New York Work Comp Board To Measure Effectiveness of Carriers/TPAs

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. medsearch7@optonline.net

 

©2015 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law.

 

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Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker, attorney, or qualified professional.

 

 

Medical Treatment Guidelines In NY Open New Role For Employers

Medical treatment of NY comp claims was virtually unlimited two decades ago, but that has changed. Not all at once, but gradually and, with some proactive participation by employers, with opportunities for significant cost containment.

 

In prior years, there were no guidelines regarding medical treatment of NY comp claims. This was especially troublesome with old claims, which could be reopened at any time for almost any reason, or occasionally for no reason at all. However, perusing the Board’s new guidelines for treating flare ups of old injuries is like a person who has never played bridge trying to read the rules for the game. It is surely difficult for a medical office, and what will it be like for the injured workers.

 

Confusion, bottlenecks and uncertainty are the raw material for lawyer participation – UNLESS a bit of help is provided to the worker.

 

 

Uncertainty Will Quickly Grow Small Claims To Expensive Propositions

 

Employers with 100-200 employees rarely have even a dozen active claims in progress, and most of those will be for medical care. An employer who stays in active interaction with its claims will find that small claims stay small. But uncertainty will quickly grown the smallest claims into expensive propositions.

 

Therefore, the employer should be aware of measures which can keep the size of claims within reasonable limits.

 

 

Communication

 

The first is reaching out to persons with claims and ask if they are having problems. Be especially on the lookout for delays in payment of benefits or denials of medical care. Then call the carrier and ask for their version.  This type of communication will have a positive effect.

 

 

Going the Extra Mile

 

The second measure is to go to a Board office and review the Board electronic file for a claim that is being delayed. You will need a request to review the file signed by an officer of the business and notarized. Once it’s in the file, the file can be reviewed by the employer in the future as well. The employer should than call the carrier and inform it that the file has been reviewed and the employer has some questions. An employer going the extra mile will receive a much better reception by the carrier.

 

 

A Small Presence Can Make A Large Difference

 

The employer should then let the employee know that the employer has made efforts to limit further misunderstandings. Large employers are more likely to do these things but smaller employers seldom do. Even a small  presence will make large differences.

 

 

 

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. medsearch7@optonline.net

 

©2014 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law.

 

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SUBSCRIBE: Workers Comp Resource Center Newsletter

 

Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker, attorney, or qualified professional.

 

Employers: In New York It Now Pays To Be A Nit-Picker

Until a decade ago, the NY comp board was all but insensate to many of the provisions of the Workers Compensation Law, a tradition which began with the 1947 changes in the law. The result was that clear provisions in the law were ignored in favor of informal “traditions”. That led to a degradation of adherence to the statute which led in turn to presentation of “close is good enough” facts and law.

 

 

Employers Receive Much Value From A Proactive Role

 

Employers, in turn, justifiably began to feel that their input was of little value in the outcome of claims, but that has changed in the last decade. Unfortunately, employers have rarely been informed of the renewed value of a more proactive role.

 

Recently, a new decision discloses the changes that have been occurring. An attorney who requested that the hearing point be changed, without sufficient cause, was fined $500, which was upheld by the court, even though the attorney had taken care to have his client request, in writing, the change. That may not seem to be a game-changing decision but the practices of just a few years ago show that it is.

 

 

Small Change In NYC Practice Means Large Opportunity For Employers

 

In the not so distant past, requesting a change of hearing point could yield large differences, especially for large firms with high volume. In particular, asbestosis claims which had a chance of being held outside of NYC, were invariable allowed to be changed if the hearing change request was to NYC. Normally, the hearings were scheduled for the hearing point closest to the workers residence but asbestosis claims originating hundreds of miles from NYC were routinely being rescheduled to the city.

 

The most recent case penalized the attorney for requesting a change of hearing point which was 25 miles away from the original, an unthinkable outcome less than 10- years ago.

 

 

What does this have to do with employers? It demonstrates that seemingly small details are now relevant. The employer’s role is important, but only if the employer participates. “Participation”, for employers, means forwarding information to the carrier, and not just the information requested on the employer’s report of injury form C-2.

