# Compensation Aggregated by Superinsight from public-domain sources, as of 2026-09-02. Domain: wc/ny. --- ## WKC § 9 — Definitions {#9} *N.Y. Workers' Comp. Law § 9* Official source: _NYS Open Legislation, revision of 2014-09-22._ § 9. Definitions. For the purposes of this article, the following terms shall mean: 1. "World Trade Center rescue" shall mean any activity involving an employee of a private voluntary hospital that worked rescue operations under contract with the city of New York under direction of the fire department of the city of New York, conducted between September eleventh and September fifteenth, two thousand one inclusive at or in the vicinity of the World Trade Center site of the September eleventh, two thousand one terrorist attack on the World Trade Center in the city of New York, commonly referred to as "Ground Zero". 2. "Vicinity of the World Trade Center site" shall mean anywhere below a line starting from the Hudson River and Canal Street; east on Canal Street to Pike Street; south on Pike Street to the East River; and extending to the lower tip of Manhattan. --- ## WKC § 10 — Liability for compensation {#10} *N.Y. Workers' Comp. Law § 10* Official source: _NYS Open Legislation, revision of 2025-06-06._ § 10. Liability for compensation. 1. Every employer subject to this chapter shall in accordance with this chapter, except as otherwise provided in section twenty-five-a hereof, secure compensation to his employees and pay or provide compensation for their disability or death from injury arising out of and in the course of the employment without regard to fault as a cause of the injury, except that there shall be no liability for compensation under this chapter when the injury has been solely occasioned by intoxication from alcohol or a controlled substance of the injured employee while on duty; or by wilful intention of the injured employee to bring about the injury or death of himself or another; or where the injury was sustained in or caused by voluntary participation in an off-duty athletic activity not constituting part of the employee's work related duties unless the employer (a) requires the employee to participate in such activity, (b) compensates the employee for participating in such activity or (c) otherwise sponsors the activity. 2. Notwithstanding any other provisions of this chapter, an injury incurred by an individual currently employed as an emergency medical technician or an advanced emergency medical technician who is certified pursuant to section three thousand two of the public health law, while voluntarily and without expectation of monetary compensation rendering medical assistance at the scene of an accident shall be deemed to have arisen out of and in the course of the employment with that emergency medical technician or advanced emergency medical technician's current employer. 3. (a) Notwithstanding any other provisions of this chapter, where a public safety worker, including but not limited to a firefighter, emergency medical technician, police officer, correction officer, civilian employee of the department of corrections and community supervision or other person employed by the state to work within a correctional facility maintained by the department of corrections and community supervision, driver and medical observer, in the course of performing his or her duties, is exposed to the blood or other bodily fluids of another individual or individuals, the executive officer of the appropriate ambulance, fire or police district may authorize such public safety worker to obtain the care and treatment, including diagnosis, recommended medicine and other medical care needed to ascertain whether such individual was exposed to or contracted any communicable disease and such care and treatment shall be the responsibility of the insurance carrier of the appropriate ambulance, fire or police district or, if a public safety worker was not so exposed in the course of performing his or her duties for such a district, then such person shall be covered for the treatment provided for in this subdivision by the carrier of his or her employer when such person is acting in the scope of his or her employment. For the purpose of this subdivision, the term "public safety worker" shall include persons who act for payment or who act as volunteers in an organized group such as a rescue squad, police department, correctional facility, ambulance corps, fire department, or fire company. (b) Where a police officer or firefighter subject to section thirty of this article, or emergency medical technician, paramedic, or other person certified to provide medical care in emergencies, or emergency dispatcher files a claim for mental injury premised upon extraordinary work-related stress incurred in a work-related emergency, the board may not disallow the claim upon a factual finding that the stress was not greater than that which usually occurs in the normal work environment. (c) The board may not disallow a claim by a covered employee upon a factual finding that the stress was not greater than that which usually occurs in the normal work environment where a claim for post-traumatic stress disorder (PTSD), acute stress disorder or major depressive disorder resulting from work-related stress is filed upon submission of medical evidence based on the criteria contained in the version of the Diagnostic and Statistical Manual of Mental Disorders in effect on the date of accident, or as otherwise adopted by the board, provided that such adoption shall be no more stringent than the current or immediately preceding version of the Diagnostic and Statistical Manual of Mental Disorders. Such covered employee must demonstrate that such disorder arose out of extraordinary work-related stress attributable to a distinct work-related event or events directly related to the employment and occurring during the performance of the employee's job duties. (d) Nothing in paragraphs (b) and (c) of this subdivision shall apply to a claim for mental injury due to a work-related physical injury. 4. Any person incarcerated upon conviction of a felony shall be deemed ineligible for all benefits provided under this chapter. All those whose benefits have ceased by operation of this section, may apply to the board for benefits upon their release from custody pursuant to regulation of the board. --- ## WKC § 11 — Alternative remedy {#11} *N.Y. Workers' Comp. Law § 11* Official source: _NYS Open Legislation, revision of 2023-01-06._ § 11. Alternative remedy. 1. The liability of an employer prescribed by the last preceding section shall be exclusive and in place of any other liability whatsoever, to such employee, his or her personal representatives, spouse, parents, dependents, distributees, or any person otherwise entitled to recover damages, contribution or indemnity, at common law or otherwise, on account of such injury or death or liability arising therefrom, except that if an employer fails to secure the payment of compensation for his or her injured employees and their dependents as provided in section fifty of this chapter, an injured employee, or his or her legal representative in case of death results from the injury, may, at his or her option, elect to claim compensation under this chapter, or to maintain an action in the courts for damages on account of such injury; and in such an action it shall not be necessary to plead or prove freedom from contributory negligence nor may the defendant plead as a defense that the injury was caused by the negligence of a fellow servant nor that the employee assumed the risk of his or her employment, nor that the injury was due to the contributory negligence of the employee. The liability under this chapter of The New York Jockey Injury Compensation Fund, Inc. created under section two hundred twenty-one of the racing, pari-mutuel wagering and breeding law shall be limited to the provision of workers' compensation coverage to jockeys, apprentice jockeys, exercise persons, and at the election of the New York Jockey Injury Compensation Fund, Inc., with the approval of the New York state gaming commission, employees of licensed trainers or owners licensed under article two or four of the racing, pari-mutuel wagering and breeding law and any statutory penalties resulting from the failure to provide such coverage. For purposes of this section the terms "indemnity" and "contribution" shall not include a claim or cause of action for contribution or indemnification based upon a provision in a written contract entered into prior to the accident or occurrence by which the employer had expressly agreed to contribution to or indemnification of the claimant or person asserting the cause of action for the type of loss suffered. An employer shall not be liable for contribution or indemnity to any third person based upon liability for injuries sustained by an employee acting within the scope of his or her employment for such employer unless such third person proves through competent medical evidence that such employee has sustained a "grave injury" which shall mean only one or more of the following: death, permanent and total loss of use or amputation of an arm, leg, hand or foot, loss of multiple fingers, loss of multiple toes, paraplegia or quadriplegia, total and permanent blindness, total and permanent deafness, loss of nose, loss of ear, permanent and severe facial disfigurement, loss of an index finger or an acquired injury to the brain caused by an external physical force resulting in permanent total disability. For purposes of this section "person" means any individual, firm, company, partnership, corporation, joint venture, joint-stock association, association, trust or legal entity. The liability under this chapter of the New York black car operators' injury compensation fund, inc. shall be limited to: (i) securing the payment of workers' compensation in accordance with article six-F of the executive law to black car operators, as defined in such article, whose injury arose out of and in the course of providing services for a central dispatch facility, as defined in such article, that is a registered member of such fund, and (ii) any statutory penalty resulting from the failure to secure such payment. The liability under this chapter of a central dispatch facility, as defined in article six-F of the executive law, that is a registered member of the New York black car operators' injury compensation fund, inc. that shall be limited to remaining a registered member in good standing of such fund and any statutory penalty, including loss of immunity provided by this section, resulting from the failure to become or remain a registered member in good standing of such fund, except, however, that such central dispatch facility shall be subject to the provisions of section one hundred thirty-one of this chapter and shall be liable for any payments for which it may become responsible pursuant to such section or pursuant to section fourteen-a of this article. The liability under this chapter of the New York independent livery driver benefit fund, inc. shall be limited to: (i) securing the payment of workers' compensation coverage to cover those matters required by article six-G of the executive law for independent livery drivers, as defined in such article, whose injury arose out of and in the course of providing covered services for a livery base, as defined in such article, that is a registered member of such fund, and (ii) any statutory penalty resulting from the failure to secure such payment. 2. Determination by the board shall not be given collateral estoppel effect in any other action or proceeding arising out of the same occurrence, other than the determination of the existence of an employer employee relationship. --- ## WKC § 12 — Compensation not allowed for first seven days {#12} *N.Y. Workers' Comp. Law § 12* Official source: _NYS Open Legislation, revision of 2014-09-22._ § 12. Compensation not allowed for first seven days. No compensation shall be allowed for the first seven days of disability, except the benefits provided for in section thirteen of this chapter, provided, however, that in case the injury results in disability of more than fourteen days, the compensation shall be allowed from the date of the disability. --- ## WKC § 13 — Treatment and care of injured employees {#13} *N.Y. Workers' Comp. Law § 13* Official source: _NYS Open Legislation, revision of 2016-06-17._ § 13. Treatment and care of injured employees. (a) The employer shall promptly provide for an injured employee such medical, dental, surgical, optometric or other attendance or treatment, nurse and hospital service, medicine, optometric services, crutches, eye-glasses, false teeth, artificial eyes, orthotics, prosthetic devices, functional assistive and adaptive devices and apparatus for such period as the nature of the injury or the process of recovery may require. The employer shall be liable for the payment of the expenses of medical, dental, surgical, optometric or other attendance or treatment, nurse and hospital service, medicine, optometric services, crutches, eye-glasses, false teeth, artificial eyes, orthotics, prosthetic devices, functional assistive and adaptive devices and apparatus, as well as artificial members of the body or other devices or appliances necessary in the first instance to replace, support or relieve a portion or part of the body resulting from and necessitated by the injury of an employee, for such period as the nature of the injury or the process of recovery may require, and the employer shall also be liable for replacements or repairs of such artificial members of the body or such other devices, eye-glasses, false teeth, artificial eyes, orthotics, prosthetic devices, functional assistive and adaptive devices or appliances necessitated by ordinary wear or loss or damage to a prosthesis, with or without bodily injury to the employee. Damage to or loss of a prosthetic device shall be deemed an injury except that no disability benefits shall be payable with respect to such injury under section fifteen of this article. Such a replacement or repair of artificial members of the body or such other devices, eye-glasses, false teeth, artificial eyes, orthotics, prosthetic devices, functional assistive and adaptive devices or appliances or the providing of medical treatment and care as defined herein shall not constitute the payment of compensation under section twenty-five-a of this article. All fees and other charges for such treatment and services shall be limited to such charges as prevail in the same community for similar treatment of injured persons of a like standard of living. The chair shall prepare and establish a schedule for the state, or schedules limited to defined localities, of charges and fees for such medical treatment and care, and including all medical, dental, surgical, optometric or other attendance or treatment, nurse and hospital service, medicine, optometric services, crutches, eye-glasses, false teeth, artificial eyes, orthotics, prosthetic devices, functional assistive and adaptive devices and apparatus in accordance with and to be subject to change pursuant to rules promulgated by the chair. Before preparing such schedule for the state or schedules for limited localities the chair shall request the president of the medical society of the state of New York and the president of the New York state osteopathic medical society to submit to him or her a report on the amount of remuneration deemed by such society to be fair and adequate for the types of medical care to be rendered under this chapter, but consideration shall be given to the view of other interested parties. In the case of physical therapy fees schedules the chair shall request the president of a recognized professional association representing physical therapists in the state of New York to submit to him or her a report on the amount of remuneration deemed by such association to be fair and reasonable for the type of physical therapy services rendered under this chapter, but consideration shall be given to the views of other interested parties. The chair shall also prepare and establish a schedule for the state, or schedules limited to defined localities, of charges and fees for outpatient hospital services not covered under the medical fee schedule previously referred to in this subdivision, to be determined in accordance with and to be subject to change pursuant to rules promulgated by the chair. Before preparing such schedule for the state or schedules for limited localities the chair shall request the president of the hospital association of New York state to submit to him or her a report on the amount of remuneration deemed by such association to be fair and adequate for the types of hospital outpatient care to be rendered under this chapter, but consideration shall be given to the views of other interested parties. In the case of occupational therapy fees schedules the chair shall request the president of a recognized professional association representing occupational therapists in the state of New York to submit to him or her a report on the amount of remuneration deemed by such association to be fair and reasonable for the type of occupational therapy services rendered under this chapter, but consideration shall be given to the views of other interested parties. The amounts payable by the employer for such treatment and services shall be the fees and charges established by such schedule. Nothing in this schedule, however, shall prevent voluntary payment of amounts higher or lower than the fees and charges fixed therein, but no physician rendering medical treatment or care, and no physical or occupational therapist rendering their respective physical or occupational therapy services may receive payment in any higher amount unless such increased amount has been authorized by the employer, or by decision as provided in section thirteen-g of this article. Nothing in this section shall be construed as preventing the employment of a duly authorized physician on a salary basis by an authorized compensation medical bureau or laboratory. (b) In the case of persons, injured outside of this state, but entitled to compensation or benefits under this chapter, the provisions as to selection of authorized physicians shall be inapplicable. In such cases the employer shall promptly provide all necessary medical treatment and care but if the employer fail to provide the same, after request by the injured employee such injured employee may do so at the expense of the employer. The employee shall not be entitled to recover any amount expended by him for such treatment or services unless he shall have requested the employer to furnish the same and the employer shall have refused or neglected to do so, or unless the nature of the injury required such treatment and services and the employer or his superintendent or foreman having knowledge of such injury shall have neglected to provide the same; nor shall any claim for medical or surgical treatment be valid and enforceable, as against such employer, unless within twenty days following the first treatment, the physician giving such treatment, furnish to the employer and the chairman a report of such injury and treatment, on a form prescribed by the chairman. The board may, however, by the unanimous vote of a panel of not less than three members qualified to act, excuse the failure to give such notice within twenty days when it finds it to be in the interest of justice to do so, and may, subject to the limitations contained in section twenty-eight of this chapter, make an award for the reasonable value of such medical or surgical treatment. All fees and other charges for such treatment and services, whether furnished by the employer or otherwise, shall be subject to regulation by the board as provided in section twenty-four of this chapter, and shall be limited to such charges as prevail in the same community for similar treatment of injured persons of a like standard of living. (c) The liability of an employer for medical treatment as herein provided shall not be affected by the fact that his employee was injured through the fault or negligence of a third party, not in the same employ. The employer shall, however, have an additional cause of action against such third party to recover any amounts paid by him for such medical treatment, in like manner as provided in section twenty-nine of this chapter. (d) (1) In the event that an insurer or health benefits plan makes payments for medical and/or hospital services for or on behalf of an injured employee they shall be entitled to be reimbursed for such payments by the carrier or employer within the limits of the medical and hospital fee schedules if the board determines that the claim is compensable. For the purposes of this section, an insurer or health benefits plan includes a medical expense indemnity corporation, a health or hospital service corporation, a commercial insurance company licensed to write accident and health insurance in the state of New York, a health maintenance organization operating in accordance with article forty-three of the insurance law or article forty-four of the public health law, or a self-insured or self-funded health care benefits plan operated by, or on behalf of, any business, municipality or other entity (including an employee welfare fund as defined in article forty-four of the insurance law or any other union trust fund or union health benefits plan). Notwithstanding any other provision of law, in no event shall the carrier or employer be required to reimburse the insurer or health benefits plan in an amount greater than the amount paid for medical and hospital services for or on behalf of the injured employer by such corporation or company; provided, however, if the carrier or employer does not reimburse the insurer or health benefits plan within thirty days after the board determines that the claim is compensable, the carrier or employer shall reimburse the insurer or health benefits plan at the amount the carrier or employer would be obligated to reimburse the hospital or other provider of medical services if the carrier or employer made payment directly to the provider of medical and/or hospital services pursuant to this chapter (or, in the case of inpatient hospital services, pursuant to paragraphs (b) and (b-1) of subdivision one of section twenty-eight hundred seven-c of the public health law). Upon reimbursement to the insurer or health benefits plan pursuant to this subdivision, the carrier or employer shall be relieved of liability for the medical and/or hospital services for which payment has been made by the insurer or health benefits plan. (2) An insurer or health benefits plan entitled to reimbursement pursuant to paragraph one of this subdivision shall receive copies of the hearing and decision notices and shall develop with the carrier or employer its own mechanisms and standard operating procedures for payment of undisputed claims for reimbursement. In cases of disputed claims for reimbursement that are filed with the board within three years of the date of payment for services rendered by the health care provider or within ninety days of the effective date of a chapter of the laws of nineteen hundred ninety-two, entitled "AN ACT to amend the workers' compensation law, in relation to reimbursement of insurers and health benefit plans", whichever is later, the sole remedy of the insurer or health benefit plan to recover on a claim arising pursuant to this subdivision shall be the submission of the controversy to mandatory arbitration or other alternative dispute resolution procedures as defined by rules and regulations promulgated by the chair in accordance with subdivision (h) of this section. (e) The board, on its own motion, or a referee, upon the recommendation of the compensation medical director for the board, hearing a claim for compensation may require examination of any claimant, or of the testimony, reports and exhibits, or both, by a physician especially qualified with respect to the diagnosis or treatment of the disability for which compensation is claimed; and may require a report from such physician on the diagnosis, the causal relationship between the alleged injury and subsequent disability or death, proper treatment, and the extent of the disability of such claimant. The employer or his or her insurance carrier shall pay for such examination in an amount to be directed by the chairman. The chairman may in his discretion designate physicians of outstanding qualifications in such fields of medicine as he deems essential in order to ascertain the diagnosis, the causal relationship between the alleged injury and subsequent disability, the type of medical care and operative procedure requisite in particular cases where such matters are not readily determinable by the regularly employed medical examiners of the board. Each of such physicians shall have had, prior to his or her designation, at least five years of practice in the field with respect to which he or she is designated, and shall receive a fee for each case, or shall be paid on a per diem basis, as determined by the chairman. Claimants maybe required to submit to examination by such physicians in the manner hereinbefore specified. The contents of reports of designated physicians when introduced in evidence shall constitute prima facie evidence of fact as to the matter contained therein, and the makers of such reports shall be subject to examination upon demand and shall be paid an additional fee, as determined by the chairman, for testifying in each case. (f) Copies of medical reports of claimant's attending physician or medical consultant, made pursuant to this chapter subsequent to the date of the request provided for in this subdivision and antedating not more than thirty days, shall be transmitted by the physician or consultant to the claimant's licensed representative or attorney representing the claimant before the board upon his written request therefor accompanied by a notice of his retainer and consent to such transmittal signed by the claimant. (g) Every hospital operating in the state shall, within twenty days of receiving a written request by a claimant, claimant's representative, employer, carrier or special fund created under this chapter, provide to such claimant, claimant's representative, employer, carrier or special fund for use in board proceedings the medical records of an employee who has received treatment in such hospital and who is claiming benefits under this chapter. Each hospital shall designate at least one officer or employee who shall be responsible for provision of such records on written request, and to whom the board, claimant, claimant's, employer, carrier representative or special fund may address informal inquiries regarding provision of such records. No hospital shall be required to produce the records of any claimant pursuant to this section without receiving the cost of copying such records as determined by the chair. Such cost shall be paid by the requesting party except that the employer or carrier or special fund shall reimburse a claimant or claimant's representative the cost of an initial set of such records where the request is made by a claimant or claimant's representative. Should the hospital not be able to provide the requested records within twenty days, they shall notify in writing the party requesting the records of the reason why the records were not provided and the date on which they will be provided. Such date shall be within a reasonable period of time, but shall not exceed thirty days. Failure to either provide the records within twenty days or to provide a reason why the records have not been provided shall subject the hospital to a fine of two hundred dollars which shall be imposed by the chair payable to the board upon finding that this subdivision has not been complied with. No hospital shall be required to produce the records of any claimant without receiving its customary fees or charges for reproduction of such records. (h) (1) The chair shall require the performance of computer searches to identify injured employees who, with respect to the same injury or illness, have filed claims under the provisions of this chapter and made claims to, or on their behalf with, a payor of medical payments eligible for reimbursement pursuant to this section. Such searches shall be done at least quarterly upon request of payors and upon submission to the board of computer tapes containing the information the chair shall need to identify injured employees who file dual claims under this section. At least quarterly, the chair shall identify injured employees who have filed dual claims by social security number and workers' compensation board number and shall notify the payor of such results. (2) Such payor shall use the information of dual filings solely for the purpose of reimbursement from the carrier or employer. The chair, upon a finding that such entity has used the information for purposes other than reimbursement from the carrier or employer, may, after hearing, impose a penalty of not more than ten thousand dollars and may prohibit such entity from receiving information under this subdivision for up to three years. (3) The chair shall adopt rules and regulations to carry out the provisions of this section, which rules and regulations shall provide for alternative dispute resolution procedures for settlement of disputed claims for reimbursement under subdivision (d) of this section including but not limited to referral and submission of disputed claims to mandatory arbitration with private arbitration associations. Such rules and regulations may provide for a reasonable fee to be charged to payors for computer searches. Claims for computer searches submitted to the board prior to March thirty-first, nineteen hundred ninety-two, may be submitted with a payment date on or after April first, nineteen hundred eighty-eight. Claims for reimbursement submitted after March thirty-first, nineteen hundred ninety-two, shall have a payment date that is no later than three years prior to the date of submission of the claim for matching purposes to the board. If disputed, these claims shall be resolved through the dispute resolution procedures set forth in this section. Upon resolution of the reimbursement dispute in accordance with this section, the amount paid to the prevailing party shall be increased by the amount of any fee paid to the arbitrator or incurred by reason of any other alternate dispute resolution procedure. (i) (1) When a claimant or pharmacy submits a claim to the employer or its carrier for payment of prescribed medicine or for reimbursement of the cost of prescribed medicine which the employer is required to provide under this section, the employer or carrier shall pay the amount prescribed by the fee schedule adopted under section thirteen-o of this article, or if the prescribed medicine is not included on the current fee schedule, the usual and customary charges for such prescribed medicine, within forty-five days of receipt of the claim, unless the liability of the employer or carrier on the claim for which the claimant seeks payment or reimbursement of payment for the prescribed medicine is not established, or the prescribed medicine is not for a causally related condition. (2) Where the liability of the employer or carrier on the claim for which the claimant seeks payment or reimbursement of payment for the prescribed medicine or reimbursement for payment of prescribed medicine is not established, or is not for a causally related condition, the employer or carrier shall pay any undisputed portion of the claim in accordance with this section and notify the claimant or pharmacy, as appropriate, in writing within forty-five days of receipt of the claim: (i) that the claim is not being paid and explaining the reasons for nonpayment; or (ii) to request all additional information reasonably needed to determine the employer's or carrier's liability for the claim. Upon receipt of the information requested in this subparagraph, the employer or carrier shall comply with paragraph one of this subdivision. (3) Each claim for payment of prescribed medicine or reimbursement for payment of prescribed medicine that is processed in violation of this section shall constitute a separate violation. In addition to the other penalties provided in this chapter, any employer or carrier that fails to reimburse the claimant or pay the pharmacy, as appropriate and as required in this section shall be obligated to pay to the claimant or pharmacy the amount prescribed on the fee schedule adopted under section thirteen-o of this article, or if the prescribed medicine is not included on the current fee schedule, the usual and customary charges for the prescribed medicine plus simple interest at the rate set forth in section five thousand four of the civil practice law and rules. (4) Nothing in this subdivision shall prohibit employers or carriers from agreeing to or arranging for direct billing by the pharmacy to the employer or carrier for the cost of prescribed