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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 (Bengali)
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 Bengali. 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 regarding the potential responsibility for medical costs.
Q: When may I be 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: What language is Form A-9 available in?
A: Form A-9 is available in Bengali in addition to English.
Q: What is Wcl 32?
A: Wcl 32 refers to a specific section of the Workers' Compensation Law in New York.
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 counsel if needed.
Q: Who is responsible for medical costs according to Form A-9?
A: You may be responsible for medical costs as indicated in Form A-9.
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.