 

 

All Claims Can Be Legitimate Unless Employer Becomes Involved

 

In the late 1990’s, a comp claim was disallowed because the worker’s uniform contained a label which said the garment was machine washable. The worker had been hit by a car while taking his laundry, including the uniform, to a dry cleaner. The worker tried to make the incident a comp claim by alleging that care of his uniform was a necessary job duty. The court said it wasn’t, based on that label. Details like that can only come from the employer, but now they make a big difference.

 

Employers have been allowed to believe that completing a C-2 form is sufficient, but there are no boxes on the form to describe cleaning instructions for work clothes. Nor are there any boxes which ask the employer to list possible defenses. The form, in fact, seems to assume that all claims are legitimate. And so will everyone else, unless the employer becomes involved.

 

 

 

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. medsearch7@optonline.net

 

©2014 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law.

 

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Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker, attorney, or qualified professional.

Why NY Workers Comp Proceedings Sooooo Slow”

New York comp claims, even the simplest ones, can take a shocking amount of time to work their way through the claims process. No one is more shocked, and too often financially ravaged, by the unexpected glacially slow flow than the injured workers and their families. But what accounts for this?

 

The law used to have an obscure section that required a decision to be formally made by the Board no later than 30 days after it received notice of a claim. If the Board backlog exceeded 30 days, the commissioners could be required to work extra hours, six days a week, until the backlog was eliminated. That section mysteriously disappeared sometime in the late 90’s.

 

 
Abuse of the System

 

One abuse, nearly universal with copying services, can serve to show how clear provisions of law can be ignored with resulting disasters to workers and the employers, and why such abuses result in inexplicable delays.

 

Comp claims exist on medical records. Without the records proceedings and decisions are meaningless. Therefore, the NY Board sees hundreds of thousands of requests for medical records each year. But before a custodian of records will comply it must receive the copy fee. The Public Health Law provides for a payment of 75 cents per page.

 

However, copying services, which are NOT legally the owners of such medical records and act only on behalf of the custodian, regularly charge three times that, also adding arbitrary miscellaneous charges. If the request for records is made by subpoena, these charges are entirely in violation of the law.

 

This abuse alone can add months to the life of a claim. But what is the redress? There are two: first, a motion in Supreme Court for contempt can be made, second, the Board has the power and the obligation to notify and refer to the Attorney General patterns of widespread abuses for widespread investigation and enforcement procedures. The Board, unfortunately, only suggests that the maker of the subpoena enforce one violation at a time in Supreme Court. The costs per contempt proceeding are far more than simply paying the extortionate charges. The elevated costs, eventually, become part of the employers’ premiums.

 

This is an isolated example of work comp abuse, which has been allowed to grow into a lucrative industry. But the abuse also adds to delay of benefits and increases the number of hearings per claim.

 

 
Abuses In The Court System

 

The point is that abuses of the system are many and that each type of abuse, each in its own way, adds to delay. Judges for decades have resorted to the expedient of making no decision, especially where wrongdoing might be involved, and simply granted “adjournments” hoping that the parties will just pay the charges and move on.

 

Other types of abuse have resulted in eyebrow raising consternation. A key stroke error by a Board typist placed the wrong carrier on notice. The error could have been corrected with a simple phone call by the judge or any party. Instead, two law firms “tried” the case, from start to finish, for NINE years. (If this seems unbelievable, see “Manticoff v American Building Maintenance”, 63 AD3d 1308 (2009))

 

Another abuse, which can serve as an example for tens of thousands of others, was a claim in which a worker was granted 11 “final” opportunities to appear. This went on for years. Neither the lawyer nor the judge knew where the claimant was, and what, if anything, he might be doing.

 

 
Stay Informed And Active On Your Claims To Avoid Problems

 

An employer would be wise to stay involved with its claims. An occasional attendance at a hearing, especially if delays are developing, can work wonders. Not to mention a polite letter and phone call.

 

 

 

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. medsearch7@optonline.net

 

©2014 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law.

 

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Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker, attorney, or qualified professional.