medicine, in order for claimants to more promptly receive prescribed medicine for which employers and carriers are liable under this section. (5) Notwithstanding any other provision of this chapter, if an employer or carrier has contracted with a pharmacy to provide prescribed medicine to claimants, then such employer or carrier may require claimants to obtain all prescribed medicines from the pharmacy with which it has contracted, except if a medical emergency occurs and it would not be reasonably possible to obtain immediately required prescribed medicine from the pharmacy with which the employer or carrier has a contract. An employer or carrier that requires claimants to obtain prescribed medicines from a pharmacy with which it has a contract must notify claimants of the pharmacy or pharmacies with which it has a contract, the locations and addresses of the pharmacy or pharmacies, if applicable, how to initially fill and refill prescriptions through the mail, internet, telephone or other means, and any other required information that must be supplied to the pharmacy or pharmacies. If the pharmacy or pharmacies with which the employer or carrier contracts does not offer mail order service and does not have a physical location within a reasonable distance from the claimant, as defined by regulation of the board, the claimant may obtain prescribed medicines at the pharmacy or pharmacies of his or her choice and the employer or carrier will be liable for such charges in accordance with the fee schedule prescribed in section thirteen-o of this chapter. --- ## WKC § 13-A — Selection of authorized physician by employee {#13-A} *N.Y. Workers' Comp. Law § 13-A* Official source: _NYS Open Legislation, revision of 2026-05-29._ * § 13-a. Selection of authorized physician by employee. (1) An injured employee may, when care is required, select to treat him or her any physician authorized by the chair to render medical care, as hereafter provided. If for any reason during the period when medical treatment and care is required, the employee wishes to transfer his or her treatment and care to another authorized physician, he or she may do so, in accordance with rules prescribed by the chair. In such instance the remuneration of the physician whose services are being dispensed with shall be limited to the value of treatment rendered at fees as established in the schedule for his or her location, unless payment in higher amounts has been approved as authorized in section thirteen, paragraph a. If a claimant shall receive treatment in any hospital or other institution operated in whole or in part by the state of New York, the employer shall be liable for food, clothing and maintenance furnished by the hospital or other institution to such employee. If the employee is unable due to the nature of the injury to select such authorized physician and the emergency nature of the injury requires immediate medical treatment and care, or if he or she does not desire to select a physician, and in writing so advises the employer, the employer shall promptly provide him or her with the necessary medical care, provided however, that nothing herein contained shall operate to prevent such employee, when subsequently able to do so, from selecting for continuance of any medical treatment or care required, any physician authorized by the chair to render medical care as hereinafter provided. (2) The chairman shall prescribe the form of a notice informing employees of their privilege under this chapter, and such notice shall be posted and maintained by the employer in a conspicuous place or places in and about his place or places of business. (3) The employer shall have the right to transfer the care of an injured employee from the attending physician, whether chosen originally by the employee or by the employer, to another authorized physician (1) if the interest of the injured employee necessitates the transfer or (2) if the physician has not been authorized to treat injured employees under this act or (3) if he has not been authorized under this act to treat the particular injury or condition as provided by section thirteen-b (2). An authorized physician from whom the case has been transferred shall have the right of appeal to an arbitration committee as provided in subdivision two of section thirteen-g and if said arbitration committee finds that the transfer was not authorized by this section, said employer shall pay to the physician a sum equal to the total fee earned by the physician to whom the care of the injured employee has been transferred, or such proportion of said fee as the arbitration committee shall deem adequate. (4) (a) No claim for medical or surgical treatment shall be valid and enforceable, as against such employer, or employee, unless within forty-eight hours following the first treatment the physician giving such treatment furnishes to the employer and directly to the chair a preliminary notice of such injury and treatment, within fifteen days thereafter a more complete report and subsequent thereto progress reports if requested in writing by the chair, board, employer or insurance carrier at intervals of not less than three weeks apart or at less frequent intervals if requested on forms prescribed by the chair. The board may excuse failure to give such notices within the designated periods when it finds it to be in the interest of justice to do so. (b) Upon receipt of the notice provided for by paragraph (a) of this subdivision, the employer, the carrier, and the claimant each shall be entitled to have the claimant examined by a physician authorized by the chair in accordance with sections thirteen-b and one hundred thirty-seven of this chapter, at a medical facility convenient to the claimant and in the presence of the claimant's physician, and refusal by the claimant to submit to such independent medical examination at such time or times as may reasonably be necessary in the opinion of the board, shall bar the claimant from recovering compensation for any period during which he or she has refused to submit to such examination. No hospital shall be required to produce the records of any claimant without receiving its customary fees or charges for reproduction of such records. (c) Where it would place an unreasonable burden upon the employer or carrier to arrange for, or for the claimant to attend, an independent medical examination by an authorized physician, the employer or carrier shall arrange for such examination to be performed by a qualified physician in a medical facility convenient to the claimant. (d) The independent medical examiner shall provide such reports and shall submit to investigation as required by the chair. (e) In order to qualify as admissible medical evidence, for purposes of adjudicating any claim under this chapter, any report submitted to the board by an independent medical examiner licensed by the state of New York shall include the following: (i) a signed statement certifying that the report is a full and truthful representation of the independent medical examiner's professional opinion with respect to the claimant's condition: (ii) such examiner's board issued authorization number; (iii) the name of the individual or entity requesting the examination; (iv) if applicable, the registration number as required by section thirteen-n of this article; and (v) such other information as the chair may require by regulation. Any report by an independent medical examiner who is not authorized, and who performs an independent medical examination in accordance with paragraph (c) of this subdivision, which is to be used as medical evidence under this chapter, shall include in the report such information as the chair may require by regulation. (5) No claim for specialist consultations, surgical operations, physiotherapeutic or occupational therapy procedures, x-ray examinations or special diagnostic laboratory tests costing more than one thousand dollars shall be valid and enforceable, as against such employer, unless such special services shall have been authorized by the employer or by the board, or unless such authorization has been unreasonably withheld, or withheld for a period of more than thirty calendar days from receipt of a request for authorization, or unless such special services are required in an emergency, provided, however, that the basis for a denial of such authorization by the employer must be based on a conflicting second opinion rendered by a physician authorized by the board. The board, with the approval of the superintendent of financial services, shall issue and maintain a list of pre-authorized procedures under this section. Such list of pre-authorized procedures shall be issued and maintained for the purpose of expediting authorization of treatment of injured workers. Such list of pre-authorized procedures shall not prohibit varied treatment when the treating provider demonstrates the appropriateness and medical necessity of such treatment. (6) (a) Any interference by any person with the selection by an injured employee of an authorized physician to treat him, except when the selection is made pursuant to article ten-A of this chapter, and the improper influencing or attempt by any person improperly to influence the medical opinion of any physician who has treated or examined an injured employee, shall be a misdemeanor; provided, however, that it shall not constitute interference or improper influence if, in the presence of such injured employee's physician, an employer, his carrier or agent should recommend or provide information concerning rehabilitation services or the availability thereof to an injured employee or his family. (b) Except as otherwise permitted by law, an employer, carrier, or third-party administrator shall not interfere or attempt to interfere with the selection by an injured employee of, or treatment by, an authorized medical provider, including by directing or attempting to direct that the injured employee seek treatment from a specific provider or type of provider selected by the employer, carrier, or third-party administrator. It shall not constitute improper interference under this paragraph if the direction or attempt to direct the injured employee to receive treatment from a specific provider or type of provider originates from the authorized medical provider while in the course of providing treatment to the injured employee. (i) Notwithstanding any other provision in this chapter, the chair shall by regulation establish a performance standard concerning the subject of any penalty imposed under this paragraph against an employer, carrier or third-party administrator. The performance standard established by the chair shall be used to measure compliance with this paragraph by employers, carriers and third-party administrators. The chair shall apply the performance standard based on multiple factors, including but not limited to, findings of improper interference submitted as complaints to the board's monitoring unit, unreasonable objections to medical care, unwarranted objections to variances, medical billing disputes, case delays brought about by employers, carriers and third-party administrators, and the unreasonable denial of medical care. (ii) Upon validating an allegation that the employer, carrier or third-party administrator has failed to meet the promulgated performance standard, a penalty shall be assessed by the board upon notice to the employer, carrier or third-party administrator. The board shall impose such penalty against the carrier, employer or third-party administrator in the amount of fifty dollars per violation identified in subparagraph (i) of this paragraph. The penalties for violations identified in subparagraph (i) of this paragraph, may be aggregated into a single penalty upon a finding that an employer, carrier or third-party administrator has interfered with an injured employee's necessary medical treatment and care. Such aggregate penalty or assessment shall be based upon the number of violations as multiplied against the applicable penalty or assessment, but may be negotiated by the chair's designee in full satisfaction of the penalty or assessment. Any aggregate penalty or assessment issued under this paragraph shall be issued administratively, and the chair shall, by regulation, specify the method of review or redetermination, and the presentment of evidence and objections shall occur solely upon the documentation. Any final determination shall be subject to review under section twenty-three of this article but penalties may not be subject to a stay. A final determination that an employer, carrier or third-party administrator has engaged in a pattern of interference with an injured worker's access to medically necessary medical care shall result in the imposition of an aggregate penalty and publication of notice of such finding on the board's web page. (7)(a) Notwithstanding any other provision of this chapter to the contrary, any insurance carrier authorized to transact the business of workers' compensation insurance in this state, self-insurer or the state insurance fund may contract with a network or networks, legally and properly organized, to perform diagnostic tests, x-ray examinations, magnetic resonance imaging, or other radiological examinations or tests of claimants and may require claimant to obtain or undergo such diagnostic test, x-ray examinations, magnetic resonance imaging or other radiological examinations or tests with a provider or at a facility that is affiliated with the network or networks with which the carrier contracts, except if a medical emergency occurs requiring an immediate diagnostic test, x-ray examination, magnetic resonance imaging or other radiological examination or test or if the network with which the insurance carrier, self-insurer or the state insurance fund contracts does not have a provider or facility able to perform the examination or test within a reasonable distance from the claimant's residence or place of employment, as defined by regulation of the board. (b) Any insurance carrier, self-insurer or the state insurance fund which requires claimants to obtain or undergo diagnostic tests, x-ray examinations, magnetic resonance imaging or other radiological examinations or tests with a provider or at a facility affiliated with a network or networks with which it contracts, must notify the claimant of the name and contact information for the network or networks at the same time the written statement of the claimant's rights as required by subdivision two of section one hundred ten of this chapter or immediately after imposing such requirement if the time period within which the written statement of the claimant's rights as required by subdivision two of section one hundred ten of this chapter has expired. (c) At the time a request for authorization for special diagnostic tests, x-ray examinations, magnetic resonance imaging or other radiological examinations or tests costing more than one thousand dollars as required by subdivision five of this section is approved, the insurance carrier, self-insurer or state insurance fund, or if so delegated the network with which the insurance carrier, self-insurer or state insurance fund has contracted, shall notify the physician requesting authorization of the requirement that the claimant obtain or undergo the special diagnostic test, x-ray examination, magnetic resonance imaging or other radiological examination or test with a provider or at a facility affiliated with the network or networks with which it has contracted, the contact information for the network and a list of the providers and facilities within the claimant's geographic location, as defined by regulation of the board. The claimant, in consultation with the provider who requested the special diagnostic test, x-ray examination, magnetic resonance imaging or other radiological test or exam, will determine the provider or facility from within the network which will perform such diagnostic test, x-ray examination, magnetic resonance imaging or other radiological examination or test. (d) The results of the special diagnostic test, x-ray examination, magnetic resonance imaging or other radiological test or exam must be sent to the physician who requested the test or exam immediately upon completion of the report detailing the results. * NB Effective until January 1, 2028 * § 13-a. Selection of authorized provider by employee. (1) An injured employee may, when care is required, select to treat with any provider authorized by the chair to render medical care or treatment, as hereafter provided. If for any reason during the period when medical care or treatment is required, the employee wishes to transfer their medical care or treatment to another authorized provider, they may do so, in accordance with rules prescribed by the chair. In such instance the remuneration of the provider whose services are being dispensed with shall be limited to the value of treatment rendered at fees as established in the schedule for their location, unless payment in higher amounts has been approved as authorized in subdivision a of section thirteen of this article. If a claimant shall receive treatment in any hospital or other institution operated in whole or in part by the state of New York, the employer shall be liable for food, clothing and maintenance furnished by the hospital or other institution to such employee. If the employee is unable due to the nature of the injury to select such authorized provider and the emergency nature of the injury requires immediate medical treatment and care, or if they do not desire to select a provider, and in writing so advises the employer, the employer shall promptly provide the employee with the necessary medical care or treatment, provided however, that nothing herein contained shall operate to prevent such employee, when subsequently able to do so, from selecting for continuance of any medical care or treatment required, any provider authorized by the chair to render medical care or treatment as hereinafter provided. (2) The chair shall prescribe the form of a notice informing employees of their privilege under this chapter, and such notice shall be posted and maintained by the employer in a conspicuous place or places in and about their place or places of business. (3) The employer shall have the right to transfer the care of an injured employee from the attending physician, whether chosen originally by the employee or by the employer, to another authorized physician (1) if the interest of the injured employee necessitates the transfer or (2) if the physician has not been authorized to treat injured employees under this act or (3) if the physician has not been authorized under this act to treat the particular injury or condition as provided by section thirteen-b (2). An authorized physician from whom the case has been transferred shall have the right of appeal to an arbitration committee as provided in subdivision two of section thirteen-g of this article and if said arbitration committee finds that the transfer was not authorized by this section, said employer shall pay to the physician a sum equal to the total fee earned by the physician to whom the care of the injured employee has been transferred, or such proportion of said fee as the arbitration committee shall deem adequate. (4) (a) No claim for medical or surgical treatment shall be valid and enforceable, as against such employer, or employee, unless within forty-eight hours following the first treatment the provider giving such treatment furnishes to the employer and directly to the chair a preliminary notice of such injury and treatment, within fifteen days thereafter a more complete report and subsequent thereto progress reports if requested in writing by the chair, board, employer or insurance carrier at intervals of not less than three weeks apart or at less frequent intervals if requested on forms prescribed by the chair. The board may excuse failure to give such notices within the designated periods when it finds it to be in the interest of justice to do so. A provider's reports or records shall be considered as evidence in support of a claim notwithstanding the provider's compliance with the foregoing time frames. (b) Upon receipt of the notice provided for by paragraph (a) of this subdivision, the employer, the carrier, and the claimant each shall be entitled to have the claimant examined by a provider authorized by the chair to perform independent medical examinations in accordance with sections thirteen-b and one hundred thirty-seven of this chapter, at a medical facility convenient to the claimant and in the presence of the claimant's provider, and refusal by the claimant to submit to such independent medical examination at such time or times as may reasonably be necessary in the opinion of the board, shall bar the claimant from recovering compensation for any period during which they have refused to submit to such examination. No hospital shall be required to produce the records of any claimant without receiving its customary fees or charges for reproduction of such records. (c) Where it would place an unreasonable burden upon the employer or carrier to arrange for, or for the claimant to attend, an independent medical examination by an authorized provider, the employer or carrier shall arrange for such examination to be performed by a qualified provider in a medical facility convenient to the claimant. (d) The independent medical examiner shall provide such reports and shall submit to investigation as required by the chair. (e) In order to qualify as admissible medical evidence, for purposes of adjudicating any claim under this chapter, any report submitted to the board by an independent medical examiner licensed by the state of New York shall include the following: (i) a signed statement certifying that the report is a full and truthful representation of the independent medical examiner's professional opinion with respect to the claimant's condition: (ii) such examiner's board issued authorization number; (iii) the name of the individual or entity requesting the examination; (iv) if applicable, the registration number as required by section thirteen-n of this article; and (v) such other information as the chair may require by regulation. Any report by an independent medical examiner who is not authorized, and who performs an independent medical examination in accordance with paragraph (c) of this subdivision, which is to be used as medical evidence under this chapter, shall include in the report such information as the chair may require by regulation. (5) No claim for specialist consultations, surgical operations, physiotherapeutic or occupational therapy procedures, x-ray examinations or special diagnostic laboratory tests costing more than one thousand five hundred dollars shall be valid and enforceable, as against such employer, unless such special services shall have been authorized by the employer or by the board, or unless such authorization has been unreasonably withheld, or withheld for a period of more than thirty calendar days from receipt of a request for authorization, or unless such special services are required in an emergency, provided, however, that the basis for a denial of such authorization by the employer must be based on a conflicting second opinion rendered by a physician authorized by the board. The board, with the approval of the superintendent of financial services, shall issue and maintain a list of pre-authorized procedures under this section. Such list of pre-authorized procedures shall be issued and maintained for the purpose of expediting authorization of treatment of injured workers. Such list of pre-authorized procedures shall not prohibit varied treatment when the treating provider demonstrates the appropriateness and medical necessity of such treatment. (6) (a) Any interference by any person with the selection by an injured employee of an authorized provider to treat such employee, except when the selection is made pursuant to article ten-A of this chapter, and the improper influencing or attempt by any person improperly to influence the medical opinion of any provider who has treated or examined an injured employee, shall be a misdemeanor; provided, however, that it shall not constitute interference or improper influence if, in the presence of such injured employee's provider, an employer, carrier or agent should recommend or provide information concerning rehabilitation services or the availability thereof to an injured employee or the employee's family. It shall not be presumed that a claimant's attorney or representative's communication with the injured employee's treating provider was an attempt to improperly influence the treating provider. The mere fact that a claimant's attorney or representative and their treating provider have communicated shall not support a finding of improper influence. The board may diminish or preclude the opinion of a treating provider based on improper influence only upon a determination that, due to the interference, the opinion will not help the board understand the evidence or determine a fact in issue. (b) Except as otherwise permitted by law, an employer, carrier, or third-party administrator shall not interfere or attempt to interfere with the selection by an injured employee of, or treatment by, an authorized provider, including by directing or attempting to direct that the injured employee seek treatment from a specific provider or type of provider selected by the employer, carrier, or third-party administrator. It shall not constitute improper interference under this paragraph if the direction or attempt to direct the injured employee to receive treatment from a specific provider or type of provider originates from the employee's authorized provider while in the course of providing treatment to the injured employee. (i) Notwithstanding any other provision in this chapter, the chair shall by regulation establish a performance standard concerning the subject of any penalty imposed under this paragraph against an employer, carrier or third-party administrator. The performance standard established by the chair shall be used to measure compliance with this paragraph by employers, carriers and third-party administrators. The chair shall apply the performance standard based on multiple factors, including but not limited to, findings of improper interference submitted as complaints to the board's monitoring unit, unreasonable objections to medical care or treatment, unwarranted objections to variances, medical billing disputes, case delays brought about by employers, carriers and third-party administrators, and the unreasonable denial of medical care or treatment. (ii) Upon validating an allegation that the employer, carrier or third-party administrator has failed to meet the promulgated performance standard, a penalty shall be assessed by the board upon notice to the employer, carrier or third-party administrator. The board shall impose such penalty against the carrier, employer or third-party administrator in the amount of fifty dollars per violation identified in subparagraph (i) of this paragraph. The penalties for violations identified in subparagraph (i) of this paragraph, may be aggregated into a single penalty upon a finding that an employer, carrier or third-party administrator has interfered with an injured employee's necessary medical care or treatment. Such aggregate penalty or assessment shall be based upon the number of violations as multiplied against the applicable penalty or assessment, but may be negotiated by the chair's designee in full satisfaction of the penalty or assessment. Any aggregate penalty or assessment issued under this paragraph shall be issued administratively, and the chair shall, by regulation, specify the method of review or redetermination, and the presentment of evidence and objections shall occur solely upon the documentation. Any final determination shall be subject to review under section twenty-three of this article but penalties may not be subject to a stay. A final determination that an employer, carrier or third-party administrator has engaged in a pattern of interference with an injured worker's access to medically necessary medical care or treatment shall result in the imposition of an aggregate penalty and publication of notice of such finding on the board's web page. (7)(a) Notwithstanding any other provision of this chapter to the contrary, any insurance carrier authorized to transact the business of workers' compensation insurance in this state, self-insurer or the state insurance fund may contract with a network or networks, legally and properly organized, to perform diagnostic tests, x-ray examinations, magnetic resonance imaging, or other radiological examinations or tests of claimants and may require claimant to obtain or undergo such diagnostic test, x-ray examinations, magnetic resonance imaging or other radiological examinations or tests with a provider or at a facility that is affiliated with the network or networks with which the carrier contracts, except if a medical emergency occurs requiring an immediate diagnostic test, x-ray examination, magnetic resonance imaging or other radiological examination or test or if the network with which the insurance carrier, self-insurer or the state insurance fund contracts does not have a provider or facility able to perform the examination or test within a reasonable distance from the claimant's residence or place of employment, as defined by regulation of the board. (b) Any insurance carrier, self-insurer or the state insurance fund which requires claimants to obtain or undergo diagnostic tests, x-ray examinations, magnetic resonance imaging or other radiological examinations or tests with a provider or at a facility affiliated with a network or networks with which it contracts, must notify the claimant of the name and contact information for the network or networks at the same time the written statement of the claimant's rights as required by subdivision two of section one hundred ten of this chapter or immediately after imposing such requirement if the time period within which the written statement of the claimant's rights as required by subdivision two of section one hundred ten of this chapter has expired. (c) At the time a request for authorization for special diagnostic tests, x-ray examinations, magnetic resonance imaging or other radiological examinations or tests costing more than one thousand five hundred dollars as required by subdivision five of this section is approved, the insurance carrier, self-insurer or state insurance fund, or if so delegated the network with which the insurance carrier, self-insurer or state insurance fund has contracted, shall notify the provider requesting authorization of the requirement that the claimant obtain or undergo the special diagnostic test, x-ray examination, magnetic resonance imaging or other radiological examination or test with a provider or at a facility affiliated with the network or networks with which it has contracted, the contact information for the network and a list of the providers and facilities within the claimant's geographic location, as defined by regulation of the board. The claimant, in consultation with the provider who requested the special diagnostic test, x-ray examination, magnetic resonance imaging or other radiological test or exam, will determine the provider or facility from within the network which will perform such diagnostic test, x-ray examination, magnetic resonance imaging or other radiological examination or test. (d) The results of the special diagnostic test, x-ray examination, magnetic resonance imaging or other radiological test or exam must be sent to the provider who requested the test or exam immediately upon completion of the report detailing the results. * NB Effective January 1, 2028 --- ## WKC § 13-AA — Medical appeals unit {#13-AA} *N.Y. Workers' Comp. Law § 13-AA* Official source: _NYS Open Legislation, revision of 2014-09-22._ § 13-aa. Medical appeals unit. 1. There is hereby created a medical appeals unit. Such medical appeals unit shall consist of three physicians licensed to practice in this state and known to represent the schools of medical practice eligible to practice under this chapter. The members of the medical appeals units shall be appointed by the governor: provided that the members of the medical appeals unit of the industrial council heretofore appointed and in office at the time this section takes effect shall be and they are hereby constituted members of the medical appeals unit hereby created, and they shall continue in office as such until July first, nineteen hundred fifty-four. The members next appointed shall be appointed as follows: one for term expiring December thirty-first, nineteen hundred fifty-five; one for term expiring December thirty-first, nineteen hundred fifty-six; and one for term expiring December thirty-first, nineteen hundred fifty-seven. The members thereafter appointed, except to fill a vacancy created otherwise than by expiration of term, shall be appointed for terms of three years each. The governor may remove any member of the medical appeals unit when such member ceases to be licensed to practice. The chairman shall designate an employee of the board to act as secretary of the medical appeals unit. 2. Members of the medical appeals unit shall be entitled to compensation at a rate not exceeding one hundred fifty dollars per day for each day actually spent in the performance of their duties under this chapter, but no member shall be entitled to compensation for such duties in excess of seven thousand five hundred dollars during any year. They shall also be paid their reasonable and necessary traveling and other expenses while engaged in the performance of their duties. 