Please do not send requests for forms to William Bryant. As of July 2007 all requests should be sent to the attention of the "Reproduction Unit".
Date: January 5, 2007
The Workers' Compensation Board has revised Form OC-400.1, Application for a Fee by Claimant's Attorney or Representative. The date of the revised form is 11-06. It is effective immediately.
Board Rule 12 NYCRR 300.17 requires that Form OC-400.1 must be filed with the Workers' Compensation Board where the amount of fee requested is more than $450, or when the form is requested by the Board. However, Form OC-400.1 may be used for any fee request. The changes made to the form are:
Revised Form OC-400.1 (11-06) is effective immediately. However, the previous version of Form OC-400.1 dated 1-04 may be used until March 1, 2007. After that, only the 11-06 version will be accepted.
Master copies of Form OC-400.1 and other common Board forms may be obtained by downloading the specific pdf file copy from the Board's web site (www.wcb.ny.gov) under the heading Common Forms, or by writing or faxing the Board at:
NYS Workers' Compensation Board - Attn: Mr. William Bryant
100 Broadway-Menands, Albany, NY 12241
FAX: (518) 486-3515
Thank you for your cooperation.