Stern Warning Issued For Misclassifying Truck Drivers as Independent Contractors

The NY Workers Comp Board, on 4/4/14, issued a bulletin warning employers that attempts to describe delivery drivers as “independent contractors” will be subject to the NY 2014 Commercial Goods Transportation Act which will carry severe penalties for violations.

 

Employers should be aware that the definition of “commercial goods” includes all forms of fuel delivery, even though oil, propane and gasoline are not normally thought of as goods.

 

Goods delivered by heavy trucks, subject to federal DOT regulations have drivers whose pay is in the $100,000/yr range, with comp premiums of $10,000-$20,000/yr per driver. Thus, the temptations to reclassify drivers will be great.

 

 

New Law Written In Response of Trend to Misclassify Truck Drivers

 

This new law was written in response to a growing trend in NY to reclassify drivers of heavy vehicles in an effort to avoid the soaring costs of comp premiums. It will go into effect on 4/10/14. However, this comes at a time when the NYC DA, Cyrus Vance, Jr., also issued, last month, a grand jury report recommending enhanced penalties for employers attempting to reclassify workers in general as “independent contractors”.0

 

But such efforts are not new; they have been around since the comp law was passed in 1914. What the new law, and grand jury report, signal is that reclassification efforts have grown to the point of endangering the solvency of the NY State Insurance Fund (NYSIF). The figures cited in the grand jury report are that NY has a $6 billion/yr comp market, with $500 million/yr in fraudulent misclassification of workers and/or unpaid premiums. NYSIF currently insures 40% of the comp market and has the bulk of the misclassified workers and unpaid premiums.

 

 

 

Grand Jury Report Recommends Upgrading Penalties For Misclassification

 

 

The grand jury report recommends upgrading of criminal penalties for misclassifications, up from a class E felony (the lowest level of felony) to class D and, perhaps, even class C. This would be far more severe than the penalties in the 2014 Commercial Goods Transportation Act. Both would apply and employers should not think that penalties under one would rule out the other, although the changes advised by the grand jury are not yet law.

 

The new law and the grand jury report signal that the economic climate in NY work comp is in for changes not seen for decades and that the changes will be felt hardest in transportation. These, in turn, will be coming at a time when health care costs for drivers will also be rising at unprecedented rates.

 

 

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. medsearch7@optonline.net

 

©2014 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law.

 

WORK COMP CALCULATOR:   http://www.LowerWC.com/calculator.php

MODIFIED DUTY CALCULATOR:   http://www.LowerWC.com/transitional-duty-cost-calculator.php

WC GROUP:  http://www.linkedin.com/groups?homeNewMember=&gid=1922050/

SUBSCRIBE: Workers Comp Resource Center Newsletter

 

Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker, attorney, or qualified professional.

Call For Change With NY Work Comp Facing $10 Billion in Death Claims

The highest court in NY recently upheld a long standing rule that death claims in comp are not apportioned. (Hroncich v. Con. Ed.) If a work condition contributes to or accelerates death, however slightly, death benefits are paid entirely by the employer, notwithstanding that unrelated, non-work, conditions were overwhelmingly responsible.

 

 

Long-Standing Death Claim Rule Potentially Being Challenged

 

In NY, that is not new; it has been the rule for decades. What is new is that the New York’s Court of Appeals is not precisely backing that result. Instead, it is acknowledging the rationality of apportionment but saying that the legislature must change the law.

 

The case itself involved an old asbestosis claim which was allowed, but the former employee later died from an unrelated cancer. However, there was testimony that the earlier asbestosis diminished lung capacity and, therefore, contributed to the death.

 

The court seems to have realized that in the past virtually all claims for asbestosis were allowed, even though most resulted in little “disability” until retirement age, at which time claims for what were actually supplements to retirement were made.

 

 

Cost of Old Death Claims Could Exceed $10 Billion

 

Currently, there are tens of thousands, or more, of such old claims for chronic conditions that have been allowed, not just asbestosis, all of which can later be said to contribute to, or accelerate, death. This has been no secret to NY comp lawyers, who have been quite willing to close these claims, often with little lost time, knowing that all will eventually mature into a death claim.

 

The aggregate cost of these warehoused claims could exceed 10 billion dollars at present value. This could easily account for the court’s new found wariness.