3. The medical appeals unit shall (a) consider all matters connected with the practice of medicine submitted to it by the workmen's compensation board or the chairman thereof; (b) prescribe rules and regulations to govern the procedure of investigations and hearings by the medical societies or boards of charges against authorized physicians and licensed compensation medical bureaus, laboratories and bureaus engaged in x-ray diagnosis or treatment, in clinical diagnosis or in physiotherapy or other therapeutic procedures, as provided in section thirteen-d and thirteen-e of this chapter; (c) review, upon request, charges made by a physician, compensation medical bureau or laboratory or bureau engaged in x-ray diagnosis or treatment, in clinical diagnosis, or in physiotherapy or other therapeutic procedures, that any medical society or board has improperly refused to recommend authorization of the physician, compensation medical bureau or laboratory or bureau to do compensation work, and if it sustain the charges, recommend such authorization to the chairman; (d) review, upon request, charges made by a physician, compensation medical bureau or laboratory or bureau engaged in x-ray diagnosis or treatment, in clinical diagnosis, or in physiotherapy or other therapeutic procedures, that any medical society or board has improperly recommended that his or its authorization to do compensation work be revoked, and if it sustain the charges, recommend to the chairman that such authorization not be revoked. In each case arising under this subdivision the medical appeals unit may re-open the matter and receive further evidence, and its decision and recommendation shall be advisory to the chairman and shall not be binding or conclusive upon him. 4. The medical appeals unit shall adopt rules and regulations to govern its own proceedings. The secretary of the medical appeals unit shall keep a complete record of all the proceedings of the unit which shall show the names of the members present at each meeting and every matter considered and the action taken thereon. Such records shall be filed in the office of the secretary of the board. 5. The provisions of sections nineteen-a and nineteen-b of this chapter limiting and restricting professional activities of physicians or surgeons in the employ of the board shall also be applicable to and binding upon members of the medical appeals unit. 6. For the purpose of exercising the powers and performing the duties set forth in this section, the medical appeals unit created hereunder shall be deemed to be a continuation of the medical appeals unit of the industrial council of the department of labor; and all proceedings pending before the medical appeals unit of the industrial council of the department of labor, are hereby transferred to the medical appeals unit without prejudice to the rights of any party to such proceeding. The medical appeals unit, subject to the provisions of this chapter, shall succeed to all the rights, powers, duties and obligations of the medical appeals unit of the industrial council, insofar as they relate to workmen's compensation. Wherever the term "medical appeals unit of the industrial council" appears in this chapter or in the rules or regulations promulgated thereunder, it shall be construed to mean the medical appeals unit created hereunder. --- ## WKC § 13-B — Authorization of providers, medical bureaus and laboratories by the chair {#13-B} *N.Y. Workers' Comp. Law § 13-B* Official source: _NYS Open Legislation, revision of 2026-05-29._ * § 13-b. Authorization of providers, medical bureaus and laboratories by the chair. 1. No person shall render medical care or conduct independent medical examinations under this chapter without such authorization by the chair. As used in this title, the following definitions shall have the following meanings unless their context requires otherwise: (a) "Acupuncturist" shall mean licensed as having completed a formal course of study and having passed an examination in accordance with the education law, the regulations of the commissioner of education, and the requirements of the board of regents. Acupuncturists are required by the education law to advise, in writing, each patient of the importance of consulting with a physician for the condition or conditions necessitating acupuncture care, as prescribed by the education law. (b) "Chair" of the board shall mean either the chair or the chair's designee. (c) "Chiropractor" shall mean licensed and having completed two years of preprofessional college study and a four-year resident program in chiropractic in accordance with the education law, and consistent with the licensing requirements of the commissioner of education. (d) "Dentist" shall mean licensed and having completed a four-year course of study leading to a D.D.S. or D.D.M. degree, or an equivalent degree, in accordance with the education law and the licensing requirements of the commissioner of education. (e) "Employer" shall mean a self-insured employer or, if insured, the insurance carrier. (f) "Independent medical examination" shall mean an examination performed by a physician, podiatrist, chiropractor or psychologist, authorized under this section to perform such examination, for the purpose of examining or evaluating injury or illness pursuant to paragraph (b) of subdivision four of section thirteen-a and section one hundred thirty-seven of this chapter and as more fully set forth in regulation. (g) "Nurse practitioner" shall mean a licensed registered professional nurse certified pursuant to section sixty-nine hundred ten of the education law acting within their lawful scope of practice. (h) "Occupational therapist" shall mean licensed as having at least a bachelor's or master's degree in occupational therapy from a registered program with the education department or receipt of a diploma or degree resulting from completion of not less than four years of postsecondary study, which includes the professional study of occupational therapy in accordance with the education law and the regulations of the commissioner of education. (i) "Physical therapist" shall mean licensed in accordance with the education law and the licensing requirements of the commissioner of education. (j) "Physician" shall mean licensed with a degree of doctor of medicine, M.D., or doctor of osteopathic medicine, D.O., or an equivalent degree in accordance with the education law and the licensing requirements of the state board of medicine and the regulations of the commissioner of education. (k) "Physician assistant" shall mean a licensed provider who is licensed as a physician assistant pursuant to section sixty-five hundred forty-one of the education law. (l) "Podiatrist" shall mean a doctor of podiatric medicine licensed as having received a doctoral degree in podiatric medicine in accordance with the regulations of the commissioner of education and the education law, and must satisfactorily meet all other requirements of the state board for podiatric medicine. (m) "Provider" shall mean a duly licensed acupuncturist, chiropractor, nurse practitioner, occupational therapist, physical therapist, physician, physician assistant, podiatrist, psychologist, or social worker authorized by the chair. (n) "Psychologist" shall mean licensed as having received a doctoral degree in psychology from a program of psychology registered with the state education department or the substantial equivalent thereof in accordance with the education law, the requirements of the state board for psychology, and the regulations of the commissioner of education. (o) "Social worker" shall mean a licensed clinical social worker. A licensed clinical social worker has completed a master's degree of social work that includes completion of a core curriculum of at least twelve credit hours of clinical courses or the equivalent post-graduate clinical coursework, in accordance with the education law and the regulations of the commissioner of education. (p) "Physical therapist assistant" shall mean licensed in accordance with the education law and the licensing requirements of the commissioner of education. (q) "Occupational therapy assistant" shall mean licensed in accordance with the education law and the licensing requirements of the commissioner of education. 2. Any provider licensed pursuant to the education law to provide medical care and treatment in the state of New York may render emergency care and treatment in an emergency hospital or urgent care setting providing emergency treatment under this chapter without authorization by the chair under this section; (a) Such licensed provider as identified in this subdivision who is on staff at any hospital or urgent care center providing emergency treatment may continue such medical care under this chapter while an injured employee remains a patient in such hospital or urgent care setting; and (b) Under the direct supervision of an authorized provider, medical care may be rendered by a registered nurse or other person trained in laboratory or diagnostic techniques within the scope of such person's specialized training and qualifications. This supervision shall be evidenced by signed records of instructions for treatment and signed records of the patient's condition and progress. Reports of such treatment and supervision shall be made by such provider to the chair in the format prescribed by the chair at such times as the chair may require. (b-1) Under the direction and supervision of an authorized occupational therapist, occupational therapy services may be rendered by an occupational therapy assistant. Under the direction and supervision of an authorized physical therapist, physical therapy services may be rendered by a physical therapist assistant. Where any such care or treatment is rendered, records of the patient's condition and progress, together with records of instruction for treatment, if any, shall be maintained by the physical therapist or occupational therapist and by the referring physician, physician assistant, podiatrist, or nurse practitioner. Said records shall be submitted to the chair on forms and at such times as the chair may require. (b-2) Under the supervision of any authorized provider, any resident or fellow who may practice medicine as an exempt person as provided for in title eight of the education law, may render medical care under this chapter so long as the supervisory requirements of the education law are met and neither the supervising provider nor resident or fellow have been prohibited from treating workers' compensation claimants pursuant to section thirteen-d of this article. (c) Where it would place an unreasonable burden upon the employer or carrier to arrange for, or for the claimant to attend, an independent medical examination by an authorized provider, the employer or carrier shall arrange for such examination to be performed by a qualified provider in a medical facility convenient to the claimant. (d) Upon the prescription or referral of an authorized physician, physician assistant, podiatrist, or nurse practitioner acting within the scope of his or her practice, care or treatment may be rendered to an injured employee by an authorized physical therapist, occupational therapist or acupuncturist provided the conditions and the treatment performed are among the conditions that the physical therapist, occupational therapist or acupuncturist is authorized to treat pursuant to the education law or the regulations of the commissioner of education. Where any such care or treatment is rendered, records of the patient's condition and progress, together with records of instruction for treatment, if any, shall be maintained by the physical therapist, occupational therapist or acupuncturist rendering treatment and by the referring physician, physician assistant, podiatrist, or nurse practitioner. Said records shall be submitted to the chair on forms and at such times as the chair may require. (e) A record, report or opinion of a physical therapist, occupational therapist, acupuncturist or physician assistant shall not be considered as evidence of the causal relationship of any condition to a work related accident or occupational disease under this chapter. Nor may a record, report or opinion of a physical therapist, occupational therapist or acupuncturist be considered evidence of disability. Nor may a record, report or opinion of a physician assistant be considered evidence of the presence of a permanent or initial disability or the degree thereof. (f) An independent medical examination performed in accordance with section one hundred thirty-seven of this chapter, may only be performed by a physician, podiatrist, chiropractor or psychologist authorized to perform such examinations by the chair, or as specified in regulation, when qualified by the board. 3. A provider properly licensed or certified pursuant to the regulations of the commissioner of education and the requirements of the education law desirous of being authorized to render medical care under this chapter and/or to conduct independent medical examinations in accordance with paragraph (b) of subdivision four of section thirteen-a and section one hundred thirty-seven of this chapter shall file an application for authorization under this chapter with the chair or chair's designee. Prior to receiving authorization, a physician must, together with submission of an application to the chair, submit such application to the medical society of the county in which the physician's office is located or of a board designated by such county society or of a board representing duly licensed physicians of any other school of medical practice in such county, and such medical society shall submit the recommendation to the board. In the event such county society or board fails to take action upon a physician's completed and signed application within forty-five days, the chair may complete review of the application without such approval. Upon approval of the application by the chair or the chair's designee, the applicant shall further agree to refrain from subsequently treating for remuneration, as a private patient, any person seeking medical treatment, or submitting to an independent medical examination, in connection with, or as a result of, any injury compensable under this chapter, if he or she has been removed from the list of providers authorized to render medical care or to conduct independent medical examinations under this chapter, or if the person seeking such treatment, or submitting to an independent medical examination, has been transferred from his or her care in accordance with the provisions of this chapter. This agreement shall run to the benefit of the injured person so treated or examined, and shall be available to him or her as a defense in any action by such provider for payment for treatment rendered by a provider after he or she has been removed from the list of providers authorized to render medical care or to conduct independent medical examinations under this chapter, or after the injured person was transferred from his or her care in accordance with the provisions of this chapter. 4. Laboratories and bureaus engaged in x-ray diagnosis or treatment or in physiotherapy or other therapeutic procedures and which participate in the diagnosis or treatment of injured workers under this chapter shall be operated or supervised by providers authorized under this chapter and shall be subject to the provisions of section thirteen-c of this article. The person in charge of diagnostic clinical laboratories duly authorized under this chapter shall possess the qualifications established by the public health and health planning council for approval by the state commissioner of health or, in the city of New York, the qualifications approved by the board of health of said city and shall maintain the standards of work required for such approval. * NB Effective until January 1, 2028 * § 13-b. Authorization of providers, medical bureaus and laboratories by the chair. 1. Any provider as defined in paragraph (m) of this subdivision shall be authorized to render medical care or treatment under this chapter. Independent medical examinations may only be performed by a physician, podiatrist, chiropractor, or psychologist authorized to perform such examinations by the chair, or as specified in regulations. No provider may conduct independent medical examinations unless performed in accordance with paragraph (b) of subdivision four of section thirteen-a and section one hundred thirty-seven of this chapter. As used in this chapter, the following definitions shall have the following meanings unless their context requires otherwise: (a) "Acupuncturist" shall mean licensed as having completed a formal course of study and having passed an examination in accordance with the education law, the regulations of the commissioner of education, and the requirements of the board of regents. Acupuncturists are required by the education law to advise, in writing, each patient of the importance of consulting with a physician for the condition or conditions necessitating acupuncture care, as prescribed by the education law. (b) "Chair" of the board shall mean either the chair or the chair's designee. (c) "Chiropractor" shall mean licensed and having completed two years of preprofessional college study and a four-year resident program in chiropractic in accordance with the education law, and consistent with the licensing requirements of the commissioner of education. (d) "Dentist" shall mean licensed and having completed a four-year course of study leading to a D.D.S. or D.D.M. degree, or an equivalent degree, in accordance with the education law and the licensing requirements of the commissioner of education. (e) "Employer" shall mean a self-insured employer or, if insured, the insurance carrier. (f) "Independent medical examination" shall mean an examination performed by a physician, podiatrist, chiropractor or psychologist, authorized under this section to perform such examination, for the purpose of examining or evaluating injury or illness in accordance with paragraph (b) of subdivision four of section thirteen-a and section one hundred thirty-seven of this chapter and as more fully set forth in regulation. (g) "Nurse practitioner" shall mean a licensed registered professional nurse certified pursuant to section sixty-nine hundred ten of the education law acting within their lawful scope of practice. (h) "Occupational therapist" shall mean licensed as having at least a bachelor's or master's degree in occupational therapy from a registered program with the education department or receipt of a diploma or degree resulting from completion of not less than four years of postsecondary study, which includes the professional study of occupational therapy in accordance with the education law and the regulations of the commissioner of education. (i) "Physical therapist" shall mean licensed in accordance with the education law and the licensing requirements of the commissioner of education. (j) "Physician" shall mean licensed with a degree of doctor of medicine, M.D., or doctor of osteopathic medicine, D.O., or an equivalent degree in accordance with the education law and the licensing requirements of the state board of medicine and the regulations of the commissioner of education. (k) "Physician assistant" shall mean a licensed provider who is licensed as a physician assistant pursuant to section sixty-five hundred forty-one of the education law. (l) "Podiatrist" shall mean a doctor of podiatric medicine licensed as having received a doctoral degree in podiatric medicine in accordance with the regulations of the commissioner of education and the education law, and must satisfactorily meet all other requirements of the state board for podiatric medicine. (m) "Authorized provider" or "provider" shall mean a duly licensed acupuncturist, chiropractor, nurse practitioner, occupational therapist, physical therapist, physician, physician assistant, podiatrist, psychologist, or social worker as defined in this section who is not currently on the exclusion list pursuant to section thirteen-d of this article. (n) "Psychologist" shall mean licensed as having received a doctoral degree in psychology from a program of psychology registered with the state education department or the substantial equivalent thereof in accordance with the education law, the requirements of the state board for psychology, and the regulations of the commissioner of education. (o) "Social worker" shall mean a licensed clinical social worker. A licensed clinical social worker has completed a master's degree of social work that includes completion of a core curriculum of at least twelve credit hours of clinical courses or the equivalent post-graduate clinical coursework, in accordance with the education law and the regulations of the commissioner of education. (p) "Physical therapist assistant" shall mean licensed in accordance with the education law and the licensing requirements of the commissioner of education. (q) "Occupational therapy assistant" shall mean licensed in accordance with the education law and the licensing requirements of the commissioner of education. (r) "Exclusion list" shall mean the list published and maintained by the chair in accordance with section thirteen-d of this article listing providers who are currently disqualified from rendering care or from performing independent medical examinations under this chapter. 2. Any provider rendering medical care or treatment under this chapter must comply with all applicable laws, regulations and guidance, including any applicable New York Medical Treatment Guidelines and the Official New York Medical Fee Schedule(s). (a) Such provider as identified in this subdivision who is on staff at any hospital or urgent care center providing emergency treatment may continue such medical care or treatment under this chapter while an injured employee remains a patient in such hospital or urgent care setting. (b) Under the direct supervision of an authorized provider, medical care may be rendered by a registered nurse or other person trained in laboratory or diagnostic techniques within the scope of such person's specialized training and qualifications. This supervision shall be evidenced by signed records of instructions for treatment and signed records of the patient's condition and progress. Reports of such treatment and supervision shall be made by such provider to the chair in the format prescribed by the chair at such times as the chair may require. (b-1) Under the direction and supervision of an authorized occupational therapist, occupational therapy services may be rendered by an occupational therapy assistant. Under the direction and supervision of an authorized physical therapist, physical therapy services may be rendered by a physical therapist assistant. Where any such care or treatment is rendered, records of the patient's condition and progress, together with records of instruction for treatment, if any, shall be maintained by the physical therapist or occupational therapist and by the referring physician, physician assistant, podiatrist, or nurse practitioner. Said records shall be submitted to the chair on forms and at such times as the chair may require. (b-2) Under the supervision of any authorized provider, any resident or fellow who may practice medicine as an exempt person as provided for in title eight of the education law, may render medical care or treatment under this chapter so long as the supervisory requirements of the education law are met and neither the supervising provider nor resident or fellow have been prohibited from treating workers' compensation claimants pursuant to section thirteen-d of this article. (c) Where it would place an unreasonable burden upon the employer or carrier to arrange for, or for the claimant to attend, an independent medical examination by a provider authorized to perform independent medical examinations in accordance with paragraph (b) of subdivision four of section thirteen-a of this article and section one hundred thirty-seven of this chapter, the employer or carrier shall arrange for such examination to be performed by a qualified provider in a medical facility convenient to the claimant. (d) Upon the prescription or referral of a physician, physician assistant, podiatrist, or nurse practitioner who is not currently on the exclusion list pursuant to section thirteen-d of this article acting within the scope of their practice, medical care or treatment may be rendered to an injured employee by a physical therapist, occupational therapist or acupuncturist who is not currently on the exclusion list pursuant to section thirteen-d of this article provided the conditions and the treatment performed are among the conditions that the physical therapist, occupational therapist or acupuncturist is authorized to treat pursuant to the education law or the regulations of the commissioner of education. Where any such medical care or treatment is rendered, records of the patient's condition and progress, together with records of instruction for treatment, if any, shall be maintained by the physical therapist, occupational therapist or acupuncturist rendering treatment and by the referring physician, physician assistant, podiatrist, or nurse practitioner. Said records shall be submitted to the chair on forms and at such times as the chair may require. (e) A record, report or opinion of a physical therapist, occupational therapist, acupuncturist or physician assistant shall not be considered as evidence of the causal relationship of any condition to a work related accident or occupational disease under this chapter. Nor may a record, report or opinion of a physical therapist, occupational therapist or acupuncturist be considered evidence of disability. Nor may a record, report or opinion of a physician assistant be considered evidence of the presence of a permanent or initial disability or the degree thereof. (f) An independent medical examination performed in accordance with section one hundred thirty-seven of this chapter, may only be performed by a physician, podiatrist, chiropractor or psychologist authorized to perform such examinations by the chair, or as specified in regulation, when qualified by the board. 3. In order to perform independent medical examinations in accordance with paragraph (b) of subdivision four of section thirteen-a and section one hundred thirty-seven of this chapter, a physician, podiatrist, chiropractor, or psychologist properly licensed or certified pursuant to the regulations of the commissioner of education and the requirements of the education law shall file an application for authorization under this chapter with the chair or chair's designee in the format prescribed by the chair. 4. Laboratories and bureaus engaged in x-ray diagnosis or treatment or in physiotherapy or other therapeutic procedures and which participate in the diagnosis or treatment of injured workers under this chapter shall be operated or supervised by providers authorized under this chapter and shall be subject to the provisions of section thirteen-c of this article. The person in charge of diagnostic clinical laboratories duly authorized under this chapter shall possess the qualifications established by the public health and health planning council for approval by the state commissioner of health or, in the city of New York, the qualifications approved by the board of health of said city and shall maintain the standards of work required for such approval. * NB Effective January 1, 2028 --- ## WKC § 13-C — Licensing of compensation medical bureaus and laboratories {#13-C} *N.Y. Workers' Comp. Law § 13-C* Official source: _NYS Open Legislation, revision of 2015-04-24._ § 13-c. Licensing of compensation medical bureaus and laboratories. 1. The chairman may, upon the recommendation of the medical society of the county or of a board as provided in section thirteen-b, authorize and license compensation medical bureaus in such counties operated by qualified physicians wholly or principally for the diagnosis and treatment of industrial injuries or illnesses in respect to which they are authorized to render medical care under this chapter. The chairman, however, shall not authorize or license more than two such bureaus operated by the same physician. The chairman may, upon the recommendation of the medical society of the county or of a board as provided in section thirteen-b, authorize and license separate laboratories and bureaus engaged in X-ray diagnosis or treatment and clinical diagnosis, or in physiotherapy or other therapeutic procedures, which participate in the diagnosis or treatment of injured workmen under this chapter. The chairman, however, shall not authorize or license more than two such laboratories or bureaus operated by the same physician. Application for such authorization shall be made on forms to be furnished by the chairman, and shall disclose in full the nature of the personnel and equipment of such bureaus. If within sixty days after such application has been filed the medical society or board refuses or fails to act or refuses to recommend to the chairman that such license be granted, the applicant may appeal to the medical appeals unit. Each such bureau or laboratory which receives such authorization shall: (a) Make reports on its personnel and equipment in such form and at such times as may be required by the chairman; and (b) Be subject to inspection by the chairman or the medical society of the county in which such bureau or laboratory is located; and 2. No claim for services in connection with x-ray examination, diagnosis or treatment of any claimant shall be valid or enforceable except by a laboratory or bureau of a voluntary hospital authorized and licensed under subdivision one of this section, or except by a physician duly authorized as a roentgenologist by the chairman for services performed by such physician or under his immediate supervision. 