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C-4.3 form - Printable Version

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C-4.3 form - Andy1689 - 08-30-2019

After my dr filled out c4.3 form, will he send it to my insurance company directly? Or my insurance company will not get it until the permanency
court?


RE: C-4.3 form - 1171 - 08-30-2019

“submit promptly to the Board, the insurance carrier and to the patient's attorney or licensed representative, if he/she has one; if not, send a copy to the patient.”
http://www.wcb.ny.gov/content/main/forms/c4_3.pdf


RE: C-4.3 form - Andy1689 - 08-30-2019

(08-30-2019, 01:23 PM)1171 Wrote: “submit promptly to the Board, the insurance carrier and to the patient's attorney or licensed representative, if he/she has one; if not, send a copy to the patient.”
http://www.wcb.ny.gov/content/main/forms/c4_3.pdf

Thanks