 

 

Court Suggests Legislature Rewrite Law

 

The court has gently suggested to the legislature that this might be a section of the law that it should wish to consider rewriting. Such suggestions are not easily ignored. The long term potential of staying the course will add greatly to the problems of the NY comp system. One dissenting judge hinted that many of these claims, rather than be allowed or apportioned, should be dismissed entirely.

 

Employers should be aware that what are treated as nuisance claims often mature decades later into claims with potential costs expressed in fractions of a million dollars.

 

 

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. medsearch7@optonline.net

 

Editor Michael B. Stack, CPA, Director of Operations, Amaxx Risk Solutions, Inc. is an expert in employer communication systems and part of the Amaxx team helping companies reduce their workers compensation costs by 20% to 50%. He is a writer, speaker, and website publisher. www.reduceyourworkerscomp.com. Contact: mstack@reduceyourworkerscomp.com.

 

©2013 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law.

 


Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker, attorney, or qualified professional about workers comp issues.

New York State Fund Is Not The Carrier You Want To Owe Money

New York State Fund Has More Power Than Any Carrier

 

If a NY employer owes unpaid premium to the State Insurance Fund (NYSIF) and the employer is owed money by a branch of New York state government, the State Fund has an expedited method of collecting. It can, and almost certainly will, see that the premium is withheld from payments due on any contract with state government, an advantage no private carrier possesses. Furthermore, this method bypasses such details as a lawsuit.

 

The basis for this is contained in a decision this week from the Appellate Division, Third Department – “Suburban Restoration, Inc. v Office of the State Comptroller”, NY Slip Op 070221. The decision recognizes that NYSIF is, for nearly every purpose, a state agency, although it is uniquely paid by assessments on insurance companies, not by taxes.

 

 

 

Connected to Inner Workings of Central Computer

 

That might seem to be a small distinction but it leads to a feature which confers upon it enormous power – it, alone among comp carriers, is connected to the inner workings of the central computer of the State of New York. It is, therefore, a mouse-click away from all the information it needs to collect any unpaid premium from a contract with the State of New York.

 

It is generally supposed that the decision will mainly affect construction contracts, but it could equally apply to selling pencils and paper to SUNY. In turn, many employers might wish to rethink using a comp carrier that can bypass every legal protection and unilaterally demand, and collect, payments.

 

 

 

Disputes Heard in Court of Claims

 

If the employer wishes to dispute the charges and collections there is a double surprise awaiting. As long as there is unpaid premium (or ALLEGED unpaid premium) access to new state contracts may be cut off. And legal disputes cannot be brought in the regular state courts – they must be heard in the Court of Claims, a court which handles suits against the state and which, it is rumored, tends to see the state’s point of view a bit more clearly than other courts.

 

 

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. medsearch7@optonline.net

 

Editor Michael B. Stack, CPA, Director of Operations, Amaxx Risk Solutions, Inc. is an expert in employer communication systems and part of the Amaxx team helping companies reduce their workers compensation costs by 20% to 50%. He is a writer, speaker, and website publisher.  www.reduceyourworkerscomp.com.  Contact:  mstack@reduceyourworkerscomp.com.
WORKERS COMP MANAGEMENT MANUAL:  www.WCManual.com
MODIFIED DUTY CALCULATOR:  www.LowerWC.com/transitional-duty-cost-calculator.php

 

Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent about workers comp issues.

 

©2012 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact us at: Info@ReduceYourWorkersComp.com.

 

3 Reasons New York Workers Comp Assessments Are Through the Roof

NY Fees over 18%

 

An employer pays, in addition to the comp premium, an assessment for the operating costs of the Workers’ Compensation Board and certain “special funds”, principally the Second Injury Fund  and a fund for claims that have been closed for several years and reopened. Other states have these surcharges, amounting to a few percent of premium, but only New York has an assessment over 15% (currently over 18%). Why?

 

 

Reason #1: Bigger is Better

 

The answer, if it can be called an answer, seems to lie in a “bigger is better” attitude which has been part of New York comp for over 80 years. New York comp is also superlative in number of comp hearings, trials and appeals, so much so that at one time the annual number of hearings was over 600,000 and the number of appeals, 40,000 per year, exceeded the number of hearings in even the largest of states.

