There is a little known provision in NY workers’ compensation laws that provides for offsets of long term disability (LTD) payments against workers’ compensation benefits. Attorney Theodore Ronca from Aquebogue, NY tells us that this law can be quite useful but is underutilized as are many “coordination of benefits” remedies. He practices in the areas of workers’ compensation, disability and benefits. Here is a summary of the WC and LTD offset provision.
Statute: NY Work Comp Law, Sect 25(4)(“c) provides that a private disability plan (other than statutory STD under Sect 206(2) of the WCL) which contains language calling for reduction of benefits for workers’ compensation payments may assert a lien against as yet unawarded compensation payments provided a written request for a lien is made to the WCB together with proof of plan terms, prior to an award of benefits being made for the period for which disability payments were made.
Forms: No specific form at present. In 1947 a form was prescribed but was declared obsolete in 1986. Written request with proof of payments and plan terms will suffice.
Procedure: Request for lien will be considered at a scheduled hearing before an administrative law judge of the Workers’ Comp Board (WCB). Disability plan may be present at hearing and represented by counsel. Parties objecting to decision may file an appeal to the WCB no later than thirty (30) days after decision of the Administrative Law Judge (ALJ) is filed. (Parties will receive written notification of decision with date of filing stated.)
Practice Advice: Few work comp claims examiners are familiar with LTD liens. It is best to call the comp carrier, explain the situation, and mail copies of documents to carrier. Same should apply to claimant and claimant’s attorney. Failure to do so will almost certainly result in requests for an adjournment. Following that, documents must be mailed to the WCB.
1- It is advisable to attend hearings with full documentation of details.
2- Appeals must be on prescribed forms, available on-line at WCB website. (See Resources for website)
3- Unless a plan has extensive prior experience with WCB hearings, representation by an attorney with work comp skills is advisable.
Advantages: The lien is the surest way to avoid difficult collection or future offset of overpayments. Although the lien was granted by law in 1947 it was all but unknown and underutilized until the last ten years. It remains a little known feature of workers’ compensation and group disability law.
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.
Do not use this information without independent verification. All state laws are different. Consult with your corporate legal counsel before implementing any cost containment programs.
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