Get Ny Wcb Ph-16.2 2014-2026

Filling out the NY WCB PH-16.2 form is an essential step in the workers' compensation process in New York. This form, also known as the Pre-Hearing Conference Statement, helps facilitate the effective adjudication of claims, ensuring that all necessary information is presented to the Workers' Compensation Board.

Follow the steps to successfully complete the NY WCB PH-16.2 online.

1. Click ‘Get Form’ button to obtain the form and open it in the editor. This allows you to access the document you need to fill out.
2. Indicate who is submitting the form by checking the appropriate box: either 'the claimant's legal representative' or 'the employer or workers' compensation insurance carrier.'
3. Enter the WCB Case Number in the designated field. This number is vital for identifying your case in the system.
4. Fill in the Date of Injury/Illness using the format MM/DD/YYYY.
5. Provide the Carrier Case Number in the appropriate section.
6. Input the Carrier Code Number as 'W' in the specified area.
7. Complete the Claimant section with the name of the person filing the claim.
8. Provide the employer's name and the Carrier information as applicable.
9. List any Other Parties-in-Interest who should be aware of or involved in the claim.
10. In Summary, provide a brief overview of the claim, including the theory of the case and any relevant statutory or case citations.
11. For section 2a, if applicable, list all defenses the carrier is raising, including supporting evidence.
12. In section 2b, answer questions regarding whether the injury occurred in specific industries and provide additional employer information if necessary.
13. List additional parties that are essential for resolving the claim in section 3.
14. Provide details of any Lay Witnesses, including their names, addresses, and the nature of their testimony.
15. Identify any Medical Witnesses intended for cross-examination along with their contact information and expected time for testimony.
16. Attach any necessary documents or reports in section 6 that support your claim.
17. Answer the discovery completion question in section 7 and provide details if necessary.
18. Indicate if an Independent Medical Examination (IME) has occurred and provide the date if applicable.
19. In section 9, state if there is a need for a broader release of medical records.
20. Fill out the proposed Average Weekly Wage in section 10 and base this figure on relevant evidence.
21. Complete the Work Status section for the claimant, attaching Form C-11 if needed.
22. Answer regarding the good faith effort made to settle the claim in section 12.
23. Finally, sign and print your name in the designated area, fulfilling all necessary requirements before submission.
24. Save changes, download, print, or share the completed form as needed.

Take the next step in your workers' compensation process by completing the NY WCB PH-16.2 form online.