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 Urdu. As of today, no separate filing guidelines for the form are provided by the issuing department.
Q: What is Form A-9?
A: Form A-9 is a notice in New York that informs individuals that they may be responsible for medical costs in certain situations.
Q: When may someone be responsible for medical costs?
A: Someone may be responsible for medical costs if there is a failure to prosecute, if the 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 Section 32 of the New York Workers' Compensation Law.
Q: What language is this form available in?
A: This form is available in Urdu.
Q: Who should use this form?
A: Individuals in New York who need to provide notice about potential responsibility for medical costs should use this form.
Form Details:
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.