3. (a) The chairman may authorize a medical center, jointly operated by labor and management representatives as a non-profit corporation or as a non-profit benefit trust, approved by and under the supervision of the New York state department of health, to provide medical, surgical, dental, optometric, podiatric, or other attendance or treatment, including X-ray diagnosis or treatment, physiotherapy or other therapeutic procedures or services, laboratory services and any and all other services required to be provided for an injured employee under section thirteen of this chapter, entitled "Treatment and care of injured employees". (b) Application for such authorization shall be made on forms to be furnished by the chairman, and shall disclose in full the nature of the personnel and equipment of such medical center. Each such medical center which receives such authorization shall: (i) Make reports on its personnel and equipment in such form and at such times as may be required by the chairman; (ii) Be subject to inspection by the chairman; (c) All treatment and services provided hereunder shall be provided on an out-patient basis to employees, who are claimants for workmen's compensation, eligible to use the medical center pursuant to an agreement, plan, deed of trust or labor-management collective bargaining agreement. (d) (i) A physician rendering medical care at a medical center authorized hereunder must be authorized to render such care pursuant to this chapter and he shall limit his professional activities hereunder to such medical care as his experience and training qualify him to render. (ii) When para-medical, laboratory or X-ray services or other medical care is required it shall be rendered, under the active and personal supervision of an authorized physician, by a registered nurse or other person trained in laboratory or diagnostic techniques within the scope of such person's specialized training and qualifications. This supervision shall be evidenced by signed records of instructions for treatment and signed records of the patient's condition and progress. Reports of such treatment and supervision shall be made by such physician to the chairman on such forms and at such times as the chairman may require. (iii) When physical therapy care is required it shall be rendered by a duly licensed physical therapist upon the referral which may be directive as to treatment of an authorized physician or podiatrist within the scope of such physical therapist's specialized training and qualifications as defined in article one hundred thirty-six of the education law. Reports of such treatment and records of instruction for treatment, if any, shall be maintained by the physical therapist and referring professional and submitted to the chairman on such forms and at such times as the chairman may require. (iv) When occupational therapy care is required it shall be rendered by a duly licensed and registered occupational therapist upon the prescription or referral of an authorized physician within the scope of such occupational therapist's specialized training and qualifications as defined in article one hundred fifty-six of the education law. Reports of such treatment and records of instruction for treatment, if any, shall be maintained by the occupational therapist and referring professional and submitted to the chairman on such forms and at such times as the chairman may require. (v) The physician rendering the medical care hereunder shall be in charge of the care unless, in his judgment, it is necessary to refer the case to a specially trained and qualified physician, which physician shall then assume complete responsibility for and supervision of any further medical care rendered. (e) Notwithstanding any provision of this chapter to the contrary, a medical center authorized by the chairman to render medical care and laboratory services under this section, is authorized and may charge for any and all services rendered in accordance with such schedule or schedules prepared and established by the chairman. (f) Nothing herein contained shall operate to prevent such employee from selecting for rendering or continuance of any medical treatment or care required, any physician authorized by the chairman to render medical care as hereinabove provided, in accordance with section thirteen-a, of this chapter. (g) The chairman shall have full power and authority and it shall be his duty to investigate instances of misconduct, or violations of the provisions of this chapter or violations of the rules promulgated by the chairman under the provisions of this chapter, or failure to submit full and truthful medical reports directly to the chairman within the time limits provided under subdivision four of section thirteen-a of this chapter; and, after a hearing, to temporarily suspend or revoke the license of any such medical center. The chairman may also temporarily suspend or revoke the license of any such medical center upon finding, after a hearing, that such medical center has been guilty of professional or other misconduct or that the personnel of such center is not properly qualified under this chapter or the equipment of such medical center is inadequate for the proper rendering of medical care. (h) The chairman may adopt such reasonable rules and regulations for the authorization and continued supervision of medical centers under this section, as he may deem necessary and proper. 4. (a) The chairman may authorize a hospital as defined in article twenty-eight of the public health law or a health maintenance organization holding a valid certificate of authority issued pursuant to article forty-four of the public health law or operating under the provisions of article forty-three of the insurance law to provide out-patient medical care under this chapter. (b) Application for such authorization shall be made on forms to be furnished by the chairman, and shall disclose in full the nature of the personnel and equipment of such hospital or health maintenance organization. Each such hospital or health maintenance organization which receives such authorization shall: (i) Make reports on its personnel and equipment in such form and at such times as may be required by the chairman; and (ii) Be subject to inspection and investigation as provided hereunder. (c) All treatment and services provided hereunder shall be provided on an out-patient basis to workers' compensation claimants. (d) (i) A physician rendering medical care at a hospital or health maintenance organization authorized hereunder must be authorized to render such care pursuant to this chapter and he or she shall limit his or her professional activities hereunder to such medical care as his or her experience and training qualify him or her to render. The physician rendering the medical care shall sign and submit all forms and reports as the chairman may require. (ii) When para-medical, laboratory or X-ray services or other medical care is required it shall be rendered, under the active and personal supervision of an authorized physician, by a registered nurse or other person trained in laboratory or diagnostic techniques within the scope of such person's specialized training and qualifications. This supervision shall be evidenced by signed records of instructions for treatment and signed records of the patient's condition and progress. Reports of such treatment and supervision shall be made by such physician to the chairman on such forms and at such times as the chairman may require. (iii) When physical therapy care is required it shall be rendered by a duly licensed physical therapist upon the referral which may be directive as to treatment of an authorized physician or podiatrist within the scope of such physical therapist's specialized training and qualifications as defined in article one hundred thirty-six of the education law. Reports of such treatment and records of instruction for treatment, if any, shall be maintained by the physical therapist and referring professional and submitted to the chairman of such forms and at such times as the chairman may require. (iv) When occupational therapy care is required it shall be rendered by a duly licensed and registered occupational therapist upon the prescription or referral of an authorized physician within the scope of such occupational therapist's specialized training and qualifications as defined in article one hundred fifty-six of the education law. Reports of such treatment and records of instruction for treatment, if any, shall be maintained by the occupational therapist and referring professional and submitted to the chairman on such forms and at such times as the chairman may require. Reports of such treatment and supervision shall be made by such physician to the chairman on such forms and at such times as the chairman may require. (v) The physician rendering the medical care hereunder shall be in charge of the care unless, in his or her judgment, it is necessary to refer the case to a specially trained and qualified authorized physician, which physician shall then assume complete responsibility for and supervision of any further medical care rendered. (e) Notwithstanding any provision of this chapter to the contrary, a hospital or health maintenance organization authorized by the chairman to render medical care and laboratory services under this section, is authorized and may charge for any and all services rendered in accordance with such schedule or schedules prepared and established by the chairman. (f) Nothing herein contained shall operate to prevent such employee from selecting for rendering or continuance of any medical treatment or care required, any physician authorized by the chairman to render medical care as hereinabove provided, in accordance with section thirteen-a of this chapter. (g) (i) The department of health shall conduct inspections and investigations and make recommendations with respect to charges of professional or other misconduct or that the personnel of an authorized hospital or health maintenance organization are not properly qualified under this chapter or that the equipment of such hospital or health maintenance organization is inadequate for the proper rendering of medical care. After such inspection and investigation the department of health shall refer its report and recommendations to the chairman, who shall have full power and authority to temporarily suspend or revoke the authorization under this subdivision of any such hospital or health maintenance organization upon finding, after a hearing, that such hospital or health maintenance organization has been guilty of professional or other misconduct, or that the personnel of such hospital or health maintenance organization are not properly qualified under this chapter or the equipment of such hospital or health maintenance organization is inadequate for the proper rendering of medical care. The recommendations of the department of health shall be advisory to the chairman only and shall not be binding or conclusive upon him. (ii) The chairman shall have full power and authority and it shall be his duty to investigate violations of the provisions of this chapter or violations of the rules promulgated by the chairman under the provisions of this chapter, or failure to submit full and truthful medical reports directly to the chairman within the time limits provided under subdivision four of section thirteen-a of this article, and, after a hearing, to temporarily suspend or revoke the authorization under this subdivision of any such hospital or health maintenance organization. (h) The chairman may adopt such reasonable rules and regulations for the authorization and continued supervision of hospitals and health maintenance organizations under this section as he may deem necessary and proper. --- ## WKC § 13-D — Removal of providers from lists of those authorized to render medical care or to conduct independent medical examinations {#13-D} *N.Y. Workers' Comp. Law § 13-D* Official source: _NYS Open Legislation, revision of 2026-05-29._ * § 13-d. Removal of providers from lists of those authorized to render medical care or to conduct independent medical examinations. 1. The medical society of the county in which the physician's office is located at the time or a board designated by such county society or a board representing duly licensed physicians of any other school of medical practice in such county shall investigate, hear and make findings with respect to all charges as to professional or other misconduct of any authorized physician as herein provided under rules and procedure to be prescribed by the medical appeals unit, and shall report evidence of such misconduct, with their findings and recommendation with respect thereto, to the chair. Failure to commence such investigation within sixty days from the date the charges are referred to the society by the chair or submit findings and recommendations relating to the charges within one hundred eighty days from the date the charges are referred shall empower the chair to appoint, as a hearing officer, a member of the board, employee, or other qualified hearing officer to hear and report on the charges to the chair. A qualified hearing officer, who is neither a member of the board, or employee thereof shall be paid at a reasonable per diem rate to be fixed by the chair. Such investigation, hearing, findings, recommendation and report may be made by the society or board of an adjoining county upon the request of the medical society of the county in which the alleged misconduct or infraction of this chapter occurred, subject to the time limit and conditions set forth herein. The medical appeals unit shall review the findings and recommendation of such medical society or board, or hearing officer appointed by the chair upon application of the accused physician and may reopen the matter and receive further evidence. The findings, decision and recommendation of such society, board or hearing officer appointed by the chair or medical appeals unit shall be advisory to the chair only, and shall not be binding or conclusive upon him or her. 2. The chair shall remove from the list of providers authorized to render medical care under this chapter, or to conduct independent medical examinations in accordance with paragraph (b) of subdivision four of section thirteen-a of this article, the name of any provider who he or she shall find after reasonable investigation is disqualified because such provider: (a) has been guilty of professional or other misconduct or incompetency in connection with rendering medical services under the law; or (b) has exceeded the limits of his or her professional competence in rendering medical care or in conducting independent medical examinations under the law, or has made materially false statements regarding his or her qualifications in his or her application for the recommendation of the medical society or board as provided in section thirteen-b of this article; or (c) has failed to transmit copies of medical reports to claimant's attorney or licensed representative as provided in subdivision (f) of section thirteen of this article; or has failed to submit full and truthful medical reports of all his or her findings to the employer, and directly to the chair or the board within the time limits provided in subdivision four of section thirteen-a of this article with the exception of injuries which do not require (1) more than ordinary first aid or more than two treatments by a provider or person rendering first aid, or (2) loss of time from regular duties of one day beyond the working day or shift; or (d) knowingly made a false statement or representation as to a material fact in any medical report made pursuant to this chapter or in testifying or otherwise providing information for the purposes of this chapter; or (e) has solicited, or has employed another to solicit for himself or herself or for another, professional treatment, examination or care of an injured employee in connection with any claim under this chapter; or (f) has refused to appear before, to testify, to submit to a deposition, or to answer upon request of, the chair, board, medical appeals unit or any duly authorized officer of the state, any legal question, or to produce any relevant book or paper concerning his or her conduct under any authorization granted to him or her under this chapter; or (g) has directly or indirectly requested, received or participated in the division, transference, assignment, rebating, splitting or refunding of a fee for, or has directly or indirectly requested, received or profited by means of a credit or other valuable consideration as a commission, discount or gratuity in connection with the furnishing of medical or surgical care, an independent medical examination, diagnosis or treatment or service, including X-ray examination and treatment, or for or in connection with the sale, rental, supplying or furnishing of clinical laboratory services or supplies, X-ray laboratory services or supplies, inhalation therapy service or equipment, ambulance service, hospital or medical supplies, physiotherapy or other therapeutic service or equipment, artificial limbs, teeth or eyes, orthopedic or surgical appliances or supplies, optical appliances, supplies or equipment, devices for aid of hearing, drugs, medication or medical supplies, or any other goods, services or supplies prescribed for medical diagnosis, care or treatment, under this chapter; except that reasonable payment, not exceeding the technical component fee permitted in the medical fee schedule, established under this chapter for X-ray examinations, diagnosis or treatment, may be made by a provider duly authorized as a roentgenologist to any hospital furnishing facilities and equipment for such examination, diagnosis or treatment, provided such hospital does not also submit a charge for the same services. Nothing contained in this paragraph shall prohibit such providers who practice as partners, in groups or as a professional corporation or as a university faculty practice corporation from pooling fees and moneys received, either by the partnership, professional corporation, university faculty practice corporation or group by the individual members thereof, for professional services furnished by any individual professional member, or employee of such partnership, corporation or group, nor shall the professionals constituting the partnerships, corporations, or groups be prohibited from sharing, dividing or apportioning the fees and moneys received by them or by the partnership, corporation or group in accordance with a partnership or other agreement. 3. Any person who violates or attempts to violate, and any person who aids another to violate or attempts to induce him or her to violate the provisions of paragraph (g) of subdivision two of this section shall be guilty of a misdemeanor. 4. Nothing in this section shall be construed as limiting in any respect the power or duty of the chair to investigate instances of misconduct, either before or after investigation by a medical society or board as herein provided, or to temporarily suspend the authorization of any provider that he or she may believe to be guilty of such misconduct. 5. Whenever the department of health or the department of education shall conduct an investigation with respect to charges of professional or other misconduct by a provider which results in a report, determination or consent order that includes a finding of professional or other misconduct or incompetency by such provider, the chair shall have full power and authority to temporarily suspend, revoke or otherwise limit the authorization under this chapter of any provider upon such finding by the department of health or the department of education that the provider has been guilty of professional or other misconduct. The recommendations of the department of health or the department of education shall be advisory to the chair only and shall not be binding or conclusive upon the chair. * NB Effective until January 1, 2028 * § 13-d. Placement of providers on the exclusion list. 1. In accordance with this section, the chair shall publish and maintain an exclusion list of providers currently disqualified from rendering medical care or treatment under this chapter or disqualified from conducting independent medical examinations in accordance with paragraph (b) of subdivision four of section thirteen-a and section one hundred thirty-seven of this chapter. 2. The exclusion list shall include the name of any provider who is found after reasonable investigation to be disqualified because such provider: (a) has been guilty of professional or other misconduct or incompetency in connection with rendering medical services under the law; or (b) has exceeded the limits of their professional competence in rendering medical care or treatment or in conducting independent medical examinations under the law, or has, as applicable, made materially false statements regarding their qualifications in their application; or (c) has failed to transmit copies of medical reports to claimant's attorney or licensed representative as provided in subdivision (f) of section thirteen of this article; or has failed to submit full and truthful medical reports of all their findings to the employer, and directly to the chair or the board within the time limits provided in subdivision four of section thirteen-a of this article with the exception of injuries which do not require (1) more than ordinary first aid or more than two treatments by a provider or person rendering first aid, or (2) loss of time from regular duties of one day beyond the working day or shift; or (d) knowingly made a false statement or representation as to a material fact in any medical report, or in any submission to the board, made pursuant to this chapter or in testifying or otherwise providing information for the purposes of this chapter; or (e) has solicited, or has employed another to solicit for either the provider's own benefit themself or for another, professional treatment, examination or care of an injured employee in connection with any claim under this chapter; or (f) has refused to appear before, to testify, to submit to a deposition, or to answer upon request of, the chair, board, or any duly authorized officer of the state, any legal question, or to produce any relevant book or paper concerning their conduct in rendering medical care or treatment or in the performance of an independent medical examination under this chapter, including when a provider has accepted payments from both the health insurer and employer or carrier and failed to reimburse the health insurer after they are given notice; or (g) has directly or indirectly requested, received or participated in the division, transference, assignment, rebating, splitting or refunding of a fee for, or has directly or indirectly requested, received or profited by means of a credit or other valuable consideration as a commission, discount or gratuity in connection with the furnishing of medical or surgical care, an independent medical examination, diagnosis or treatment or service, including X-ray examination and treatment, or for or in connection with the sale, rental, supplying or furnishing of clinical laboratory services or supplies, X-ray laboratory services or supplies, inhalation therapy service or equipment, ambulance service, hospital or medical supplies, physiotherapy or other therapeutic service or equipment, artificial limbs, teeth or eyes, orthopedic or surgical appliances or supplies, optical appliances, supplies or equipment, devices for aid of hearing, drugs, medication or medical supplies, or any other goods, services or supplies prescribed for medical diagnosis, care or treatment, under this chapter; except that reasonable payment, not exceeding the technical component fee permitted in the medical fee schedule, established under this chapter for X-ray examinations, diagnosis or treatment, may be made by a provider duly authorized as a roentgenologist to any hospital furnishing facilities and equipment for such examination, diagnosis or treatment, provided such hospital does not also submit a charge for the same services. Nothing contained in this paragraph shall prohibit such providers who practice as partners, in groups or as a professional corporation or as a university faculty practice corporation from pooling fees and moneys received, either by the partnership, professional corporation, university faculty practice corporation or group by the individual members thereof, for professional services furnished by any individual professional member, or employee of such partnership, corporation or group, nor shall the professionals constituting the partnerships, corporations, or groups be prohibited from sharing, dividing or apportioning the fees and moneys received by them or by the partnership, corporation or group in accordance with a partnership or other agreement; or (h) has demonstrated a repeated failure to follow the laws of this chapter and applicable laws, regulations, and guidance, including any applicable New York medical treatment guidelines and the official New York medical fee schedule(s); or (i) has misrepresented their credentials; or (j) has failed to timely complete any trainings required by the chair; or (k) had previously lost the privilege to treat injured workers by being suspended, removed, denied authorization, or by voluntarily resigning their authorization under this chapter prior to January first, two thousand twenty-eight, and whose authorization had not been restored prior to January first, two thousand twenty-eight. 3. Any person who violates or attempts to violate, and any person who aids another to violate or attempts to induce them to violate the provisions of paragraph (g) of subdivision two of this section shall be guilty of a misdemeanor. 4. Nothing in this section shall be construed as limiting in any respect the power or duty of the chair to investigate instances of misconduct, either before or after investigation by a medical society or board as herein provided, or to add any provider to the exclusion list that the chair or the chair's designee may believe to be guilty of such misconduct. 5. Whenever the department of health or the department of education shall conduct an investigation with respect to charges of professional or other misconduct by a provider which results in a report, determination or consent order that includes a finding of professional or other misconduct or incompetency by such provider, the chair shall have full power and authority to add any provider to the exclusion list upon such finding by the department of health or the department of education that the provider has been guilty of professional or other misconduct. The recommendations of the department of health or the department of education shall be advisory to the chair only and shall not be binding or conclusive upon the chair. 6. The chair may promulgate regulations to effectuate the publication and maintenance of the exclusion list. Providers on the exclusion list may petition the board to be taken off the exclusion list in a format prescribed by the chair. * NB Effective January 1, 2028 --- ## WKC § 13-E — Revocation of licenses of compensation medical bureaus and laboratories {#13-E} *N.Y. Workers' Comp. Law § 13-E* Official source: _NYS Open Legislation, revision of 2014-09-22._ § 13-e. Revocation of licenses of compensation medical bureaus and laboratories. The chairman may revoke the license of any compensation medical bureau or laboratory upon a finding certified to him by the medical society of the county in which such bureau or laboratory is located, or by a board designated by such medical society or otherwise, as provided under section thirteen-b, or by the medical appeals unit, that such bureau or laboratory has been guilty of professional or other misconduct, or of violation of the provisions of this chapter, or that the personnel of such bureau is not properly qualified under this chapter, or that the equipment of such bureau or laboratory is inadequate for the proper rendering of medical care. The medical appeals unit may review the determination of such medical society or board, and on application of the compensation medical bureau or laboratory accused must do so, and may reopen the matter and receive further evidence. The decision and recommendation of the medical appeals unit shall be advisory to the chairman, and shall not be binding or conclusive upon him. The medical appeals unit shall prescribe the rules of procedure governing the investigation, hearing and determination of all charges of professional or other misconduct under this section. Nothing in this section shall be construed as limiting in any respect the power or duty of the chairman to investigate instances of misconduct, or violations of the provisions of this chapter, or violations of rules promulgated by the chairman under the provisions of this chapter, or failure to submit full and truthful medical reports directly to the chairman within the time limits provided under subdivision four of section thirteen-a of this chapter, either before or after investigation or hearing by a medical society or board, or review by the medical appeals unit as herein provided, and to temporarily suspend the license of any laboratory or medical bureau, or after a hearing to revoke the same. --- ## WKC § 13-F — Payment of medical fees {#13-F} *N.Y. Workers' Comp. Law § 13-F* Official source: _NYS Open Legislation, revision of 2026-05-29._ * § 13-f. Payment of medical fees. (1) Fees for medical services shall be payable only to a physician or other qualified person permitted by sections thirteen-b, thirteen-k, thirteen-l and thirteen-m of this chapter or other authorized provider of health care under the education law or the public health law permitted to render medical care or treatment under this chapter, or to the agent, executor or administrator of the estate of such physician or such other qualified person. Except as provided in section thirteen-d of this chapter, no provider of health care rendering medical care or treatment to a compensation claimant, shall collect or receive a fee from such claimant within this state, but shall have recourse for payment of services rendered only to the employer under the provisions of this chapter. Any compensation claimant who pays a fee to a provider of health care for medical care or treatment under this chapter shall have a cause of action against such provider of health care for the recovery of the money paid, which cause of action may be assigned to the chair in trust for the assigning claimant. All such assignments shall run to the chair. The chair may sue the physician, or other authorized provider of health care as herein described on the assigned cause of action with the benefits and subject to the provisions of existing law applying to such actions by the claimant himself or herself. Hospitals shall not be entitled to receive the remuneration paid to physicians on their staff for medical and surgical services. (2) Whenever his attendance at a hearing is required, the physician of the injured employee shall be entitled to receive a fee from the employer, or carrier, in an amount to be fixed by the board in addition to any fee payable under section eight thousand one of the civil practice law and rules. * NB Effective until January 1, 2028 * § 13-f. Payment of medical fees. (1) Fees for medical services shall be payable only to a provider permitted by section thirteen-b of this article or other authorized provider of health care under the education law or the public health law permitted to render medical care or treatment under this chapter, or to the agent, executor or administrator of the estate of such provider or such other qualified person. Except as provided in section thirteen-d of this article, no provider of health care rendering medical care or treatment to a compensation claimant, shall collect or receive a fee from such claimant within this state, but shall have recourse for payment of services rendered only to the employer under the provisions of this chapter. Any compensation claimant who pays a fee to a provider of health care for medical care or treatment under this chapter shall have a cause of action against such provider of health care for the recovery of the money paid, which cause of action may be assigned to the chair in trust for the assigning claimant. All such assignments shall run to the chair. The chair may sue the physician, or other authorized provider of health care as herein described on the assigned cause of action with the benefits and subject to the provisions of existing law applying to such actions by the claimant. Hospitals shall not be entitled to receive the remuneration paid to providers on their staff for medical and surgical services. (2) Whenever their attendance at a hearing is required, the provider of the injured employee shall be entitled to receive a fee from the employer, or carrier, in an amount to be fixed by the board in addition to any fee payable under section eight thousand one of the civil practice law and rules. * NB Effective January 1, 2028 --- ## WKC § 13-G — Payment of bills for medical care {#13-G} *N.Y. Workers' Comp. Law § 13-G* Official source: _NYS Open Legislation, revision of 2020-01-10._ § 13-g. Payment of bills for medical care. (1) Within forty-five days after a bill for medical care or supplies delivered pursuant to section thirteen of this article has been rendered to the employer, such employer must pay the bill or notify the medical care provider or supplier in the format prescribed by the chair that the bill is not being paid and explain the reasons for non-payment. In the event that the employer fails to make payment or notify the medical care provider or supplier within such forty-five day period that payment is not being made, the medical care provider or supplier may notify the board in the format prescribed by the chair that the bill has not been paid and request that the board make an award for payment of such bill. The board or the chair may make an award not in excess of the established fee schedules for any such bill or part thereof which remains unpaid after said forty-five day period or thirty days after all other questions duly and timely raised in accordance with the provisions of this chapter, relating to the employer's liability for the payment of such amount, shall have been finally determined adversely to the employer, whichever is later, in accordance with rules promulgated by the chair, and such award may be collected in like manner as an award of compensation. The chair shall assess the sum of fifty dollars against the employer for each such award made by the board, which sum shall be paid into the state treasury. In the event that the employer has provided an explanation in writing why the bill has not been paid, in part or in full, within the aforesaid time period, and the parties can not agree as to the value of medical aid rendered under this chapter, such value shall be decided by arbitration as set forth in rules and regulations promulgated by the chair. Where a bill for medical care or supplies has been determined to be due and owing in accordance with the provisions of this section the board shall include in the amount of the award interest of not more than one and one-half percent (1 1/2%) per month payable to the medical care provider or supplier, in accordance with the rules and regulations promulgated by the board. Interest shall be calculated from the forty-fifth day after the bill was rendered or from the thirtieth day after all other questions duly and timely raised in accordance with the provisions of this chapter, relating to the employer's liability for the payment of such amount, shall have been finally determined adversely to the employer, whichever is later, in accordance with rules promulgated by the chair. (2) If the parties fail to agree to the value of medical aid rendered under this chapter, such value shall be decided by a single arbitrator process, pursuant to rules promulgated by the chair. The chair shall appoint a physician who is a member in good standing of the medical society of the state of New York to determine the value of such disputed medical bill. Where the physician whose charges are being arbitrated is a member in good standing of the New York osteopathic society, the value of such disputed bill shall be determined by a member in good standing of the New York osteopathic society appointed by the chair. Where the physician whose charges are being arbitrated is a member in good standing of the New York homeopathic society, the value of such disputed bill shall be determined by a member in good standing of the New York homeopathic society appointed by the chair. Where the value of any other authorized provider's services are at issue, such value shall be determined by a member in good standing of one or more recognized professional associations representing its respective profession in the state of New York appointed by the chair. Decisions rendered under the single arbitrator process shall be conclusive upon the parties as to the value of the services in dispute. (3) A provider or supplier initiating a single arbitrator process, pursuant to this section shall not pay a fee to cover the costs related to the conduct of such arbitration. (4) In claims where the employer has failed to secure compensation to his employees as required by section fifty of this chapter, the board may make an award for the value of medical services, supplies or treatment rendered to such employees, in accordance with the schedules of fees and charges prepared and established under the provisions of this chapter. Such award shall be made to the medical care provider or supplier entitled thereto. A default in the payment of such award may be enforced in the manner provided for the enforcement of compensation awards as set forth in section twenty-six of this article. In all cases coming under this subdivision the payment of the claim for medical care or supplies shall be subordinate to that of the claimant or his or her beneficiaries. --- ## WKC § 13-H — Ombudsman for injured workers {#13-H} *N.Y. Workers' Comp. Law § 13-H* Official source: _NYS Open Legislation, revision of 2014-09-22._ § 13-h. Ombudsman for injured workers. 