eForm Information
Form ID | Form Title | Who Files | Where to File | When to File | Submittal Options |
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RFA-1LC | Request for Further Action by Legal Counsel | Claimant's Representative | Electronically filed with the Workers' Compensation Board, with PDF copy to employer's insurance carrier or directly to employer or third-party administrator if employer is a Board-approved self-insurer. | The form may be filed at any time after the assembly or indexing of a claim or after the Board has indicated that no further action (NFA) will be taken. |
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Requirements and Examples
Please note, the files listed below are in a draft status and may not be indicative of a final version for those files.
File name | Description |
---|---|
DRAFT_RFA-1LC-XML-Data-Requirements-and-Edits-V3.0.xlsx | Draft – XML documentation/guidelines for RFA-1LC XML data elements. This spreadsheet contains list of error codes, list of valid values, element requirements and element rules. |
DRAFT_eFormsCnw1.xml | Draft – XML layout example for RFA-1LC submission of request reason code CNW (Claimant is not working and not receiving payments) |
DRAFT_eFormsCaw1.xml | Draft – XML layout example for RFA-1LC submission of request reason code CAW |
DRAFT_eFormsXMLAckTemplate.xml | Draft – XML acknowledgement template for RFA-1LC. After processing the API submission the acceptance and rejection of the transaction will be returned back to the sender. |
DRAFT_eFormsXmlTemplate.xml | Draft – XML template for the RFA-1LC submission. This template contains the data elements for all submission reasons. It is recommended to review the API requirements and edits spreadsheet for the submission reason specific data element list. |
DRAFT_eFormsRfa1lc.xsd | Draft – XML schema definition for RFA-1LC XML data submission. API submitters are expected to use this schema definition to validate the data before sending XML submission via API. |
Resources
- Form RFA-1LC Engagement Session
- Form RFA-1LC Engagement Session Video
For more information or questions, please email eForms@wcb.ny.gov