Oc 400 1 form 2025

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The document is an application form for a fee request by a claimant's attorney or representative in accordance with New York State Workers' Compensation Board rules. It outlines the process for submitting fee requests, including details on services rendered, substitution of attorneys, and procedures if the claimant is not present at the hearing. The form also includes information on how claimants can object to fee requests and the legal implications of providing false information.

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Can I file a CA-1 online?

After signing into ECOMP with your email address and password, your Employee Dashboard will be displayed, which lists all forms you have filed in ECOMP. Information about filing a claim on form CA-1 or CA-2 will be displayed. Click File a CA-1 or CA- 2 to proceed.

How to file a CA 1 form?

Email to the Boards centralized email address, wcbclaimsfiling@wcb.ny.gov; Mail to the Boards centralized mailing address, P.O. Box 5205, Binghamton, NY 13902-5205; or. Fax to the Boards centralized fax number, (877) 533-0337.

Who fills out a CA-1?

As the supervisor, it is your responsibility to complete this form. However, if you have any reason to believe that the information provided by the employee is not correct, there are sections of the CA-1 where additional information should be provided: Section 28: Was the employee injured in the performance of duty?

How to file CA-1 form?

Form CA-1 is made of two parts: one, which you fill in, and the other, which your supervisor completes. This form must be handed over to your supervisor to be sent over to the OWCP offices within 30 calendar days from the injury date.

How long does it take to file a CA-1?

For traumatic injuries, file Form CA-1 within 30 days following the injury, and for occupational disease claims, file Form CA-2.