1. The office of ombudsman for injured workers is created within the workers' compensation board. The ombudsman shall report directly to the chair. The ombudsman shall act as an advocate for injured workers by accepting complaints concerning matters related to workers' compensation, investigating them and attempting to resolve them. The ombudsman shall also provide information to injured workers to enable them to protect their rights in the workers' compensation system. 2. The office of ombudsman for small business is created within the workers' compensation board. The ombudsman shall report directly to the chair. The ombudsman shall provide information and assistance to small businesses with regard to workers' compensation insurance and claim processing matters. --- ## WKC § 13-I — Solicitation prohibited {#13-I} *N.Y. Workers' Comp. Law § 13-I* Official source: _NYS Open Legislation, revision of 2014-09-22._ § 13-i. Solicitation prohibited. Any person who shall make it a business to solicit employment for any person authorized by this chapter to render medical care to an injured employee in connection with any claim under this chapter, shall be guilty of a misdemeanor, except that the employer shall have the right subject to regulations prescribed by the chairman, to recommend to the injured employee the names of enrolled physicians who he believes to be competent to treat him. --- ## WKC § 13-J — Medical or surgical treatment by insurance carriers and employers {#13-J} *N.Y. Workers' Comp. Law § 13-J* Official source: _NYS Open Legislation, revision of 2014-09-22._ § 13-j. Medical or surgical treatment by insurance carriers and employers. (1) An insurance carrier shall not participate in the treatment of injured workers, except as provided in paragraph five of subdivision (i) of section thirteen of this article and subdivision seven of section thirteen-a of this article and except, that it may employ medical inspectors to examine compensation cases periodically, while under treatment, and report upon the adequacy of medical care, and other matters relative to the medical conduct of the case, a copy of which report shall be filed directly with the chair within ten days, and that it may maintain rehabilitation bureaus operated by qualified physicians if authorized by the chair in accordance with section thirteen-c of this article. (2) An employer may maintain a compensation medical bureau at the place or places of employment, if such bureau is required because of the nature of the industrial hazards, or the frequency of injuries to employees arising out of industry. Such bureau or bureaus shall be authorized and licensed pursuant to section thirteen-c, and their use by an injured employee shall be optional in accordance with the provisions of section thirteen-a. --- ## WKC § 13-K — Care and treatment of injured employees by duly licensed podiatrists {#13-K} *N.Y. Workers' Comp. Law § 13-K* Official source: _NYS Open Legislation, revision of 2026-05-29._ * § 13-k. Care and treatment of injured employees by duly licensed podiatrists. 1. When the term "chairman" is hereinafter used, it shall be deemed to mean the chair of the workers' compensation board of the state of New York. 2. An employee injured under circumstances which make such injury compensable under this article, when care is required for an injury to the foot which injury or resultant condition therefrom may lawfully be treated by a duly registered and licensed podiatrist of the state of New York, may select to treat him or her any podiatrist authorized by the chair to render podiatric medical care, as hereinafter provided. If the injury or condition is one which is without the limits prescribed by the education law for podiatric medical care and treatment, or the injuries involved affect other parts of the body in addition to the foot, the said podiatrist must so advise the said injured employee and instruct him or her to consult a physician of said employee's choice for appropriate care and treatment. Such physician shall thenceforth have overall supervision of the treatment of said patient including the future treatment to be administered to the patient by the podiatrist. If for any reason during the period when podiatric medical treatment and care is required, the employee wishes to transfer his or her treatment and care to another authorized podiatrist he or she may do so, in accordance with rules prescribed by the chair, provided however that the employer shall be liable for the proper fees of the original podiatrist for the care and treatment he or she shall have rendered. The chair shall prepare and establish a schedule for the state, or schedules limited to defined localities, of charges and fees for podiatric medical treatment and care, to be determined in accordance with and to be subject to change pursuant to rules promulgated by the chair. Before preparing such schedule for the state or schedules for limited localities the chair shall request the podiatric medicine practice committee to submit to him or her a report on the amount of remuneration deemed by such committee to be fair and adequate for the types of podiatric medical care to be rendered under this chapter, but consideration shall be given to the view of other interested parties. The amounts payable by the employer for such treatment and services shall be the fees and charges established by such schedule. 3. (a) No claim for podiatry care or treatment shall be valid and enforceable as against the employer or employee unless within forty-eight hours following the first treatment the podiatrist giving such care or treatment furnish to the employer and directly to the chair a preliminary notice of such injury and treatment, within fifteen days thereafter a more complete report and subsequent thereto progress reports as requested in writing by the chair, board, employer or insurance carrier, at intervals of not less than three weeks apart or at less frequent intervals if requested on forms prescribed by the chair. The board may excuse the failure to give such notices within the designated periods when it finds it to be in the interest of justice to do so. (b) Upon receipt of the notice provided for by paragraph (a) of this subdivision, the employer, the carrier and the claimant each shall be entitled to have the claimant examined by a qualified podiatrist authorized by the chair in accordance with section thirteen-b and section one hundred thirty-seven of this chapter, at a medical facility convenient to the claimant and in the presence of the claimant's podiatrist, and refusal by the claimant to submit to such independent medical examination at such time or times as may reasonably be necessary in the opinion of the board shall bar the claimant from recovering compensation for any period during which he or she has refused to submit to such examination. (c) Where it would place an unreasonable burden upon the employer or carrier to arrange for, or for the claimant to attend, an independent medical examination by an authorized podiatrist, the employer or carrier shall arrange for such examination to be performed by a qualified podiatrist in a medical facility convenient to the claimant. (d) The independent podiatric examiner shall provide such reports and shall submit to investigation as required by the chair. (e) In order to qualify as admissible medical evidence, for purposes of adjudicating any claim under this chapter, any report submitted to the board by an independent podiatric examiner licensed by the state of New York shall include the following: (i) a signed statement certifying that the report is a full and truthful representation of the independent podiatric examiner's professional opinion with respect to the claimant's condition, (ii) such examiner's board issued authorization number, (iii) the name of the individual or entity requesting the examination, (iv) if applicable, the registration number as required by section thirteen-n of this article, and (v) such other information as the chair may require by regulation. 4. Fees for podiatry services shall be payable only to a duly authorized podiatrist as defined in this section or to the agent, executor or administrator of the estate of such podiatrist. No podiatrist rendering treatment to a compensation claimant, shall collect or receive a fee from such claimant within this state, but shall have recourse for payment of services rendered only to the employer under the provisions of this section. 5. Whenever his attendance at a hearing is required, the podiatrist of the injured employee shall be entitled to receive a fee from the employer in an amount to be fixed by the board, in addition to any fee payable under section eight thousand one of the civil practice law and rules. 6. (a) The provisions of subdivisions one and three of section thirteen-g of this article with respect to the conditions under which a hospital, physician or self-employed physical or occupational therapist may request payment or arbitration of a bill, or under which an award may be made for payment of such bill, shall be applicable to bills rendered by a podiatrist for services rendered to an injured employee. (b) If the parties fail to agree as to the value of podiatry care rendered under this chapter to a claimant, and the amount of the disputed bill is one thousand dollars or less, or where the amount of the disputed bill exceeds one thousand dollars and the podiatrist expressly so requests, such value shall be decided by a single arbitrator process, pursuant to rules promulgated by the chair. The chair shall appoint a member in good standing of a recognized professional association representing podiatrists in the state of New York to determine the value of such disputed bill. Decisions rendered under the single arbitrator process shall be conclusive upon the parties as to the value of the services in dispute. (c) If the parties fail to agree as to the value of podiatry care rendered under this chapter to a claimant and the amount of the disputed bill exceeds one thousand dollars and the podiatrist does not expressly request a single arbitrator process in accordance with paragraph (b) of this subdivision, such value shall be decided by an arbitration committee consisting of three duly registered and licensed podiatrists who are members of a recognized professional association representing podiatrists in the state of New York, one to be appointed by the president of such an association, one to be appointed by the employer or carrier and one to be appointed by the chair of the workers' compensation board and the majority decision of such committee shall be conclusive upon the parties as to the value of the services rendered. (d) The board or the chair may make an award not in excess of the established fee schedules for any such bill or part thereof which remains unpaid in the same manner as an award for bills rendered under subdivisions one and three of section thirteen-g of this article, and such award may be collected in like manner as an award of compensation. Where a podiatrist's bill has been determined to be due and owing in accordance with the provisions of this section the board shall include in the amount of the award interest of not more than one and one-half percent (1 1/2%) per month payable to the podiatrist in accordance with the rules and regulations promulgated by the board. The chair shall assess the sum of fifty dollars against the employer for each such award made by the board, which sum shall be paid into the state treasury. (e) A provider initiating an arbitration, including a single arbitration process, pursuant to this section shall not be required to pay a fee related to the conduct of such arbitration. Each member of the arbitration committee shall be entitled to receive and shall be paid a fee for each day's attendance at an arbitration session in an amount fixed by the chair of the workers' compensation board. 7. Within the limits prescribed by the education law for podiatry care and treatment, the report or testimony of an authorized podiatrist concerning the condition of the foot of an injured employee and the treatment thereof shall be deemed competent evidence and the professional opinion of the podiatrist as to causal relation and as to required treatment shall be deemed competent but shall not be controlling. Nothing in this section shall be deemed to deprive any employer or insurance carrier of any right to medical examination or presentation of medical testimony now conferred by law. 8. The chairman shall promulgate rules governing the procedure to be followed by those rendering podiatry care under this section, which rules so far as practicable shall conform to the rules presently in effect with reference to medical care furnished to claimants in workmen's compensation. In connection with the promulgation of said rules the chairman may consult the podiatry practice committee hereinafter provided and may take into consideration the view of other interested parties. 9. The chairman shall appoint for and with jurisdiction in the entire state of New York a single podiatry practice committee composed of one duly licensed physician and two duly registered and licensed podiatrists of the state of New York. Each podiatry member of said committee shall have been engaged in the practice of podiatry as a duly registered and licensed podiatrist of the state of New York at least ten years prior to the time of his appointment and shall receive compensation either on an annual basis or on a per diem basis to be fixed by the chairman within amounts appropriated therefor. One of said members shall be designated by the chairman as chairman of said podiatry practice committee. No member of said committee shall render podiatry treatment under this section nor be employed by or accept or participate in any fee from any insurance company authorized to write workmen's compensation insurance in this state or from any self-insurer, whether such employment or fee relates to a workmen's compensation claim or otherwise. The attorney general, upon request, shall advise and assist such committee. 10. The podiatry practice committee shall investigate, hear and make findings with respect to all charges as to professional or other misconduct of any authorized podiatrist as herein provided under rules and procedures to be prescribed by the chair and shall report evidence of such misconduct, with their findings and recommendation with respect thereto, to the chair. The findings, decision and recommendation of such podiatry practice committee shall be advisory to the chair only, and shall not be binding or conclusive upon him or her. The chair shall remove from the list of podiatrists authorized to render podiatry care under this chapter or to conduct independent medical examinations in accordance with paragraph (b) of subdivision three of this section the name of any podiatrist who he or she shall find after reasonable investigation is disqualified because such podiatrist (a) has been guilty of professional or other misconduct or incompetency in connection with podiatry services rendered under the law; or (b) has exceeded the limits of his or her professional competence in rendering podiatry care under the law, or has made materially false statements regarding his or her qualifications in his or her application for authorization; or (c) has failed to submit timely, full and truthful podiatry reports of all his or her findings to the employer and directly to the chair or the board within the time limits provided in this section; or (d) has knowingly made a false statement or presentation as to a material fact in any medical report made pursuant to this chapter or in testifying or otherwise providing information for the purposes of this chapter; or (e) has solicited or has employed another to solicit for himself or herself or for another professional treatment, examination or care of an injured employee with any claim under this chapter; or (f) has refused to appear before, to testify, to submit to a deposition, or to answer upon request of, the chair, board, podiatry practice committee or any duly authorized officer of the state, any legal question or produce any relevant book or paper concerning his or her conduct under an authorization granted to him or her under the law, or (g) has directly or indirectly requested, received or participated in the division, transference, assignment, rebating, splitting or refunding of a fee for, or has directly or indirectly requested, received or profited by means of a credit or other valuable consideration as a commission, discount or gratuity in connection with the treatment, or independent medical examination, of a workers' compensation claimant. Nothing contained in this paragraph shall prohibit such podiatrists who practice as partners, in groups or as a professional corporation from pooling fees and moneys received, either by the partnership, professional corporation or group by the individual members thereof, for professional services furnished by any individual professional member, or employee of such partnership, corporation or group, nor shall the professionals constituting the partnership, corporation, or group be prohibited from sharing, dividing or apportioning the fees and moneys received by them or by the partnership, corporation or group in accordance with a partnership or other agreement. 11. Any person who violates or attempts to violate, and any person who aids another to violate or attempts to induce him to violate the provisions of paragraph g of subdivision ten of this section shall be guilty of a misdemeanor. 12. Nothing in this section shall be construed as limiting in any respect the power or duty of the chairman to investigate instances of misconduct, either before or after investigation by the podiatry practice committee or to temporarily suspend the authorization of any podiatrist that he may believe to be guilty of such misconduct. The provisions of subdivision one of section thirteen-d of this article which are not inconsistent with the provisions of this section shall be applicable as fully as if set forth herein. 13. Upon the referral which may be directive as to treatment of an authorized podiatrist physical therapy care may be rendered by a duly licensed physical therapist. * NB Repealed January 1, 2028 --- ## WKC § 13-L — Care and treatment of injured employees by duly licensed chiropractors {#13-L} *N.Y. Workers' Comp. Law § 13-L* Official source: _NYS Open Legislation, revision of 2026-05-29._ * § 13-l. Care and treatment of injured employees by duly licensed chiropractors. 1. Where the term "chairman" is hereinafter used, it shall be deemed to mean the chair of the workers' compensation board of the state of New York. 2. An employee injured under circumstances which make such injury compensable under this article, when care is required for an injury which consists solely of a condition which may lawfully be treated by a chiropractor as defined in section sixty-five hundred fifty-one of the education law may select to treat him or her, any duly registered and licensed chiropractor of the state of New York, authorized by the chair to render chiropractic care as hereinafter provided. If the injury or condition is one which is outside the limits prescribed by the education law for chiropractic care and treatment, the said chiropractor must so advise the said injured employee and instruct him or her to consult a physician of said employee's choice for appropriate care and treatment. Such physician shall thenceforth have supervision of the treatment of said condition including the future treatment to be administered to the patient by the chiropractor. The chair shall prepare and establish a schedule for the state, or schedules limited to defined localities of charges and fees for chiropractic treatment and care, to be determined in accordance with and to be subject to change pursuant to rules promulgated by the chair. Before preparing such schedule for the state or schedules for limited localities the chair shall request the chiropractic practice committee to submit to him or her a report on the amount of remuneration deemed by such committee to be fair and adequate for the types of chiropractic care to be rendered under this chapter, but consideration shall be given to the view of other interested parties, the amounts payable by the employer for such treatment and services shall be the fees and charges established by such schedule. 3. (a) No claim for chiropractic care or treatment shall be valid and enforceable as against the employer or employees unless within forty-eight hours following the first treatment the chiropractor giving such care or treatment furnishes to the employer and directly to the chair a preliminary notice of such injury and treatment, and within fifteen days thereafter a more complete report and subsequent thereto progress reports as requested in writing by the chair, board, employer or insurance carrier, at intervals of not less than three weeks apart or at less frequent intervals if requested on forms prescribed by the chair. The board may excuse the failure to give such notices within the designated periods when it finds it to be in the interest of justice to do so. (b) Upon receipt of the notice provided for by paragraph (a) of this subdivision, the employer, the carrier, and the claimant each shall be entitled to have the claimant examined by a qualified chiropractor authorized by the chair in accordance with section thirteen-b and section one hundred thirty-seven of this chapter at a medical facility convenient to the claimant and in the presence of the claimant's chiropractor, and refusal by the claimant to submit to such independent medical examination at such time or times as may reasonably be necessary in the opinion of the board shall bar the claimant from recovering compensation, for any period during which he or she has refused to submit to such examination. (c) Where it would place an unreasonable burden upon the employer or carrier to arrange for, or for the claimant to attend, an independent medical examination by an authorized chiropractor, the employer or carrier shall arrange for such examination to be performed by a qualified chiropractor in a medical facility convenient to the claimant. (d) The independent chiropractic examiner shall provide such reports and shall submit to investigation as required by the chair. (e) In order to qualify as admissible chiropractic evidence, for purposes of adjudicating any claim under this chapter, any report submitted to the board by an independent medical examiner licensed by the state of New York shall include the following: (i) a signed statement certifying that the report is a full and truthful representation of the independent chiropractic examiner's professional opinion with respect to the claimant's condition, (ii) such examiner's board issued authorization number, (iii) the name of the individual or entity requesting the examination, (iv) if applicable, the registration number as required by section thirteen-n of this article, and (v) such other information as the chair may require by regulation. 4. Fees for chiropractic services shall be payable only to a duly authorized chiropractor as defined in this section, or to the agent, executor or administrator of the estate of such chiropractor. No chiropractor rendering treatment to a compensation claimant shall collect or receive a fee from such claimant within this state, but shall have recourse for payment of services rendered only to the employer under the provisions of this section. 5. Whenever his attendance at a hearing is required the chiropractor of the injured employee shall be entitled to receive a fee from the employer in an amount to be fixed by the board, in addition to any fee payable under section eight thousand and one of the civil practice law and rules. 6. (a) The provisions of subdivisions one and three of section thirteen-g of this article with respect to the conditions under which a hospital, physician or self-employed physical or occupational therapist may request payment or arbitration of a bill, or under which an award may be made for payment of such bill, shall be applicable to bills rendered by a chiropractor for services rendered to an injured employee. (b) If the parties fail to agree as to the chiropractic care rendered under this chapter to a claimant, and the amount of the disputed bill is one thousand dollars or less, or where the amount of the disputed bill exceeds one thousand dollars and the chiropractor expressly so requests, such value shall be decided by a single arbitrator process, pursuant to rules promulgated by the chair. The chair shall appoint a member in good standing of a recognized professional association representing chiropractors in the state of New York to determine the value of such disputed bill. Decisions rendered under the single arbitrator process shall be conclusive upon the parties as to the value of the services in dispute. (c) If the parties fail to agree as to the chiropractic care rendered under this chapter to a claimant, and the amount of the disputed bill exceeds one thousand dollars and the chiropractor does not expressly request a single arbitrator process in accordance with paragraph (b) of this subdivision, such value shall be decided by the chiropractic practice committee and the majority decision of such committee shall be conclusive upon the parties as to the value of the services rendered. (d) The board or the chair may make an award not in excess of the established fee schedules for any such bill or part thereof which remains unpaid in the same manner as an award for bills rendered under subdivisions one and three of section thirteen-g of this article, and such award may be collected in like manner as an award of compensation. Where a chiropractor's bill has been determined to be due and owing in accordance with the provisions of this section the board shall include in the amount of the award interest of not more than one and one-half percent (1 1/2%) per month payable to the chiropractor in accordance with the rules and regulations promulgated by the board. The chair shall assess the sum of fifty dollars against the employer for each such award made by the board, which sum shall be paid into the state treasury. (e) A provider initiating an arbitration, including a single arbitrator process, pursuant to this section shall not pay a fee to cover the costs related to the conduct of such arbitration. 7. Within the limits prescribed by the education law for chiropractic care and treatment, the report or testimony of an authorized chiropractor concerning the condition of an injured employee and treatment thereof shall be deemed competent evidence and the professional opinion of the chiropractor as to causal relation and as to required treatment shall be deemed competent but shall not be controlling. Nothing in this section shall be deemed to deprive any employer or insurance carrier of any right to medical examination or presentation of medical testimony now conferred by law. 8. The chairman shall promulgate rules governing the procedure to be followed by those rendering chiropractic care under this section, which rules so far as practicable shall conform to the rules presently in effect with reference to medical care furnished to claimants in workmen's compensation. In connection with the promulgation of said rules the chairman may consult the chiropractic practice committee hereinafter provided and may take into consideration the view of other interested parties. 9. The chair shall appoint for and with jurisdiction in the entire state of New York a single chiropractic practice committee composed of three duly registered and licensed chiropractors of the state of New York. Each member of said committee shall receive compensation either on an annual basis or on a per diem basis to be fixed by the chair within amounts appropriated therefor. One of said chiropractic members shall be designated by the chair as a chair of said chiropractic practice committee. No member of said committee shall render chiropractic treatment under this section nor be employed or accept or participate in any fee from any insurance company authorized to write workers' compensation insurance in this state or from any self-insurer, whether such employment or fee relates to a workers' compensation claim or otherwise. The attorney general, upon request, shall advise and assist such committee. 10. The chiropractic practice committee shall investigate, hear and make findings with respect to all charges as to professional or other misconduct of any authorized chiropractor as herein provided under rules and procedure to be prescribed by the chair and shall report evidence of such misconduct, with their findings and recommendations with respect thereto, to the chair. The findings, decision and recommendation of such chiropractic practice committee shall be advisory to the chair only, and shall not be binding or conclusive upon him or her. The chair shall remove from the list of chiropractors authorized to render chiropractic care under this chapter or to conduct independent medical examinations in accordance with paragraph (b) of subdivision three of this section the name of any chiropractor who he or she shall find after reasonable investigation is disqualified because such chiropractor, (a) has been guilty of professional or other misconduct or incompetency in connection with chiropractic services rendered under the law, or (b) has exceeded the limits of his or her professional competence in rendering chiropractic services under the law, or has made false statements regarding his or her qualifications in his or her application for authorization, or (c) has failed to submit timely, full and truthful chiropractic reports of all his or her findings to the employer and directly to the chair of the board within the time limits provided in this section, or (d) has knowingly made a false statement or representation as to a material fact in any medical report made pursuant to this chapter or in testifying or otherwise providing information for the purposes of this chapter, or (e) has solicited or has employed another to solicit for himself or herself or for another professional treatment, examination or care of an injured employee with any claim under this chapter, or (f) has refused to appear before, to testify, to submit to a deposition, or answer upon request of the chair, board, chiropractic practice committee or any duly authorized officer of the state, any legal question or produce any relevant book or paper concerning his or her conduct under an authorization granted to him or her under the law, or (g) has directly or indirectly requested, received or participated in the division, transference, assignment, rebating, splitting or refunding of a fee for, or has directly or indirectly requested, received or profited by means of a credit or otherwise valuable consideration as a commission, discount or gratuity, in connection with the treatment, or independent medical examination, of a workers' compensation claimant. Nothing contained in this paragraph shall prohibit such chiropractors who practice as partners, in groups or as a professional corporation, or as a university faculty practice corporation from pooling fees and moneys received, either by the partnership, professional corporation, university faculty practice corporation or group by the individual members thereof, for professional services furnished by any individual professional member, or employee of such partnership, corporation or group, nor shall the professionals constituting the partnership, corporation, or group be prohibited from sharing, dividing or apportioning the fees and moneys received by them or by the partnership, corporation or group in accordance with a partnership or other agreement. 