as specified in the instructions on the form.