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New York State
Workers' Compensation Board
328 State Street  Schenectady, New York 12305
Governor Andrew M. Cuomo

Subject No. 046-670

WCB Announces Licensed Representative Examination
to be Held on June 12, 2014

Date: April 10, 2014

The Workers' Compensation Board (the Board) is offering a Licensed Representative Examination on Thursday, June 12, 2014 at 9:30 a.m. (Arrival is required by 8:30 a.m.) The exam will be given at the Board’s Albany office located at 328 State Street, Schenectady, New York. A second location may be offered for this exam at the Albany district office located at 100 Broadway, Menands, New York, if enrollment exceeds location capacity.

Individuals interested in seeking a license to represent claimants pursuant to Section 24-a of the Workers' Compensation Law, or to become a third-party administrator (TPA) to represent self-insured employers and/or insurance carriers, should complete Form OC-409. Applicants should submit the application form, along with a $100 check or money order, payable to the "Chair, Workers' Compensation Board", to the NYS Workers’ Compensation Board Licensing Office at 328 State Street, Schenectady, NY 12305-2318. Completed applications, accompanied by the required application fee, are due by the close of business on Wednesday, April 30, 2014.

For more information about becoming a Licensed Representative and for updates related to time, date and location, please refer to the NYS Workers’ Compensation Board website, under the "Representatives" tab, the "Application and Instructions to become a Licensed Representative" and the Licensed Representative Examination Guide.

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Robert E. Beloten