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Get NY C-72.1 2012-2024

G pursuant to Workers' Compensation Law Section 49-gg. For measurement of traumatic loss of hearing, see the Board's Medical Guidelines (2012). Claimant______________________________ NOTE WCB Case No.__________________________ 500 Hz. frequency is to be used only when the claimant's date of disablement is on or after January 1, 1984. RIGHT EAR LEFT EAR Hearing Levels at Frequencies of Hearing Levels at Frequencies of Test No. Name and Model Number of Audiometer A. 1 Audiometer Stand.

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  • NYCRR
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  • 49-gg
  • disablement
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