The New York Workers Compensation Board has announced a new initiative to measure the effectiveness of carriers and TPAs in prompt filing of first reports of new injuries and effective denials of compensation claims. In 2015, data on all carriers/TPAs will be kept. Eventually, there will be unspecified penalties imposed on carriers/TPAs for poor performance.
Carriers Can Speed Up Handling By Receiving Better Information From Employers
Carriers/TPAs, however are linked to employers. Carriers can speed up their own handling, and contest unwarranted claims with greater chance of success with proper preparation but they just necessarily rely to a large degree on information provided by employers. This presents employers with opportunities never before seen in New York.
Since the carriers/TPAs will be under scrutiny they will gratefully accept efforts by employers to speed up and present useful information. An employer can do this in one obvious way (far better first reports to the carrier/TPA) and one which is not at all obvious (employer completion of a Ph 16.1 form which the carrier, not the employer, normally completes on contested claims).
Both of these measures will receive more detailed discussion in soon to be written posts. They are extremely important for employer control of compensation costs and need more explanation. However, for the present, employers should be aware of the following in NY.
First Report in New York is Form C-2
The employer’s first report to the carrier is the NYWCB Form C-2. This form should be completed in less than 10 days following a reported injury or illness. Many are not – and that is easily correctible. With a little effort, it can be completed in 48 hours, which will make a great difference in results for employer and carrier.
Then, most C-2s submitted by employers have a number of boxes left blank. A blank box is an invitation to disaster. A fully completed C-2 is not at all difficult to submit, but a few more explanations on how to do that are needed.
Completing Form 16.1 Will Greatly Enhance Success
For contested compensation claims there is a simple way that the employer can effectively organize information being sent to the carrier which will greatly enhance chance of success and greatly diminish unnecessary contests. That is for the employer to complete a form normally completed by only the carrier (NYWCB Form 16.1). The form must be submitted by the carrier alone, but there is nothing wrong with the employer filling out the same form and sending it to the carrier alone. This will organize the information needed by the carrier and make it possible for the carrier to get additional information, if needed, in a fraction of the time.
The benefits from such cooperation? Well, an employer/carrier team doing this will easily be in the top 10% on the performance results being measured by the NYWCB. (Top 1% is more likely, but let’s be conservative.) Well worth the effort.
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. [email protected]
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