Tips from Ted: How Important are Accurate Payment Records for Lost Time Claims

It’s both costly and painful to learn by our mistakes. As in many workers’ comp cases, a too detailed summary of the proceeding loses the whole point. In this case, we know little about the exact details, but we know a bunch of lawyers submitted a lot of bills – because the employer did not keep unambiguous records.

In a decision this week in the Matter of McLean v. Amsterdam Nursing Home, (2010 NY Slip Op 03017, dec’d 2/15/10,NYAD, 3d Dept.) the court decided the evidence regarding the employer’s payments to the worker for lost time years after an accident needed further development. The case illustrates the need for accurate, unambiguous record keeping for all lost time payments, even many years after a compensation claim.

If a claim is reopened at least seven years after the original accident and at least three years after the last payment of compensation, the claim is no longer the liability of the employer but become the responsibility of the Special Funds.

Many times, however, payment of sick benefits for lost time and/or accrued vacation time becomes an issue. Was it intended to be an advanced payment of compensation? Or was it simply payment of employee benefits having nothing to do with a work-related accident?

The best evidence is a contemporaneous note, written at the time of payment, as to the exact purpose of the payment, i.e., full documentation.

Because the facts in the above case were somewhat unclear the need for further developments became necessary. (workersxzcompxzkit)

Clarity results in fewer hearings and appeals, resulting in savings for the employer.

Author: Attorney Theodore Ronca is a practicing lawyer from Aquebogue, NY. He is a frequent writer and speaker, and has represented employers in the areas of workers’ compensation, Social Security disability, employee disability plans and subrogation for over 30 years. Attorney Ronca can be reached at 631-722-2100.

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