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Printing L: MODOC MYDOCUME OC110AS FRP - Workers

Printing L: MODOC MYDOCUME OC110AS FRP - Workers 2025

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The document is an authorization form for claimants to allow access to their files at the New York State Workers' Compensation Board, in accordance with Section 110-a of the Workers' Compensation Law. It outlines the necessary information required from the claimant, restrictions on information release, and instructions for submission. The form emphasizes that authorizations cannot be used for future employment evaluations and details legal implications for unauthorized disclosure of information.

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