11. Any person who violates or attempts to violate, and any person who aids another to violate or attempts to induce him to violate the provisions of paragraph (g) of subdivision ten of this section shall be guilty of a misdemeanor. 12. Nothing in this section shall be construed as limiting in any respect the power or duty of the chairman to investigate instances of misconduct, either before or after investigation by the chiropractic practice committee or to temporarily suspend the authorization of any chiropractor that he may believe to be guilty of such misconduct. The provisions of subdivision one of section thirteen-d of this article which are not inconsistent with the provisions of this section shall be applicable as fully as if set forth herein. * NB Repealed January 1, 2028 --- ## WKC § 13-M — Care and treatment of injured employees by duly licensed psychologists {#13-M} *N.Y. Workers' Comp. Law § 13-M* Official source: _NYS Open Legislation, revision of 2026-05-29._ * § 13-m. Care and treatment of injured employees by duly licensed psychologists. 1. Where the term "chairman" is hereinafter used, it shall be deemed to mean the chair of the workers' compensation board of the state of New York. 2. (a) An injured employee, injured under circumstances which make such injury compensable under this article, may lawfully be treated by a psychologist, duly registered and licensed by the state of New York, authorized by the chair to render psychological care pursuant to section thirteen-b of this article. Such services shall be within the scope of such psychologist's specialized training and qualifications as defined in article one hundred fifty-three of the education law. (b) Medical bureaus, medical centers jointly operated by labor and management representatives, hospitals and health maintenance organizations, authorized to provide medical care pursuant to section thirteen-c of this article, may provide psychological services when required. (c) A psychologist rendering service pursuant to this section shall maintain records of the patient's psychological condition and treatment, and such records or reports shall be submitted to the chair on such forms and at such times as the chair may require. 3. The chair shall prepare and establish a schedule for the state or schedules limited to defined localities of charges and fees for psychological treatment and care, to be determined in accordance with and be subject to change pursuant to rules promulgated by the chair. Before preparing such schedule for the state or schedules for limited localities the chair shall request the psychology practice committee to submit to such chair a report on the amount of remuneration deemed by such committee to be fair and adequate for the types of psychological care to be rendered under this chapter, but consideration shall be given to the view of other interested parties. The amounts payable by the employer for such treatment and services shall be the fees and charges established by such schedule. 4. (a) No claim for psychological care or treatment shall be valid and enforceable as against the employer or employees unless within forty-eight hours following the first treatment the psychologist giving such care or treatment furnishes to the employer and directly to the chair a preliminary notice of such injury and treatment, and within fifteen days thereafter a more complete report and subsequent thereto progress reports as requested in writing by the chair, board, employer or insurance carrier, at intervals of not less than three weeks apart or at less frequent intervals if requested on forms prescribed by the chair. The board may excuse the failure to give such notices within the designated periods when it finds it to be in the interest of justice to do so. (b) Upon receipt of the notice provided for by paragraph (a) of this subdivision, the employer, the carrier, and the claimant each shall be entitled to have the claimant examined by a qualified psychologist, authorized by the chair in accordance with section thirteen-b and section one hundred thirty-seven of this chapter, at a medical facility convenient to the claimant and in the presence of the claimant's psychologist, and refusal by the claimant to submit to such independent medical examination at such time or times as may reasonably be necessary in the opinion of the board shall bar the claimant from recovering compensation, for any period during which he or she has refused to submit to such examination. (c) Where it would place an unreasonable burden upon the employer or carrier to arrange for, or for the claimant to attend, an independent medical examination by an authorized psychologist, the employer or carrier shall arrange for such examination to be performed by a qualified psychologist in a medical facility convenient to the claimant. (d) The independent psychological examiner licensed by the state of New York shall provide such reports and shall submit to investigation as required by the chair. (e) In order to qualify as admissible medical evidence, for purposes of adjudicating any claim under this chapter, any report submitted to the board by an independent psychological examiner licensed by the state of New York shall include the following: (i) a signed statement certifying that the report is a full and truthful representation of the independent psychological examiner's professional opinion with respect to the claimant's condition, (ii) such examiner's board issued authorization number, (iii) the name of the individual or entity requesting the examination, (iv) if applicable, the registration number as required by section thirteen-n of this article, and (v) such other information as the chair may require by regulation. 5. Fees for psychological services shall be payable only to a duly authorized psychologist as licensed in article one hundred fifty-three of the education law, or to the agent, executor or administrator of the estate of such psychologist. No psychologist rendering treatment to a compensation claimant shall collect or receive a fee from such claimant within this state, but shall have recourse for payment of services rendered only to the employer under the provisions of this section. 6. Whenever his attendance at a hearing is required the psychologist of the injured employee shall be entitled to receive a fee from the employer in an amount to be fixed by the board, in addition to any fee payable under section eight thousand one of the civil practice law and rules. 7. (a) The provisions of subdivisions one and three of section thirteen-g of this article with respect to the conditions under which a hospital, physician or self-employed physical or occupational therapist may request payment or arbitration of a bill, or under which an award may be made for payment of such bill, shall be applicable to bills rendered by a psychologist for services rendered to an injured employee. (b) If the parties fail to agree as to the psychological care rendered under this chapter to a claimant, and the amount of the disputed bill is one thousand dollars or less, or where the amount of the disputed bill exceeds one thousand dollars and the psychologist expressly so requests, such value shall be decided by a single arbitrator process, pursuant to rules promulgated by the chair. The chair shall appoint a member in good standing of a recognized professional association representing psychologists in the state of New York to determine the value of such disputed bill. Decisions rendered under the single arbitrator process shall be conclusive upon the parties as to the value of the services in dispute. (c) If the parties fail to agree as to the psychological care rendered under this chapter to a claimant, and the amount of the disputed bill exceeds one thousand dollars and the psychologist does not expressly request a single arbitrator process in accordance with paragraph (b) of this subdivision, such value shall be decided by the psychology practice committee and the majority decision of such committee shall be conclusive upon the parties as to the value of the services rendered. (d) The board or the chair may make an award not in excess of the established fee schedules for any such bill or part thereof which remains unpaid in the same manner as an award for bills rendered under subdivisions one and three of section thirteen-g of this article, and such award may be collected in like manner as an award of compensation. The chair shall assess the sum of fifty dollars against the employer for each such award made by the board, which sum shall be paid into the state treasury. Where a psychologist's bill has been determined to be due and owing in accordance with the provisions of this section the board shall include in the amount of the award interest of not more than one and one-half percent per month payable to the psychologist in accordance with the rules and regulations promulgated by the board. (e) A provider initiating an arbitration, including a single arbitrator process, pursuant to this section shall not be required to pay a fee to cover the costs related to the conduct of such arbitration. 8. Within the limits prescribed by the education law for psychological care and treatment, the report or testimony of an authorized psychologist concerning the condition of an injured employee and treatment thereof shall be deemed competent evidence and the professional opinion of the psychologist as to causal relation and as to required treatment shall be deemed competent but shall not be controlling. Nothing in this section shall be deemed to deprive any employer or insurance carrier of any right to a medical examination or presentation of medical testimony now conferred by law. 9. The chairman shall promulgate rules governing the procedure to be followed by those rendering psychological care under this section, which rules so far as practicable shall conform to the rules presently in effect with reference to medical care furnished to claimants in workers' compensation. In connection with the promulgation of said rules the chairman may consult the psychology practice committee hereinafter provided and may take into consideration the view of other interested parties. 10. The chair shall appoint for and with jurisdiction in the entire state of New York a single psychology practice committee composed of three duly registered and licensed psychologists, at least one of whom shall be a member in good standing of the New York state psychological association recommended by the president of such organization. Each member of said committee shall receive compensation either on an annual basis or on a per diem basis to be fixed by the chair within amounts appropriated therefor. One of said psychologists shall be designated by the chair as a chair of said psychology practice committee. No member of said committee shall render psychological treatment under this section nor be an employer or accept or participate in any fee from any insurance company authorized to write workers' compensation insurance in this state or from any self-insurer, whether such employment or fee relates to a workers' compensation claim or otherwise. The attorney general, upon request, shall advise and assist such committee. 11. The psychology practice committee shall investigate, hear and make findings with respect to all charges as to professional or other misconduct of any authorized psychologist as herein provided under rules and procedures to be prescribed by the chair and shall report evidence of such misconduct, with their findings and recommendations with respect thereto, to the chair. The findings, decision and recommendation of such psychology practice committee shall be advisory to the chair only, and shall not be binding or conclusive upon him or her. The chair shall remove from the list of psychologists authorized to render psychological care under this chapter or to conduct independent medical examinations in accordance with paragraph (b) of subdivision four of this section the name of any psychologist who he or she shall find after reasonable investigation is disqualified because such psychologist: (a) has been guilty of professional or other misconduct or incompetency in connection with the rendering of psychological services, or (b) has exceeded the limits of his or her professional competence in rendering psychological services under the law, or has made false statements regarding qualifications in the application for authorization, or (c) has failed to submit timely, full and truthful psychological reports of all findings to the employer and directly to the chair of the board within the time limits provided in this section, or (d) has knowingly made a false statement or representation as to a material fact in any medical report made pursuant to this chapter or in testifying or otherwise providing information for the purposes of this chapter, or (e) has solicited or has employed another to solicit for himself/herself or for another professional treatment, examination or care of an injured employee with any claim under this chapter, or (f) has refused to appear before, to testify, to submit to a deposition, or answer upon request of the chair, board, psychology practice committee or any duly authorized officer of the state, any legal question or produce any relevant book or paper concerning conduct under an authorization granted under law, or (g) has directly or indirectly requested, received or participated in the division, transference, assignment, rebating, splitting or refunding of a fee for, or has directly or indirectly requested, received or profited by means of a credit or otherwise valuable consideration as a commission, discount or gratuity in connection with the treatment of a workers' compensation claimant. 12. Any person who violates or attempts to violate, and any person who aids another to violate or attempts to induce him to violate the provisions of paragraph (g) of subdivision eleven of this section shall be guilty of a misdemeanor. 13. Nothing in this section shall be construed as limiting in any respect the power or duty of the chairman to investigate instances of misconduct, either before or after investigation by the psychology practice committee, or to temporarily suspend the authorization of any psychologist believed to be guilty of such misconduct. The provisions of subdivision one of section thirteen-d of this article which are not inconsistent with the provisions of this section shall be applicable as if fully set forth herein. 14. Nothing contained in this section shall prohibit psychologists who practice as partners, in groups or as a professional corporation from pooling fees and moneys received, either by the partnership, professional corporation or group or by the individual members thereof, for professional services furnished by any individual professional member, or employee of such partnership, corporation or group, nor shall the professionals constituting the partnerships, corporations, or groups be prohibited from sharing, dividing or apportioning the fees and moneys received by them or by the partnership, corporation or group in accordance with a partnership or other agreement. * NB Repealed January 1, 2028 --- ## WKC § 13-N — Mandatory registration of entities which derive income from independent medical examinations {#13-N} *N.Y. Workers' Comp. Law § 13-N* Official source: _NYS Open Legislation, revision of 2026-05-29._ § 13-n. Mandatory registration of entities which derive income from independent medical examinations. * 1. Any entity which derives income from independent medical examinations performed in accordance with subdivision four of section thirteen-a, subdivision three of section thirteen-k, subdivision three of section thirteen-1 and subdivision four of section thirteen-m of this article, whether by employing or contracting with independent examiners to conduct such independent medical examinations or by acting as a referral service or otherwise facilitating such examinations, shall register with the chair by filing a statement of registration containing such information prescribed by the chair in regulation. A fee may be imposed in accordance with regulations promulgated by the chair. Any such fees collected shall be used for the purpose of administering this section. * NB Effective until January 1, 2028 * 1. Any entity which derives income from independent medical examinations performed in accordance with subdivision four of section thirteen-a of this article and section one hundred thirty-seven of this chapter, whether by employing or contracting with independent examiners to conduct such independent medical examinations or by acting as a referral service or otherwise facilitating such examinations, shall register with the chair by filing a statement of registration containing such information prescribed by the chair in regulation. A fee may be imposed in accordance with regulations promulgated by the chair. Any such fees collected shall be used for the purpose of administering this section. * NB Effective January 1, 2028 2. The chair shall assign a registration number to the entity upon registration. If an entity operates under more than one name, or in more than one location, the chair may assign a series of registration numbers which would differentiate each such sub-entity. In order to qualify as admissible medical evidence, for purposes of adjudicating any claim under this chapter, any report submitted to the board by an independent medical examiner who is employed by, or has contracted with, an entity as described in subdivision one of this section for the purpose of performing independent medical examinations, must include the registration number of such entity. 3. The chair, upon finding that an entity that derives income from independent medical examinations has materially altered an independent medical examination report, or caused such a report to be materially altered, may revoke the registration of such entity, impose a penalty not exceeding ten thousand dollars and refer the matter to the attorney general for prosecution. --- ## WKC § 13-O — Pharmaceutical fee schedule {#13-O} *N.Y. Workers' Comp. Law § 13-O* Official source: _NYS Open Legislation, revision of 2014-09-22._ § 13-o. Pharmaceutical fee schedule. The chair shall adopt a pharmaceutical fee schedule which shall establish maximum allowable fees for prescription medicines provided pursuant to this chapter. The schedule shall include a single dispensing fee. Nothing in the fee schedule shall preclude mail order supply of scheduled medicines, provided that the fees for such mail ordered medicines do not exceed the costs provided by such fee schedule. Any pharmacy providing prescription medicines shall provide the generic drug equivalent, if a generic equivalent is available, unless the prescribing physician specifically provides otherwise by prescription. The fee schedule may be modified on each succeeding April first, provided, however, that usual and customary fees may be charged for drugs that are not included in a then-current fee schedule, but are approved for use by the chair. --- ## WKC § 13-P — Comprehensive prescription drug formulary {#13-P} *N.Y. Workers' Comp. Law § 13-P* Official source: _NYS Open Legislation, revision of 2017-04-21._ § 13-p. Comprehensive prescription drug formulary. The chair shall establish a comprehensive prescription drug formulary on or before December thirty-first, two thousand seventeen. The prescription drug formulary shall include a tiered list of high-quality, cost-effective medications that are pre-approved to be prescribed and dispensed, as well as additional non-preferred drugs that can be prescribed with prior approval. Such prescription drug formulary, shall include but not be limited to implementation of a pharmacy reimbursement strategy, administration of a prescription drug rebate program for formulary drugs, a pre-approval program, drug utilization review, and limitations on the prescribing of compounded medications and compounded topical preparations. The board shall promulgate regulations to permit an interested party to submit a request to the medical director of the board to alter or amend the formulary to consider changing the status of a drug from non-preferred to preferred. Regulations may include a provision for reasonable costs and fees associated with the review. --- ## WKC § 14 — Weekly wages basis of compensation {#14} *N.Y. Workers' Comp. Law § 14* Official source: _NYS Open Legislation, revision of 2014-09-22._ § 14. Weekly wages basis of compensation. Except as otherwise provided in this chapter, the average weekly wages of the injured employee at the time of the injury shall be taken as the basis upon which to compute compensation or death benefits, and shall be determined as follows: 1. If the injured employee shall have worked in the employment in which he was working at the time of the accident, whether for the same employer or not, during substantially the whole of the year immediately preceding his injury, his average annual earnings shall consist of three hundred times the average daily wage or salary for a six-day worker, and two hundred sixty times the average daily wage or salary for a five-day worker, which he shall have earned in such employment during the days when so employed; 2. If the injured employee shall not have worked in such employment during substantially the whole of such year, his average annual earnings, if a six-day worker, shall consist of three hundred times the average daily wage or salary, and, if a five-day worker, two hundred and sixty times the average daily wage or salary, which an employee of the same class working substantially the whole of such immediately preceding year in the same or in a similar employment in the same or a neighboring place shall have earned in such employment during the days when so employed; 3. If either of the foregoing methods of arriving at the annual average earnings of an injured employee cannot reasonably and fairly be applied, such annual average earnings shall be such sum as, having regard to the previous earnings of the injured employee and of other employees of the same or most similar class, working in the same or most similar employment, or other employment as defined in this chapter, in the same or neighboring locality, shall reasonably represent the annual earning capacity of the injured employee in the employment in which he was working at the time of the accident, provided, however, his average annual earnings shall consist of not less than two hundred times the average daily wage or salary which he shall have earned in such employment during the days when so employed, further provided, however, that if the injured employee shall have been in the military or naval service of the United States or of the state of New York within twelve months prior to his injury, and his average annual earnings cannot be fairly determined under subdivisions one and two, then the average annual earnings shall be determined by multiplying his average daily wage during the days so employed by not less than two hundred and forty; 4. The average weekly wages of an employee shall be one-fifty-second part of his average annual earnings; 5. If it be established that the injured employee was under the age of twenty-five when injured, and that under normal conditions his wages would be expected to increase, that fact may be considered in arriving at his average weekly wages. 6. If the injured employee is concurrently engaged in more than one employment at the time of injury, the employee's average weekly wages shall be calculated upon the basis of wages earned from all concurrent employments covered under this chapter. The employer in whose employment the employee was injured shall be liable for the benefits that would have been payable if the employee had had no other employment. Any additional benefits resulting from the increase in average weekly wages due to the employee's concurrent employments shall be payable in the first instance by the employer in whose employment the employee was injured and shall be reimbursed by the special disability fund created under subdivision eight of section fifteen of this article, but only if such claim is presented in accordance with subparagraph two of paragraph (h) of subdivision eight of section fifteen of this article. The employer in whose employment the employee was injured shall be liable for all medical costs. 7. The average weekly wages of a jockey, apprentice jockey or exercise person licensed under article two or four of the racing, pari-mutuel wagering and breeding law shall be computed based upon all of the earnings of such jockey, apprentice jockey or exercise person, including those derived from outside of the state. --- ## WKC § 14-A — Double compensation and death benefits when minors illegally employed {#14-A} *N.Y. Workers' Comp. Law § 14-A* Official source: _NYS Open Legislation, revision of 2017-04-14._ § 14-a. Double compensation and death benefits when minors illegally employed. 1. Compensation, death benefits, and awards to the commissioner of taxation and finance in accordance with subdivision nine of section fifteen and section twenty-five-a, as provided in this article, shall be double the amount otherwise payable if the injured employee at the time of the accident is a minor employed, permitted or suffered to work in violation of any provision of the labor law or in violation of any rule heretofore or hereafter adopted by the board of standards and appeals pursuant to subdivision four of section one hundred thirty-three of said law. An employer who knowingly permits or suffers a newspaper carrier to work in violation of section thirty-two hundred twenty-eight of the education law, shall be liable for the increased awards provided by this section. 2. The employer alone and not the insurance carrier shall be liable for the increased compensation, increased death benefits, or awards to the commissioner of taxation and finance provided for by this section. Any provision in an insurance policy undertaking to relieve an employer from such increased liability shall be void. 3. A person over eighteen years of age may apply for a certificate of age to the superintendent of schools or to an employment certificating officer. Upon such application a certificate of age, signed by the officer issuing it and containing the name, date of birth, address and signature of the applicant shall be issued to him if he furnishes evidence that he is over eighteen years of age such as is required for the issuance of an employment certificate. Such a certificate of age shall be conclusive evidence for an employer that the person has reached the age certified to therein, and the provisions of this section shall not apply to the employer of such person while the person is engaged in employment lawful for the age and sex as certified to in the certificate of age. 4. With respect to a jockey, apprentice jockey or exercise person licensed under article two or four of the racing, pari-mutuel wagering and breeding law, and at the election of the New York Jockey Injury Compensation Fund, Inc., with the approval of the New York state gaming commission, an employee of a licensed trainer or owner, who, pursuant to section two of this chapter, is an employee of all owners and trainers licensed or required to be licensed under article two or four of the racing, pari-mutuel wagering and breeding law and The New York Jockey Injury Compensation Fund, Inc., the owner or trainer for whom such jockey, apprentice jockey, exercise person or, if approved by the New York state gaming commission, employee of a licensed trainer or owner was performing services at the time of the accident shall be solely responsible for the double payments described in subdivision one of this section, to the extent that such payments exceed any amounts otherwise payable with respect to such jockey, apprentice jockey, exercise person or, if approved by the New York state gaming commission, employee of a licensed trainer or owner under any other section of this chapter, and the New York Jockey Injury Compensation Fund, Inc. shall have no responsibility for such excess payments, unless there shall be a failure of the responsible owner or trainer to pay such award within the time provided under this chapter. In the event of such failure to pay and the board requires the fund to pay the award on behalf of such owner or trainer who has been found to have violated this section, the fund shall be entitled to an award against such owner or trainer for the amount so paid which shall be collected in the same manner as an award of compensation. 5. With respect to a black car operator who, pursuant to section two of this chapter, is an employee of the New York black car operators' injury compensation fund, inc., the central dispatch facility for which the black car operator was performing services at the time of the accident shall be solely responsible for the double payments described in subdivision one of this section, to the extent that such payments exceed any amounts otherwise payable with respect to such black car operator under any other section of this chapter, and the New York black car operators' injury compensation fund, inc. shall have no responsibility for such excess payments, unless there shall be a failure of the responsible central dispatch facility to pay such award within the time provided under this chapter. In the event of such failure to pay, the board may require the fund to pay the award on behalf of the central dispatch facility that is found to have violated this section. In such a case, the fund shall be entitled to an award against the central dispatch facility for the excess amount paid by the fund, which shall be collected in the same manner as an award of compensation. --- ## WKC § 15 — Schedule in case of disability {#15} *N.Y. Workers' Comp. Law § 15* Official source: _NYS Open Legislation, revision of 2023-09-08._ § 15. Schedule in case of disability. The following schedule of compensation is hereby established: 1. Permanent total disability. In case of total disability adjudged to be permanent sixty-six and two-thirds per centum of the average weekly wages shall be paid to the employee during the continuance of such total disability. Loss of both hands, or both arms, or both feet, or both legs, or both eyes, or of any two thereof shall, in the absence of conclusive proof to the contrary, constitute permanent total disability. In all other cases permanent total disability shall be determined in accordance with the facts. Notwithstanding any other provision of this chapter, an injured employee disabled due to the loss or total loss of use of both eyes, or both hands, or both arms, or both feet, or both legs, or of any two thereof shall not suffer any diminution of his compensation by engaging in business or employment provided his earnings or wages, when combined with his compensation, shall not be in excess of the wage base on which the maximum weekly compensation benefit is computed under the law in effect at time of such earning; further provided, that if the combination exceeds such wage base, the compensation shall be diminished to an amount which, together with his earnings or wages, shall equal the wage base; and further provided that the application of this subdivision shall not result in reduction of compensation which an injured employee who is disabled due to the loss or total loss of use of both eyes, or both hands, or both arms, or both feet, or both legs or of any two thereof, would otherwise be entitled to under any other provision of this section. 