New York > Workers Compensation
Settlement Agreement - Section 32 WCL C-32 - New York
| Settlement Agreement - Section 32 WCL Form. This is a New York form and can be used in Workers Compensation . |
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State of New York THIS AGENCY EMPLOYS AND WORKERS COMPENSATION BOARD SERVES PEOPLE WITH DISABILITIES WITHOUT DISCRIMINATION. SETTLEMENT AGREEMENT - Section 32 WCL WCB CASE NO.(S) DATE(S) OF ACCIDENT CLAIMANTS NAME (PLEASE PRINT) CLAIMANTS ADDRESS (PLEASE PRINT) CARRIER CASE NO. CARRIER CODE EMPLOYER (Please Print) CARRIER (Please Print) THIS AGREEMENT IS PREPARED AND SUBMITTED PURSUANT TO SECTION 32 OF THE WORKERS COMPENSATION LAW. BY SIGNING BELOW, EACH PARTY TO THE AGREEMENT AFFIRMS THAT (S)HE HAS READ AND UNDERSTANDS ITS PROVISIONS, AND UNDERSTANDS THAT THE AGREEMENT, IF APPROVED BY THE WORKERS COMPENSATION BOARD, IS CONCLUSIVE, FINAL AND BINDING ON ALL THE PARTIES INVOLVED. THE UNDERSIGNED HEREBY CONSENT OF THEIR OWN FREE WILL TO BE SUBJECT TO THE ABOVE PROVISIONS AND ACKNOWLEDGE RECEIPT OF A COPY OF THIS AGREEMENT. _______________________________________________ ____________________________________________________________________ CLAIMANT - PLEASE PRINT CLAIMANT - SIGNATURE DATE _______________________________________________ ____________________________________________________________________ CARRIER OR SELF-INSURED EMPLOYER - PLEASE PRINT CARRIER OR SELF-INSURED EMPLOYER - SIGNATURE DATE ______________________________________________ _____________________________________________________________________ OTHER - PLEASE PRINT OTHER - SIGNATURE DATE C-32 (2-05) SEE IMPORTANT INFORMATION ON THE REVERSE American LegalNet, Inc. www.USCourtForms.com<<<<<<<<<********>>>>>>>>>>>>> 2 NYCRR 300.36. Section 32 Agreements Statement of Purpose. To encourage the parties in interest to enter into agreements settling upon and determining the compensation and other benefits due to the claimant or the claimants dependents. (a) The parties in interest to a claim for compensation may settle upon and determine any and all issues and matters by agreement, in accordance with section 32 of the Workers Compensation Law, subject to the terms and conditions of this rule. (b) Any agreement submitted to the board for approval shall be on a form prescribed by the chair or, alternatively, contain the information prescribed by the chair. (c) The submission of an agreement to the board for approval shall act as a stay on all related proceedings before the board. (d) An agreement submitted pursuant to section 32 of the Workers Compensation Law shall not be binding on the parties in interest unless it is approved by the chair, a designee of the chair, a member of the board, or a Workers Compensation Law Judge. The agreement shall be approved unless it is determined that: (1) the agreement is unfair, unconscionable, or improper as a matter of law; or, (2) the agreement is the result of an intentional misrepresentation of a material fact; or, (3) within ten days of submission of the agreement, the board has received from any party in interest a written request that the agreement be disapproved by the board. (e) After at least 10 calendar days have passed since the submission of the agreement to the Board, the agreement shall be reviewed by the chair, a designee of the chair, a member of the board, or a Workers Compensation Law Judge, who will make a determination whether to approve or disapprove the agreement. The chair, designee of the chair, member of the board, or Workers Compensation Law Judge reviewing the agreement may approve or disapprove the agreement administratively, based on a review of the record before the board, or may chose to schedule a meeting to question the parties about the agreement. If the agreement is reviewed administratively, the Board shall advise the parties in writing of the date the agreement shall be deemed submitted for the purposes of Section 32 of the Workers Compensation Law and this section. If a meeting is scheduled to question the parties about the agreement, the agreement will be deemed submitted for the purposes of Section 32 of the Workers Compensation Law and this section at such meeting. (f) The board will advise the parties of the approval or disapproval of all agreements by duly filing and serving a notice of decision. (g) An agreement which is approved shall be final and conclusive on the parties in interest, and shall not be subject to review pursuant to section 23 of the Workers Compensation Law. An agreement which is disapproved shall be subject to review pursuant to section 23 of the Workers Compensation Law. (h) The carrier shall make payments of any award as required in the agreement within ten days of the filing of the decision approving the agreement. If the carrier fails to make such payments, the carrier shall be subject to penalties pursuant to paragraph (f) of subdivision 3 of section 25 of the Workers Compensation Law. (i) An agreement may provide for reasonable fees commensurate with the services rendered by the claimants attorney or licensed representative. Whenever a fee is requested in excess of $450, the requested fee is to be made upon form OC-400.1 attached to the submitted agreement. (j) Any agreement submitted and approved pursuant to section 32 of the Workers Compensation Law and this rule may be modified at any time by agreement of all parties in interest provided such modification is approved by the board. C-32 (2-05) Reverse American LegalNet, Inc. www.USCourtForms.com
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