 

The number of hearings was so great that a research institute studying the NY comp system at first concluded that the number of hearings had an extra zero added by mistake. (Hearings are currently at 200,000/yr, or less.)

 

To manage all this, the NY comp board required over 1,500 employees, which was more than the combined comp board staffs of all states east of the Mississippi (if Florida is not included).

 

 

Reason #2: Second Injury Fund Payments

 

NY also led in second injury fund payments. A second injury fund pays most of an employer’s comp claim if the worker had a previous serious permanent injury. What drove the payments to the highest in the nation was the NY board’s stunning number claims for “permanent partial disability”, an award that was infrequent to rare in other states but was present, or at least possible, on nearly every claim in NY involving a back. Since extended disability on back claims was greater for older workers, second injury fund was usually involved. Older workers have the bulk of preexisting disability.

 

 

Reason #3: Reopened Cases

 

Finally, the assessments for “reopened cases” were anomalously high in NY. A back claim which remained open would in all likelihood continue to be litigated. But if the attorney asked that the claim be declared a permanent partial disability, but be closed without awards, the board would grant the request.

 

Such claims would be “warehoused” by the law firms as future assets. When the worker retired, the claim would be reopened and considered for permanent partial disability settlement since, it was claimed, the worker had retired in part due to the disability. (This has since been changed and future claims are more likely to be treated as voluntary retirements not qualifying for settlements, but many still in the pipeline must be paid for by the fund for reopened claims.)

 

 

Can Assessments Ever Come Down?

 

That, in brief, is why the assessments are so high. Can they ever come down to the level of the national average? Certainly, when it is recognized how they came to be so high in the first place, and there is hope for the future.

 

First, the number of reopened claims will diminish, since the new law for maximum amounts of future payments for permanent disability are a hindrance to “warehousing”. Then, the Second Injury Fund is in the process of being closed. Although that will take years there will be a steady decrease in payments each year.

 

The last factor, board expenses, will be a bit more difficult. The board has never shown an interest in substantial reduction of its total staff. It was predicted that the change from paper files to e-files would greatly reduce the staff, but that is still in the future, if ever. (Imagine the work hours which were necessary to transport paper files for 600,000 hearings a year to hearing points dozens of miles from the point of storage.)

 

So, the assessments, slowly, will come down. But they have a long way to go.

 

 

 

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. medsearch7@optonline.net

 

Editor Michael B. Stack, CPA, Director of Operations, Amaxx Risk Solutions, Inc. is an expert in employer communication systems and part of the Amaxx team helping companies reduce their workers compensation costs by 20% to 50%. He is a writer, speaker, and website publisher.  www.reduceyourworkerscomp.com.  Contact:  mstack@reduceyourworkerscomp.com.
WORKERS COMP MANAGEMENT MANUAL:  www.WCManual.com
MODIFIED DUTY CALCULATOR:  www.LowerWC.com/transitional-duty-cost-calculator.php

 

Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent about workers comp issues.

 

©2012 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact us at: Info@ReduceYourWorkersComp.com.

 

New York Makes Strides with New Rules for Changing Hearing Point

Hearings Automatically Set for County in which Worker Resides

 
The NY Work Comp Board published on 7/3/12 established new rules for changing the hearing point (“Rule on Request for Venue Change, Subject No. 046-486). The hearings are automatically set for the county in which the worker resides, unless the worker resides out of state, in which case the worker can ask for a particular county. Special rules apply if the employer is a governmental body, in which case, hearings must be held in the same board district where the governmental body has offices.
 
After that, a change can only be made if the worker requests it in writing and gives a good reason for a change. The senior comp judge rules on the request and gives a written opinion.
 
 
New System Significant Improvement from Decades Past
 
In decades past, changes in hearing points resembled a game of dysfunctional musical chairs. The principal reasons for changes, especially in the New York City area, had nothing to do with the wishes of the worker or the convenience of witnesses – it had everything to do with the local culture of the comp system and, most importantly, how attorney fees were awarded.
 