2. Temporary total disability. In case of temporary total disability, sixty-six and two-thirds per centum of the average weekly wages shall be paid to the employee during the continuance thereof, except as otherwise provided in this chapter. 3. Permanent partial disability. In case of disability partial in character but permanent in quality the compensation shall be sixty-six and two-thirds per centum of the average weekly wages and shall be paid to the employee for the period named in this subdivision, as follows: Number of Member lost weeks' compensation a. Arm ............................................................. 312 b. Leg ............................................................. 288 c. Hand ............................................................ 244 d. Foot ............................................................ 205 e. eye ............................................................. 160 f. Thumb ............................................................ 75 g. First finger ..................................................... 46 h. Great toe ........................................................ 38 i. Second finger .................................................... 30 j. Third finger ..................................................... 25 k. Toe other than great toe ......................................... 16 l. Fourth finger .................................................... 15 m. Loss of hearing. Compensation for the complete loss of the hearing of one ear, for sixty weeks, for the loss of hearing of both ears, for one hundred and fifty weeks. n. Phalanges. Compensation for the loss of more than one phalange of a digit shall be the same as for loss of the entire digit. Compensation for loss of the first phalange shall be one-half of the compensation for loss of the entire digit. o. Amputated arm or leg. Compensation for an arm or a leg, if amputated at or above the wrist or ankle, shall be for the proportionate loss of the arm or leg. p. Binocular vision or per centum of vision. Compensation for loss of binocular vision or for eighty per centum or more of the vision of an eye shall be the same as for loss of the eye. q. Two or more digits. Compensation for loss or loss of use of two or more digits, or one or more phalanges of two or more digits, of a hand or foot may be proportioned to the loss of use of the hand or foot occasioned thereby but shall not exceed the compensation for loss of a hand or foot. r. Total loss of use. Compensation for permanent total loss of use of a member shall be the same as for loss of the member. s. Partial loss or partial loss of use. Compensation for permanent partial loss or loss of use of a member may be for proportionate loss or loss of use of the member. Compensation for permanent partial loss or loss of use of an eye shall be awarded on the basis of uncorrected loss of vision or corrected loss of vision resulting from an injury whichever is the greater. t. Disfigurement. 1. The board may award proper and equitable compensation for serious facial or head disfigurement, not to exceed twenty thousand dollars, including a disfigurement continuous in length which is partially in the facial area and also extends into the neck region as described in paragraph two hereof. 2. The board, if in its opinion the earning capacity of an employee has been or may in the future be impaired, may award compensation for any serious disfigurement in the region above the sterno clavicular articulations anterior to and including the region of the sterno cleido mastoid muscles on either side, but no award under subdivisions one and two shall, in the aggregate, exceed twenty thousand dollars. 3. Notwithstanding any other provision hereof, two or more serious disfigurements, not continuous in length, resulting from the same injury, if partially in the facial area and partially in the neck region as described in paragraph two hereof, shall be deemed to be a facial disfigurement. u. Total or partial loss or loss of use of more than one member or parts of members. In any case in which there shall be a loss or loss of use of more than one member or parts of more than one member set forth in paragraphs a through t, inclusive, of this subdivision, but not amounting to permanent total disability, the board shall award compensation for the loss or loss of use of each such member or part thereof, which awards shall be fully payable in one lump sum upon the request of the injured employee. v. Additional compensation for impairment of wage earning capacity in certain permanent partial disabilities. Notwithstanding any other provision of this subdivision, additional compensation shall be payable for impairment of wage earning capacity for any period after the termination of an award under paragraphs a, b, c, or d, of this subdivision for the loss or loss of use of fifty per centum or more of a member, provided such impairment of earning capacity shall be due solely thereto. Such additional compensation shall be determined in accordance with paragraph w of this subdivision. The additional compensation shall be reduced by fifty per centum of any amount of disability benefits which the disabled employee is receiving or entitled to receive for the same period under the social security act, and shall cease on the date the disabled employee receives or is entitled to receive old-age insurance benefits under the social security act. As soon as practicable after the injury, the worker shall be required to participate in a board approved rehabilitation program; or shall have demonstrated cooperation with efforts to institute such a board approved program and shall have been determined by the board not to be a feasible candidate for rehabilitation; such rehabilitation shall constitute treatment and care as provided in this chapter. w. Other cases. In all other cases of permanent partial disability, the compensation shall be sixty-six and two-thirds percent of the difference between the injured employee's average weekly wages and his or her wage-earning capacity thereafter in the same employment or otherwise. Compensation under this paragraph shall be payable during the continuance of such permanent partial disability, without the necessity for the claimant who is entitled to benefits at the time of classification to demonstrate ongoing attachment to the labor market, but subject to reconsideration of the degree of such impairment by the board on its own motion or upon application of any party in interest however, all compensation payable under this paragraph shall not exceed (i) five hundred twenty-five weeks in cases in which the loss of wage-earning capacity is greater than ninety-five percent; (ii) five hundred weeks in cases in which the loss of wage-earning capacity is greater than ninety percent but not more than ninety-five percent; (iii) four hundred seventy-five weeks in cases in which the loss of wage-earning capacity is greater than eighty-five percent but not more than ninety percent; (iv) four hundred fifty weeks in cases in which the loss of wage-earning capacity is greater than eighty percent but not more than eighty-five percent; (v) four hundred twenty-five weeks in cases in which the loss of wage-earning capacity is greater than seventy-five percent but not more than eighty percent; (vi) four hundred weeks in cases in which the loss of wage-earning capacity is greater than seventy percent but not more than seventy-five percent; (vii) three hundred seventy-five weeks in cases in which the loss of wage-earning capacity is greater than sixty percent but not more than seventy percent; (viii) three hundred fifty weeks in cases in which the loss of wage-earning capacity is greater than fifty percent but not more than sixty percent; (ix) three hundred weeks in cases in which the loss of wage-earning capacity is greater than forty percent but not more than fifty percent; (x) two hundred seventy-five weeks in cases in which the loss of wage-earning capacity is greater than thirty percent but not more than forty percent; (xi) two hundred fifty weeks in cases in which the loss of wage-earning capacity is greater than fifteen percent but not more than thirty percent; and (xii) two hundred twenty-five weeks in cases in which the loss of wage-earning capacity is fifteen percent or less. For a claimant with a date of accident or disablement after the effective date of the chapter of the laws of two thousand seventeen that amended this subdivision, where the carrier or employer has provided compensation pursuant to subdivision five of this section beyond one hundred thirty weeks from the date of accident or disablement, all subsequent weeks in which compensation was paid shall be considered to be benefit weeks for purposes of this section, with the carrier or employer receiving credit for all such subsequent weeks against the amount of maximum benefit weeks when permanent partial disability under this section is determined. In the event of payment for intermittent temporary partial disability paid after one hundred thirty weeks from the date of accident or disablement, such time shall be reduced to a number of weeks, for which the carrier will receive a credit against the maximum benefit weeks. For a claimant with a date of accident or disablement after the effective date of the chapter of the laws of two thousand seventeen that amended this subdivision, when permanency is at issue, and a claimant has submitted medical evidence that he or she is not at maximum medical improvement, and the carrier has produced or has had a reasonable opportunity to produce an independent medical examination concerning maximum medical improvement, and the board has determined that the claimant is not yet at maximum medical improvement, the carrier shall not receive a credit for benefit weeks prior to a finding that the claimant has reached maximum medical improvement, at which time the carrier shall receive credit for any weeks of temporary disability paid to claimant after such finding against the maximum benefit weeks awarded under this subdivision. For those claimants classified as permanently partially disabled who no longer receive indemnity payments because they have surpassed their number of maximum benefit weeks, the following provisions will apply: (1) There will be a presumption that medical services shall continue notwithstanding the completion of the time period for compensation set forth in this section and the burden of going forward and the burden of proof will lie with the carrier, self-insured employer or state insurance fund in any application before the board to discontinue or suspend such services. Medical services will continue during the pendency of any such application and any appeals thereto. (2) The board is directed to promulgate regulations that establish an independent review and appeal by an outside agent or entity of the board's choosing of any administrative law judge's determination to discontinue or suspend medical services before a final determination of the board. x. Impairment guidelines. The chair shall consult with representatives of labor, business, medical providers, insurance carriers, and self-insured employers regarding revisions to permanency impairment guidelines, including permitting review and comment by such representatives' chosen medical advisors, and after consultation shall, in accordance with the state administrative procedure act, propose for public comment revised permanency guidelines concerning medical evaluation of impairment and the determination of permanency as set forth in paragraphs a through v of this subdivision by September first, two thousand seventeen, with such guidelines to be adopted by the chair by January first, two thousand eighteen. The permanency impairment guidelines shall be reflective of advances in modern medicine that enhance healing and result in better outcomes. In the event the chair fails to adopt such permanency guidelines to be effective by January first, two thousand eighteen, the chair shall adopt, by emergency regulation, permanency impairment guidelines. The permanency impairment guidelines adopted by emergency regulation shall be either the impairment guidelines proposed by the chair on September first, two thousand seventeen or the permanency impairment guidelines created by the consultant to the board and submitted to representatives of labor, business, medical providers, insurance carriers, and self-insured employers, as voted on in an emergency meeting of the board to be held on December twenty-ninth, two thousand seventeen. In the event the board is unable to reach a decision at such meeting, the chair shall select the permanency guidelines to be adopted by emergency regulations. Emergency regulations shall be in effect for ninety days or until such time as permanent regulations are adopted by the chair. As of January first, two thousand eighteen the 2012 permanency impairment guidelines pertaining to paragraphs a through v of subdivision three of section fifteen of this article are repealed, and shall have no effect. The board shall train adjudication and other staff to ensure timely and effective implementation. 4. Effect of award. An award made to a claimant under subdivision three shall in case of death arising from causes other than the injury be payable to and for the benefit of the persons following: a. If there be a surviving spouse and no child of the deceased under the age of eighteen years, to such spouse. b. If there be a surviving spouse and surviving child or children of the deceased under the age of eighteen years, one-half shall be payable to the surviving spouse and the other half to the surviving child or children. The board may in its discretion require the appointment of a guardian for the purpose of receiving the compensation of the minor child. In the absence of such a requirement by the board the appointment for such a purpose shall not be necessary. c. If there be a surviving child or children of the deceased under the age of eighteen years, but no surviving spouse then to such child or children. d. If there be no surviving spouse and no surviving child or children of the deceased under the age of eighteen years, then to such dependent or dependents as defined in section sixteen of this chapter, as directed by the board; and if there be no such dependents, then to the estate of such deceased in an amount not exceeding reasonable funeral expenses as provided in subdivision one of section sixteen of this chapter, or, if there be no estate, to the person or persons paying the funeral expenses of such deceased in an amount not exceeding reasonable funeral expenses as provided in subdivision one of section sixteen of this chapter. An award for disability may be made after the death of the injured employee. 4-a. Protracted temporary total disability in connection with permanent partial disability. In case of temporary total disability and permanent partial disability both resulting from the same injury, if the temporary total disability continues for a longer period than the number of weeks set forth in the following schedule, the period of temporary total disability in excess of such number of weeks shall be added to the compensation period provided in subdivision three of this section: Arm, thirty-two weeks; leg, forty weeks; hand, thirty-two weeks; foot, thirty-two weeks; ear, twenty-five weeks; eye, twenty weeks; thumb, twenty-four weeks; first finger, eighteen weeks; great toe, twelve weeks; second finger, twelve weeks; third finger, eight weeks; fourth finger, eight weeks; toe other than great toe, eight weeks. In any case resulting in loss or partial loss of use of arm, leg, hand, foot, ear, eye, thumb, finger or toe, where the temporary total disability does not extend beyond the periods above mentioned for such injury, compensation shall be limited to the schedule contained in subdivision three. 5. Temporary partial disability. In case of temporary partial disability resulting in decrease of earning capacity, the compensation shall be two-thirds of the difference between the injured employee's average weekly wages before the accident and his wage earning capacity after the accident in the same or other employment. 5-a. Determination of wage earning capacity. The wage earning capacity of an injured employee in cases of partial disability shall be determined by his actual earnings, provided, however, that if he has no such actual earnings the board may in the interest of justice fix such wage earning capacity as shall be reasonable, but not in excess of seventy-five per centum of his former full time actual earnings, having due regard to the nature of his injury and his physical impairment. 5-b. Non-schedule adjustments. Notwithstanding any other provision of this chapter, in any case coming within the provisions of subdivisions three or five of this section, in which the right to compensation has been established and compensation has been paid for not less than three months, in which the continuance of disability and of future earning capacity cannot be ascertained with reasonable certainty, the board may, in the interest of justice, approve a non-schedule adjustment agreed to between the claimant and the employer or his insurance carrier. The board shall require, before approving any such agreement, that there be an examination of the claimant in accordance with section nineteen of this chapter, and such approval shall only be given when it is found that the adjustment is fair and in the best interest of the claimant. The board may, in such case, order all future compensation to be paid in one or more lump sums or periodically, and any such adjustment shall be regarded as a closing of the claim unless the board find upon proof that there has been a change in condition or in the degree of disability of claimant not found in the medical evidence and, therefore, not contemplated at the time of the adjustment. 6. Maximum and minimum compensation for disability. (a) Compensation for permanent or temporary total disability due to an accident or disablement resulting from an occupational disease that occurs, (1) on or after January first, nineteen hundred seventy-eight, shall not exceed one hundred twenty-five dollars per week, that occurs (2) on or after July first, nineteen hundred seventy-eight, shall not exceed one hundred eighty dollars per week, that occurs (3) on or after January first, nineteen hundred seventy-nine, shall not exceed two hundred fifteen dollars per week, that occurs (4) on or after July first, nineteen hundred eighty-three, shall not exceed two hundred fifty-five dollars per week, that occurs (5) on or after July first, nineteen hundred eighty-four, shall not exceed two hundred seventy-five dollars per week, that occurs (6) on or after July first, nineteen hundred eighty-five, shall not exceed three hundred dollars per week, that occurs (7) on or after July first, nineteen hundred ninety, shall not exceed three hundred forty dollars per week; and in the case of temporary total disability shall not be less than thirty dollars per week and in the case of permanent total disability shall not be less than twenty dollars per week except that if the employee's wages at the time of injury are less than thirty or twenty dollars per week respectively, he or she shall receive his or her full weekly wages. Compensation for permanent or temporary partial disability due to an accident or disablement resulting from an occupational disease that occurs (1) on or after January first, nineteen hundred seventy-eight, shall not exceed one hundred five dollars per week, that occurs (2) on or after July first, nineteen hundred eighty-three, shall not exceed one hundred twenty-five dollars per week, that occurs (3) on or after July first, nineteen hundred eighty-four, shall not exceed one hundred thirty-five dollars per week, that occurs (4) on or after July first, nineteen hundred eighty-five, shall not exceed one hundred fifty dollars per week, that occurs (5) on or after July first, nineteen hundred ninety, shall not exceed two hundred eighty dollars per week; nor be less than twenty dollars per week; except that if the employee's wages at the time of injury are less than twenty dollars per week, he or she shall receive his or her full weekly wages. In no event shall compensation when combined with decreased earnings or earning capacity exceed the amount of wages which the employee was receiving at the time the injury occurred. Compensation for permanent or temporary partial disability, or for permanent or temporary total disability due to an accident or disablement resulting from an occupational disease that occurs (1) on or after July first, nineteen hundred ninety-one and prior to July first, nineteen hundred ninety-two, shall not exceed three hundred fifty dollars per week; (2) on or after July first, nineteen hundred ninety-two, shall not exceed four hundred dollars per week; nor be less than forty dollars per week except that if the employee's wages at the time of injury are less than forty dollars per week, the employee shall receive his or her full wages. Compensation for permanent or temporary partial disability, or for permanent or temporary total disability due to an accident or disablement resulting from an occupational disease that occurs (1) on or after July first, two thousand seven shall not exceed five hundred dollars per week, (2) on or after July first, two thousand eight shall not exceed five hundred fifty dollars per week, (3) on or after July first, two thousand nine shall not exceed six hundred dollars per week, and (4) on or after July first, two thousand ten, and on or after July first of each succeeding year, shall not exceed two-thirds of the New York state average weekly wage for the year in which it is reported. Compensation for permanent or temporary partial disability, or for permanent or temporary total disability due to an accident or disablement resulting from an occupational disease that occurs on or after July first, two thousand seven shall not be less than one hundred dollars per week except that if the employee's wages at the time of injury are less than one hundred dollars per week, the employee shall receive his or her full wages. Compensation for permanent or temporary partial disability, or for permanent or temporary total disability due to an accident or disablement resulting from an occupational disease that occurs on or after May first, two thousand thirteen shall not be less than one hundred fifty dollars per week except that if the employee's wages at the time of injury are less than one hundred fifty dollars per week, the employee shall receive his or her full wages. Compensation for permanent or temporary partial disability, or for permanent or temporary total disability due to an accident or disablement resulting from an occupational disease that occurs on or after January first, two thousand twenty-four and before January first, two thousand twenty-five shall not be less than two hundred seventy-five dollars per week except that if the employee's wages at the time of injury are less than two hundred seventy-five dollars per week, the employee shall receive his or her full wages. Compensation for permanent or temporary partial disability, or for permanent or temporary total disability due to an accident or disablement resulting from an occupational disease that occurs on or after January first, two thousand twenty-five and before July first, two thousand twenty-six shall not be less than three hundred twenty-five dollars per week except that if the employee's wages at the time of injury are less than three hundred twenty-five dollars per week, the employee shall receive his or her full wages. Compensation for permanent or temporary partial disability, or for permanent or temporary total disability due to an accident or disablement resulting from an occupational disease that occurs on or after July first, two thousand twenty-six and on or after July first of each succeeding year shall not be less than one-fifth of the New York state average weekly wage for the year in which it is reported except that if the employee's weekly wages are equal to or less than one-fifth of the New York state average weekly wage for the year in which it is reported, the employee shall receive his or her full wages. In no event shall compensation when combined with decreased earnings or earning capacity exceed the amount of wages the employee was receiving at the time the injury occurred. Compensation for permanent or temporary partial disability, or for permanent or temporary total disability due to an accident or disablement resulting from an occupational disease or injury that occurred as a result of World Trade Center rescue activity by an employee of a private voluntary hospital, who passed a physical examination upon employment as a rescue worker that failed to reveal evidence of a condition that was the proximate cause of disablement or occupational disease or injury, shall not exceed three-quarters of a claimant's wage on September eleventh, two thousand one. In no event shall compensation when combined with decreased earnings or earning capacity exceed the amount of wages the employee was receiving on September eleventh, two thousand one. (b) Compensation for temporary total disability due to an accident or disablement resulting from an occupational disease that occurs on or after July first, nineteen hundred seventy-four, and prior to July first, nineteen hundred seventy-eight, shall not exceed one hundred twenty-five dollars per week nor be less than thirty dollars per week; except that if the employee's wages at the time of injury are less than thirty dollars per week, he shall receive his full weekly wages. Compensation for permanent total disability or for permanent or temporary partial disability due to an accident or disablement resulting from an occupational disease that occurs on or after July first, nineteen hundred seventy-four, and prior to January first, nineteen hundred seventy-eight, shall not exceed ninety-five dollars per week; nor be less than twenty dollars per week; except that if the employee's wages at the time of injury are less than twenty dollars per week, he shall receive his full weekly wages. In no event shall compensation when combined with decreased earnings or earning capacity exceed the amount of wages which the employee was receiving at the time the injury occurred. (c) Compensation for temporary total disability due to an accident or disablement resulting from an occupational disease that occurs on or after July first, nineteen hundred seventy and prior to July first, nineteen hundred seventy-four, shall not exceed ninety-five dollars per week nor be less than thirty dollars per week; except that if the employee's wages at the time of injury are less than thirty dollars per week, he shall receive his full weekly wages. Compensation for permanent total disability or for permanent or temporary partial disability due to an accident or disablement resulting from an occupational disease that occurs on or after July first, nineteen hundred seventy and prior to July first, nineteen hundred seventy-four, shall not exceed eighty dollars per week; nor be less than twenty dollars per week; except that if the employee's wages at the time of injury are less than twenty dollars per week, he shall receive his full weekly wages. In no event shall compensation when combined with decreased earnings or earning capacity exceed the amount of wages which the employee was receiving at the time the injury occurred. (d) Compensation for temporary total disability due to an accident or disablement resulting from an occupational disease that occurs on or after July first, nineteen hundred sixty-eight, and prior to July first, nineteen hundred seventy, shall not exceed eighty-five dollars per week nor be less than thirty dollars per week; except that if the employee's wages at the time of injury are less than thirty dollars per week, he shall receive his full weekly wages. Compensation for permanent total disability or for permanent or temporary partial disability due to an accident or disablement resulting from an occupational disease that occurs on or after July first, nineteen hundred sixty-eight, and prior to July first, nineteen hundred seventy, shall not exceed seventy dollars per week; nor be less than twenty dollars per week; except that if the employee's wages at the time of injury are less than twenty dollars per week, he shall receive his full weekly wages. In no event shall compensation when combined with decreased earnings or earning capacity exceed the amount of wages which the employee was receiving at the time the injury occurred. (e) Compensation for permanent or temporary partial disability, or for permanent or temporary total disability due to an accident or disablement resulting from an occupational disease that occurs on or after July first, nineteen hundred sixty-five, and prior to July first, nineteen hundred sixty-eight, shall not exceed sixty dollars per week; nor be less than twenty dollars per week; except that if the employee's wages at the time of injury are less than twenty dollars per week, he shall receive his full weekly wages. In no event shall compensation when combined with decreased earnings or earning capacity exceed the amount of wages which the employee was receiving at the time the injury occurred. (f) Compensation for permanent or temporary partial disability, or for permanent or temporary total disability due to an accident or disablement resulting from an occupational disease that occurs on or after July first, nineteen hundred sixty-two and prior to July first nineteen hundred sixty-five, shall not exceed fifty-five dollars per week; nor be less than twenty dollars per week; except that if the employee's wages at the time of injury are less than twenty dollars per week, he shall receive his full weekly wages. In no event shall compensation when combined with decreased earnings or earning capacity exceed the amount of wages which the employee was receiving at the time the injury occurred. (g) Compensation for permanent or temporary partial disability, or for permanent or temporary total disability due to an accident or disablement resulting from an occupational disease that occurs on or after July first, nineteen hundred sixty and prior to July first, nineteen hundred sixty-two, shall not exceed fifty dollars per week; nor be less than twenty dollars per week, except that if the employee's wages at the time of injury are less than twenty dollars per week, he shall receive his full weekly wages. In no event shall compensation when combined with decreased earnings or earning capacity exceed the amount of wages which the employee was receiving at the time the injury occurred. (h) Compensation for permanent or temporary partial disability, or for permanent or temporary total disability due to an accident or disablement resulting from an occupational disease that occurs on or after July first, nineteen hundred fifty-eight and prior to July first, nineteen hundred sixty, shall not exceed forty-five dollars per week; nor, except in cases of permanent total disability, be less than twenty dollars per week; except that if the employee's wages at the time of injury are less than twenty dollars per week, he shall receive his full weekly wages; further provided, that in each case of permanent total disability minimum compensation shall not be less than twenty dollars per week, except that where the employee's wages at the time of injury are less than twenty dollars per week he shall receive his full weekly wages. In no event shall compensation when combined with decreased earnings or earning capacity exceed the amount of wages which the employee was receiving at the time the injury occurred. (i) Compensation for permanent or temporary partial disability, or for permanent or temporary total disability due to an accident or disablement resulting from an occupational disease that occurs on or after July first, nineteen hundred fifty-four and prior to July first, nineteen hundred fifty-eight, shall not exceed thirty-six dollars per week; nor, except in cases of permanent total disability, be less than twelve dollars per week; except that if the employee's wages at the time of injury are less than twelve dollars per week, he shall receive his full weekly wages; further provided, that in each case of permanent total disability minimum compensation shall not be less than fifteen dollars per week, except that where the employee's wages at the time of injury are less than fifteen dollars per week he shall receive his full weekly wages. In no event shall compensation when combined with decreased earnings or earning capacity exceed the amount of wages which the employee was receiving at the time the injury occurred. (j) Compensation for permanent or temporary partial disability, or for permanent or temporary total disability due to an accident or disablement resulting from an occupational disease that occurs on or after July first, nineteen hundred forty-eight and prior to July first, nineteen hundred fifty-four, shall not exceed thirty-two dollars per week and compensation for permanent or temporary partial disability, or for permanent or temporary total disability due to an accident or disablement resulting from an occupational disease that occurs on or after June first, nineteen hundred forty-six, and prior to July first, nineteen hundred forty-eight, shall not exceed twenty-eight dollars per week; nor, except in cases of permanent total disability, be less than twelve dollars per week; except that if the employee's wages at the time of injury are less than twelve dollars per week, he shall receive his full weekly wages; further provided, that in each case of permanent total disability minimum compensation shall not be less than fifteen dollars per week, except that where the employee's wages at the time of injury are less than fifteen dollars per week, he shall receive his full weekly wages but in no event shall compensation when combined with decreased earnings or earning capacity exceed the amount of wages which the employee was receiving at the time the injury occurred; further provided, that compensation may be in excess of twenty-five dollars but shall not exceed twenty-eight dollars per week for permanent or temporary total disability due to an accident or disablement resulting from an occupational disease that occurred on or after June first, nineteen hundred forty-four, and prior to July first, nineteen hundred forty-eight, and in each case of temporary total disability minimum compensation shall not be less than twelve dollars per week, except that where the employee's wages at the time of injury are less than twelve dollars per week, he shall receive his full weekly wages; and further provided that, because of existing conditions due to the war compensation for permanent or temporary total disability may be in excess of twenty-five dollars but shall not exceed twenty-eight dollars per week for any period of disability arising out of claims accruing during the three year period commencing June first, nineteen hundred forty-four. 6-a. Reclassification of disabilities. Subject to the limitations set forth in sections twenty-five-a and one hundred twenty-three of this chapter, the board may, at any time, without regard to the date of accident, upon its own motion, or on application of any party in interest, reclassify a disability upon proof that there has been a change in condition, or that the previous classification was erroneous and not in the interest of justice. 