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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 (Korean)
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 Korean. 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 in New York regarding potential responsibility for medical costs.
Q: What does Form A-9 inform about?
A: Form A-9 informs individuals about their potential responsibility for medical costs in certain situations.
Q: When are you potentially responsible for medical costs?
A: You may be responsible for medical costs if there is a failure to prosecute, if your compensation claim is disallowed, or if an agreement pursuant to WCL 32 is approved.
Q: Is Form A-9 specific to a particular language?
A: Yes, this version of Form A-9 is in Korean.
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.