Employers should be kept aware of any requests for a change in hearing points. A change should not be granted for the convenience of a medical witness since medical testimony is now taken by telephone depositions and no longer at hearings. It is no more difficult to take the deposition of doctors in Florida than doctors locally as the procedures are the same.
 
In the past, attorneys would ask that a change of hearing point be made to inconvenience the employer’s witnesses – using a worker’s remote address of a relative. The employer was sometimes directed to have three or four witnesses appear at a point hundreds of miles away, only to be informed, when they arrived, that the hearing was adjourned. Since depositions are now used, that gambit no longer works.
 
 
Employer Should be Updated on Requests for Changes
 
An employer should be kept in the loop on requests for changes of hearing point and should review the application to see if any reasons for a change are given that appear to contradict facts. If the request is not in accordance with known facts, a reply should be made.
 
 
 

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. medsearch7@optonline.net

 

Editor Michael B. Stack, CPA, Director of Operations, Amaxx Risk Solutions, Inc. is an expert in employer communication systems and part of the Amaxx team helping companies reduce their workers compensation costs by 20% to 50%. He is a writer, speaker, and website publisher.  www.reduceyourworkerscomp.com Contact mstack@reduceyourworkerscomp.com


WORKERS COMP MANAGEMENT MANUAL:  www.WCManual.com
MODIFIED DUTY CALCULATOR:  www.LowerWC.com/transitional-duty-cost-calculator.php

 

Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent about workers comp issues.

 

©2012 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact us at: Info@ReduceYourWorkersComp.com.

Smile, Your Facebook Post Can be Read by Millions

 

The Internet is Where Comp Claim Investigation Starts
 
Perhaps your workers are among the last to realize that the net is public and world wide. Millions of others don’t. Judging from the stories emerging, investigation of comp claims starts on the net – and quickly ends there.
 
Many workers are posting pictures and stories about their active and exciting lives, complete with photos, locations and dates, while pursuing comp, negligence and Social Security Disability claims.
 
 
Facebook Posts Are Not Necessarily Reality
 
Most internet chatter is from younger workers who are just trying to build a persona that is more attractive than “Disabled. Waiting for settlement.”, and who can blame them? So the statements shouldn’t automatically be considered a game winning find for the employer or carrier.
 
Your correspondent discovered a young man on total for a back blogging with members of his surf club about conditions on each beach. Suspicious, but what else did he have to talk about? At least he was trying to maintain social connections, which is always good for morale. Since he identified where, and when, he and his friends could be found, this was a photo shoot made in heaven for an investigator. Or maybe not. (All our suspect did was talk. He never seemed to leave the house.)
 
In the 1980s, a NYS fire fighter on total disability actually WON the race up the Empire State Building. Videos, news stories and copies of TV interviews were quickly assembled to defeat his claim.
 
He won! Among other responsibilities, he had to be able to carry a 150 pound person, on his back, and down a ladder.  If he could not, he met the particular definition for total. And being on the evening news is not exactly evidence of “concealment”.
 
 
Check the Web, Keep an Open Mind
 
That is not to say that the net shouldn’t be consulted. But keep an open mind. In checking the web for a consultant’s reputation and qualifications in insurance your author instead read a copy of his application for a reduction in his prison sentence, written while in a federal facility two years previously.
 
That search, at least, produced a very desirable result.
 
 

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. medsearch7@optonline.net

 

Editor Michael B. Stack, CPA, Director of Operations, Amaxx Risk Solutions, Inc. is an expert in employer communication systems and part of the Amaxx team helping companies reduce their workers compensation costs by 20% to 50%. He is a writer, speaker, and website publisher.  www.reduceyourworkerscomp.com Contact mstack@reduceyourworkerscomp.com


WORKERS COMP MANAGEMENT MANUAL:  www.WCManual.com
MODIFIED DUTY CALCULATOR:  www.LowerWC.com/transitional-duty-cost-calculator.php

 

Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent about workers comp issues.

 

©2012 Amaxx Risk Solutions, Inc. All rights reserved under International Copyright Law. If you would like permission to reprint this material, contact us at: Info@ReduceYourWorkersComp.com.

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