Client Forms
At Peter M. Cordovano P.C., we understand that filing for workers' compensation can be a difficult process. We are here to help you navigate the process and ensure you receive the compensation you are entitled to.
To get started, please fill out our New Client Forms. Our New Client Forms include questions about your injury, your employer, and your medical history. This information will help us build a strong case for you and ensure you get the compensation you deserve. Once you have completed the forms, please submit them to our office. We will review your forms and contact you to discuss your case.
New York State Worker's Compensation Forms
- Claim for Compensation in a Death Case (C-62)
- Volunteer Firefighter's Claim for Benefits (VF-3)
- Loss of Wage Earning Capacity Vocational Data Form (VDF-1)
- Volunteer Ambulance Worker's Claim for Benefits (VAW-3)
- Notice of Retainer and Appearance on Behalf of Employer (OC-406)
- State of New York - Workers' Compensation Board (OC-400)
- Discharge or Discrimination Compliant (DC-120)
- Notice and Proof of Claim for Disability Benefits (DB-450)
- Claimant's Record of Job Search Efforts/Contacts (C-258)
- Claimant’s Record of Medical and Travel Expenses and Request for Reimbursement (C-257)
- Doctor's Report of MMI/Permanent Partial Impairment (C-4.3)
- Employee Claim (C-3)
Social Security Disability Forms
- Request for Social Security Statement (SSA-7004)
- Disability Report - Appeal (SSA-3441-BK)
- Disability Report - Adult (SSA-3368-BK)
- Instructions for Completing Form SSA-1696
- Authorization to Disclose Information to the Social Security Administration (SSA-827)
- Request for Reconsideration (SSA-561-U2)
- Social Security Attorney Fee and Retainer Agreement
- Claimant's Work Background (HA-4633)
- Claimant's Medications (HA-4632)
- Claimant's Recent Medical Treatments (HA-4631)
- Request for Administrative Law Judge (HA-501)
- Apply Online for Disability Benefits
- Disability Benefits
If you have any questions about the New Client Forms or the workers' compensation process, please do not hesitate to contact us. We are here to help you every step of the way.
What Makes Us Different
-
Respected in the Legal Field
Not only does Peter M. Cordovano have a profound respect for the legal profession, he has earned an esteemed reputation for his tireless dedication to Workers' Compensation and Social Security Disability clients.
-
Valuable Medical InsightAttorney Peter M. Cordovano has a solid grasp of the medical issues involved in his clients' cases and can effectively engage with medical providers and insurance company representatives.
-
Thousands of Clients HelpedOver the years, our firm has had the pleasure of helping more than 1,500 clients navigate complex Social Security Disability and Worker's Compensation cases.
-
Over 35 Years of ExperienceSince 1987, Attorney Peter M. Cordovano has fought for distressed clients who need capable case management and calm reassurance.
Client Testimonials
Hear From Past Clients We've Helped
-
"Thanks For All Your Help"
Thanks for all your help in getting this case resolved with WAMO. Your suggestion that I write to the Senior Law Judge was the key I think.
- Marge -
"Most Excellent Lawyer"
I would like to thank you, for all you have done for me and my son. You are the kindest person and most excellent lawyer I have known in my life. You are our angel.
- Maria I. -
"I'm in Good Hands"
You have been excellent in all matters pertaining to my case, and I feel I'm in good hands. I’ll keep in communication in updates as I'm sure PMA will as well God Bless...
- Darren P. -
"We Appreciate It More Than You Know"
We can’t thank you enough for all of your help! We appreciate it more than you know!
- Rick, Debbie, & Ricky -
"Levelheadedness and Perseverance"
I know we’ve had our difficult moments (usually due to my constant need for reassurance from you). But there isn’t a day that I don’t thank God for your levelheadedness and perseverance.
- Eileen -
"Thank You for Everything"
Thank you for everything you’ve done for me. I really do appreciate you.
- Valerie S. -
"Caring and Professional"
Thank you for meeting us and assessing Spencer and his needs in such a caring and professional way. Your staff was friendly, caring and supportive the entire time we were in touch with your office. Many thanks for your time! Blessings to you all!
- D.E. -
"You’re the Best"
I would like to thank you for all you have done for me and my family. You’re the best!
- A. Chambers