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Get NY DT-1 2012-2024

Ests and Examinations through the Carrier's Diagnostic Testing Network(s) identified below. This Notice is supplied to the Claimant and Treating Medical Provider pursuant to Workers' Compensation Law §13-a(7) and 12 NYCRR 325-7. Failure to provide the required notice relieves the Claimant of his/her obligation to use the diagnostic testing network(s). Date of Notice: Check the applicable box below: Notice to the Claimant Claimant: First Name WCB Case Number: Last Name Middle Initial (If .

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