7. Previous disability. The fact that an employee has suffered previous disability or received compensation therefor shall not preclude him from compensation for a later injury nor preclude compensation for death resulting therefrom; but in determining compensation for the later injury or death his average weekly wages shall be such sum as will reasonably represent his earning capacity at the time of the later injury, provided, however, that an employee who is suffering from a previous disability shall not receive compensation for a later injury in excess of the compensation allowed for such injury when considered by itself and not in conjunction with the previous disability except as hereinafter provided in subdivision eight of this section. 8. Disability following previous permanent physical impairment. (a) Declaration of policy and legislative intent. As a guide to the interpretation and application of this subdivision, the policy and intent of this legislature is declared to be as follows: First: That every person in this state who works for a living is entitled to reasonable opportunity to maintain his independence and self-respect through self-support even after he/she has been physically handicapped by injury or disease; Second: That any plan which will reasonably, equitably and practically operate to break down hindrances and remove obstacles to the employment of partially disabled persons who (i) are honorably discharged from our armed forces, or (ii) have a qualifying condition, as defined in section one of the veterans' services law, and received a discharge other than bad conduct or dishonorable from such service, or (iii) are discharged LGBT veterans, as defined in section one of the veterans' services law, and received a discharge other than bad conduct or dishonorable from such service, or any other physically handicapped persons, is of vital importance to the state and its people and is of concern to this legislature; Third: That it is the considered judgment of this legislature that the system embodied in this subdivision, which makes a logical and equitable adjustment of the liability under the workers' compensation law which an employer must assume in hiring employees, constitutes a practical and reasonable approach to a solution of the problem for the employment of physically handicapped persons. Moreover, because of the insidious nature of slowly developing diseases such as silicosis and other dust diseases and because of the reluctance on the part of employers to employ persons previously exposed to silica or other harmful dust, means should also be provided whereby employers will be encouraged to employ and to continue the employment of such persons, by apportioning liability fairly between the employer and industry as a whole without at the same time removing any incentive for the prevention of harmful dust diseases. (b) Definition. As used in this subdivision, "permanent physical impairment" means any permanent condition due to previous accident or disease or any congenital condition which is or is likely to be a hindrance or obstacle to employment. (c) Permanent total disability after permanent partial disability. Notwithstanding the provisions of paragraph (d) of this subdivision, if an employee who has previously incurred permanent partial disability through the loss of one hand, one arm, one foot, one leg, or one eye, incurs permanent total disability through the loss of another member or organ, he/she shall be paid, in addition to the compensation for permanent partial disability provided in this section and after the cessation of the payments for the prescribed period of weeks special additional compensation during the continuance of such total disability to the amount of sixty-six and two-thirds per centum of the average weekly wage earned by him/her at the time the total permanent disability was incurred. If such employee shall establish an earning capacity by employment he shall be paid during the period of such employment, instead of the additional compensation above provided, two-thirds of the difference between his average weekly wages at the time the total disability was incurred and his wage earning capacity as determined by his actual earnings in such employment, subject to the limitations in subdivision six of this section. Such additional compensation, and expense as in this subdivision provided, shall be paid out of the special disability fund and in the manner as hereinafter in this subdivision provided. (d) If an employee of an employer who has secured the payment of compensation as required under the provisions of section fifty of this chapter, who had a total or partial loss or loss of use of one hand, one arm, one foot, one leg or one eye, or who has other permanent physical impairment incurs a subsequent disability by accident arising out of and in the course of his employment or an occupational disease arising therefrom, resulting in a permanent disability caused by both conditions that is materially and substantially greater than that which would have resulted from the subsequent injury or occupational disease alone, the employer or his insurance carrier shall in the first instance pay all awards of compensation and all medical expense provided by this chapter, but such employer or his insurance carrier, except as specifically provided in paragraph (ee) of this subdivision, shall be reimbursed from the special disability fund created by this subdivision for all compensation and medical benefits subsequent to those payable for the first one hundred four weeks of disability for claims where the date of accident or date of disablement occurred prior to August first, nineteen hundred ninety-four, and two hundred sixty weeks of disability for claims where the date of accident or date of disablement occurred on or after August first, nineteen hundred ninety-four, regardless of knowledge on the part of the employer as to the existence of such pre-existing permanent physical impairment. Notwithstanding anything to the contrary in this chapter, there may be apportionment of liability for the special disability fund under this subdivision within a single claim by disposition between the fund, carriers, self-insurers or employers. (e) If the subsequent injury of such an employee resulting from an accident arising out of and in the course of his employment or an occupational disease resulting therefrom, as set forth in paragraph (d) of this subdivision, shall result in the death of the employee and it shall be determined that either the injury or death would not have occurred except for such pre-existing permanent physical impairment, the employer or his insurance carrier shall in the first instance pay the funeral expenses and the death benefits prescribed by this chapter, but he or his insurance carrier, except as specifically provided in paragraph (ee) of this subdivision, shall be reimbursed from the special disability fund created by this subdivision for all death benefits payable in excess of one hundred four weeks of disability for claims where the date of accident or date of disablement occurred prior to August first, nineteen hundred ninety-four, and two hundred sixty weeks of disability for claims where the date of accident or date of disablement occurred on or after August first, nineteen hundred ninety-four, regardless of knowledge on the part of the employer as to the existence of such pre-existing permanent physical impairment. (ee) If an employee of an employer who has secured the payment of compensation as required under the provisions of section fifty of this chapter is disabled from silicosis or other dust disease, or in the event of death, death was due to silicosis or other dust disease, and if such an employee has been subject to an injurious exposure in an employment defined under paragraph twenty-nine of subdivision two of section three of this chapter, the provisions of this subdivision shall apply except as hereinafter stated; and it shall not be required that the employee had, either at the time of hiring or during the employment, any previous physical condition or disability which may result in such disability or death. In all such cases the employer or his insurance carrier shall in the first instance pay all awards of compensation and all medical expense provided by this chapter; and in the event of death, the employer or his insurance carrier shall also in the first instance pay the funeral expenses and the death benefits prescribed by this chapter; but such employer or his insurance carrier shall subject to the limitations of subparagraphs two and three of paragraph (h) of this subdivision be reimbursed from the special disability fund created by this subdivision for all compensation and medical benefits subsequent to those payable for the first one hundred four weeks of disability for claims where the date of accident or date of disablement occurred prior to August first, nineteen hundred ninety-four, and two hundred sixty weeks of disability for claims where the date of accident or date of disablement occurred on or after August first, nineteen hundred ninety-four, and, in the event of death, the employer or his insurance carrier shall be reimbursed from the special disability fund created by this subdivision for all death benefits payable in excess of one hundred four weeks for claims where the date of accident or date of disablement occurred prior to August first, nineteen hundred ninety-four, and two hundred sixty weeks for claims where the date of accident or date of disablement occurred on or after August first, nineteen hundred ninety-four; provided, however, that when total disability or death occurred after July first, nineteen hundred forty-seven, and prior to July first, nineteen hundred seventy-four, the employer or his insurance carrier shall be reimbursed from the special disability fund created by this subdivision for all compensation and medical benefits including funeral expenses and death benefits subsequent to those payable for the first two hundred sixty weeks of disability and death benefits combined; and further provided, however, that in the event of death due to silicosis or other dust disease on or after July first, nineteen hundred forty-seven, of such an employee who shall have been totally disabled from silicosis or other dust disease prior to such date, the employer or his insurance carrier shall be reimbursed from the special disability fund created by this subdivision for death benefits subsequent to those payable for the first one hundred four weeks. The compensation of an employee who has heretofore been found to be totally and permanently disabled from silicosis or other dust disease and whose disablement occurred prior to July first, nineteen hundred forty-seven, shall be continued or resumed, as the case may be, after June first, nineteen hundred fifty-one, and payments shall be made during continuance of such disability at his/her regular weekly rate, notwithstanding the fact that such compensation is in excess of the maximum provided for his/her case under former article four-a of this chapter; but such compensation in excess of the maximum so provided shall be paid from the special fund created by this subdivision. (f) Any award under this subdivision shall be made against the employer or his or her insurance carrier, but if such employer or insurance carrier be entitled to reimbursement as provided in this subdivision, notice or claim of the right to such reimbursement shall be filed with the board in writing prior to the final determination that the resulting disability is permanent, but in no case more than one hundred four weeks after the date of disability or death or fifty-two weeks after the date that a claim for compensation is filed with the chair, whichever is later, or in the event of the reopening of a case theretofore closed, no later than the determination of permanency upon such reopening. In no event shall such a notice of claim be filed beyond the dates set forth in subparagraph two of paragraph (h) of this subdivision. The employer or his or her insurance carrier shall in the first instance make the payments of compensation and medical expenses provided by this subdivision. Whenever for any reason payments are not made by the employer or his or her insurance carrier at any time after the payments have been made for the first one hundred four weeks for claims where the date of accident or date of disablement occurred prior to August first, nineteen hundred ninety-four, and two hundred sixty weeks for claims where the date of accident or date of disablement occurred on or after August first, nineteen hundred ninety-four, the payments of subsequent compensation and medical expenses shall be made out of the special disability fund by the commissioner of taxation and finance upon vouchers approved by the chair of the workers' compensation board. In case any payments prior to the expiration of the first one hundred four weeks for claims where the date of accident or date of disablement occurred prior to August first, nineteen hundred ninety-four, and two hundred sixty weeks for claims where the date of accident or date of disablement occurred on or after August first, nineteen hundred ninety-four are not made by the employer or his or her insurance carrier by reason of the insolvency of such carrier, the payments until the expiration of one hundred four weeks for claims where the date of accident or date of disablement occurred prior to August first, nineteen hundred ninety-four, and two hundred sixty weeks for claims where the date of accident or date of disablement occurred on or after August first, nineteen hundred ninety-four shall be made out of the stock workers' compensation security fund created by the provisions of section one hundred seven of this chapter if the insolvent carrier be a stock company, or out of the mutual workers' compensation security fund created under the provisions of section one hundred nine-d of this chapter if the carrier be a mutual company. If any such payments are not made by an employer permitted to secure the payment of compensation pursuant to the provisions of subdivision three of section fifty of this chapter, the payments shall be made out of the proceeds of the sale of any securities deposited by the employer with the chair, upon vouchers approved by the chair, until such payments have been made for one hundred four weeks for claims where the date of accident or date of disablement occurred prior to August first, nineteen hundred ninety-four, and two hundred sixty weeks for claims where the date of accident or date of disablement occurred on or after August first, nineteen hundred ninety-four, from the date of disability, after which date they shall be made out of the special disability fund in the manner above provided. In all cases in which awards have been made and charged against the special fund or injuries have occurred which would require payments to be made in accordance with the provisions of former subdivision eight of this section as it existed immediately prior to the time this subdivision, as hereby added, takes effect, the compensation so awarded or that shall be awarded in such cases shall continue to be paid out of the special disability fund by the commissioner of taxation and finance upon vouchers approved by the chair of the workers' compensation board, as though this subdivision had not been enacted. (g) Upon the making of a determination that an employer or insurance carrier is entitled to reimbursement from the special disability fund in any case where the employer or insurance carrier has made payment into the aggregate trust fund, as provided in section twenty-seven of this chapter, or where payment of compensation has been commuted into one or more lump sum payments, the employer or insurance carrier shall be reimbursed forthwith for the sums paid in excess of those payable for one hundred four weeks for claims where the date of accident or date of disablement occurred prior to August first, nineteen hundred ninety-four, two hundred sixty weeks for claims where the date of accident or date of disablement occurred on or after August first, nineteen hundred ninety-four or two hundred sixty weeks in a silicosis or other dust disease case as otherwise provided in paragraph (ee) of this subdivision, exclusive of administrative and loading charges paid pursuant to section twenty-seven, in accordance with the decision and order of the board. In all other cases such employer or insurance carrier shall, periodically every six months from the decision and order of the board, be reimbursed from such special disability fund for all compensation and medical expense in accordance with the provisions of paragraph (f) of this subdivision. (h) Special disability fund. (1) The fund heretofore maintained and provided for by and pursuant to former subdivision eight of this section, is hereby continued and shall retain the liabilities heretofore charged or chargeable thereto under the provisions of such former subdivision eight of this section as it existed immediately prior to the time this subdivision, as hereby added, takes effect, and the liabilities chargeable thereto under the provisions of former subdivision eight-a of this section as added by chapter seven hundred forty-nine of the laws of nineteen hundred forty-four and repealed at the same time this subdivision, as heretofore added, takes effect, and payments therefrom on account of such liabilities shall continue to be made as provided herein. The said fund shall be known as the special disability fund and shall be available only for the purposes stated in this subdivision, and the assets thereof shall not at any time be appropriated or diverted to any other use or purpose. (2) (A) No carrier or employer, or the state insurance fund, may file a claim for reimbursement from the special disability fund, for an injury or illness with a date of accident or date of disablement on or after July first, two thousand seven. No carrier or employer, or the state insurance fund, may file a claim for reimbursement from the special disability fund after July first, two thousand ten, and no written submissions or evidence in support of such a claim may be submitted after that date. (B) All requests for reimbursement from the special disability fund with a date of injury or date of disablement prior to July first, two thousand seven as to which the board has determined that the special disability fund is liable must be submitted to the special disability fund by the later of (i) one year after the expense has been paid, or (ii) one year from the effective date of this paragraph. (3) Effective the first day of January, two thousand fourteen, and annually thereafter, the chair of the board shall collect from all affected employers (A) a sum equal to one hundred fifty per centum of the total expected disbursements made from the special disability fund during the year (not including any disbursements made on account of anticipated liabilities or waiver agreements funded by bond proceeds and related earnings), less the estimated amount of the net assets in such fund expected as of December thirty-first and (B) a sum sufficient to cover debt service, and associated costs (the "debt service assessment") to be paid during the calendar year by the dormitory authority, as calculated in accordance with subparagraph four of this paragraph. Such assessments shall be included in the assessment rate established pursuant to subdivision two of section one hundred fifty-one of this chapter. Such assessments shall be deposited with the commissioner of taxation and finance and transferred to the benefit of such fund following payment of debt service and associated costs, if any, pursuant to section one hundred fifty-one of this chapter. (4) The chair and the commissioner of taxation and finance are authorized and directed to enter into a financing agreement with the dormitory authority, to be known as the "special disability fund financing agreement." Such agreement shall set forth the process for calculating the annual debt service of the bonds issued by the dormitory authority and any other associated costs. For purposes of this section, "associated costs" may include a coverage factor, reserve fund requirements, all costs of any nature incurred by the dormitory authority in connection with the special disability fund financing agreement or pursuant thereto, the operating costs of the waiver agreement management office, the costs of any independent audits undertaken under this section, and any other costs for the implementation of this subparagraph and the issuance of bonds by the dormitory authority, including interest rate exchange payments, rebate payments, liquidity fees, credit provider fees, fiduciary fees, remarketing, dealer, auction agent and related fees and other similar bond-related expenses, unless otherwise funded. By January first of each year, the dormitory authority shall provide to the chair the calculation of the amount expected to be paid by the dormitory authority in debt service and associated costs for purposes of calculating the debt service assessment as set forth in subparagraph three of this paragraph. All monies received on account of any assessment under subparagraph three of this paragraph and this subparagraph shall be applied in accordance with this subparagraph and in accordance with the financing agreement until the financial obligations of the dormitory authority in respect to its contract with its bondholders are met and all associated costs payable to the dormitory authority have been paid, notwithstanding any other provision of law respecting secured transactions. This provision may be included by the dormitory authority in any contract of the dormitory authority with its bondholders. The special disability fund financing agreement may restrict disbursements, investments, or rebates, and may prescribe a system of accounts applicable to the special disability fund, including custody of an account with a trust indenture trustee that may be prescribed by the dormitory authority as part of its contract with the bondholders. For purposes of this paragraph, the term "bonds" shall include notes issued in anticipation of the issuance of bonds, or notes issued pursuant to a commercial paper program. (5) The commissioner of taxation and finance is hereby authorized to receive and credit to such special disability fund any sum or sums that may at any time be contributed to the state by the United States of America under any act of congress, or otherwise, to which the state may be or become entitled by reason of any payments made out of such fund. (6) The commissioner of taxation and finance shall be the custodian of said fund and, unless otherwise provided for in the special disability fund financing agreement, shall invest any surplus or reserve moneys thereof in securities which constitute legal investments for savings banks under the laws of this state and in interest bearing certificates of deposit of a bank or trust company located and authorized to do business in this state or of a national bank located in this state secured by a pledge of direct obligations of the United States or of the state of New York in an amount equal to the amount of such certificates of deposit, and may sell any of the securities or certificates of deposit in which such fund is invested if necessary for the proper administration or in the best interest of such fund. Disbursements from such fund as provided by this subdivision shall be made by the commissioner of taxation and finance upon vouchers signed by the chair of the board unless the financing agreement provides for some other means of authorizing such disbursements that is no less protective of the fund. The commissioner of taxation and finance, as custodian of such fund, annually as soon as practicable after January first, shall furnish to the chair of the workers' compensation board a statement of the fund, setting forth the balance of moneys in the said fund as of the beginning of the calendar year, the income of the fund, the summary of payments out of the fund on account of reimbursements and other charges ordered to be paid by the board, and all other charges against the fund, and setting forth the balance of the fund remaining to its credit on December thirty-first. Such statement shall be open to public inspection in the office of the secretary of the board. The chair, not less than ninety days after the issuance of the dormitory authority's annual audit, shall furnish to the temporary president of the senate and the speaker of the assembly the following reports on the special disability fund: a revenue and operating expense statement; a financing plan; a report concerning the assets and liabilities; the number of waiver agreements entered into by the waiver agreement management office; the number of claimants remaining in the fund; the estimated current unfunded liability of the fund with respect to such claims; and a debt issuance report including but not limited to (i) pledged assessment revenue and securitization coverage, (ii) debt service maturities, (iii) interest rate exchange or similar agreements, and (iv) financing and issuance costs. The commissioner of taxation and finance may establish within the special disability fund such accounts and sub-accounts as he or she deems useful for the operation of the fund, or as necessary to segregate moneys within the fund, subject to the provisions of the financing agreement. The waiver agreement management office, as defined in section thirty-two of this article, shall make application to the chair on a quarterly basis for any administrative costs incurred by the office. (i) When an application for apportionment of compensation is made under this subdivision, the chair of the workers' compensation board shall appoint an attorney to represent and defend such fund in such proceedings. Such attorney shall thereafter be given notice of all proceedings involving the rights or obligations of such fund. Such attorney may apply to the chair of the board for authority to hire such medical and other experts and to defray the expense thereof and of such witnesses as may be necessary to a proper defense of any claim, within an amount in the discretion of the chair and, if authorized, such amount shall be a charge against such special disability fund. The provisions of this chapter with respect to procedure, except as may be otherwise provided in this subdivision, and the right of appeal shall be preserved to the claimant and to the employer or his insurance carrier and to such fund through its attorney as herein provided. (j) The provisions of this subdivision, except as herein otherwise provided, shall not be applicable to any case where the accident causing the subsequent injury or death or the disablement or death from a subsequent occupational disease shall have occurred prior to the time this subdivision, as hereby added, takes effect, provided, however, that any rights that have accrued under former subdivision eight or eight-a of this section prior to the time this subdivision, as hereby added, takes effect shall continue to inure to the benefit of any persons affected thereby as though such subdivisions had not been repealed. (k) The additional compensation required to be paid by an employer in the case of the injury of a minor illegally employed, in accordance with the provisions of subdivisions one and two of section fourteen-a of this chapter, shall not be reimbursable under the provisions of this subdivision. (l) Notwithstanding anything to the contrary in this subdivision, when an employer or carrier shall have paid additional benefits to an employee pursuant to subdivision six of section fourteen of this article as a result of the employee's increased average weekly wages from wages earned in concurrent employment, reimbursement for all such additional benefits shall be made to the employer or carrier from the special disability fund created by this subdivision. It shall not be required that the employee had, either at the time of hiring or during the employment, any previous physical condition or disability, nor shall it be required that the employee's disability be permanent in nature. Notice of the right to reimbursement shall be filed with the board in writing prior to the decision making an award, and reimbursement shall be made periodically, every six months from the decision of the board. 9. Expenses for rehabilitating injured employees. An employee, who as a result of injury is or may be expected to be totally or partially incapacitated for a remunerative occupation and who, under the direction of the state education department is being rendered fit to engage in a remunerative occupation, may receive additional compensation necessary for his rehabilitation, not more than thirty dollars per week of which may be expended for maintenance. Such expense and such of the administrative expenses of the state education department as are properly assignable to the expenses of rehabilitating employees entitled to compensation as a result of injuries under this chapter, shall be paid out of a special fund created in the following manner: The employer, or if insured, his insurance carrier, shall pay into the vocational rehabilitation fund for every case of injury causing death, in which there are no persons entitled to compensation, the sum of five hundred dollars where such injury occurred prior to July first, nineteen hundred sixty-three and the sum of one thousand dollars where such injury shall occur on or after July first, nineteen hundred sixty-three and the sum of two thousand dollars where such injury shall occur on or after September first, nineteen hundred seventy-eight. The commissioner of taxation and finance and the state comptroller shall be the joint custodians of this special fund and may invest any surplus moneys thereof in securities which constitute legal investments for savings banks under the laws of this state and in interest bearing certificates of deposit of a bank or trust company located and authorized to do business in this state or of a national bank located in this state secured by a pledge of direct obligations of the United States or of the state of New York in an amount equal to the amount of such certificates of deposit. He may also sell any of the securities or certificates of deposit in which such fund is invested if necessary for the proper administration or in the best interests of such fund. The provisions of this paragraph shall not apply with respect to policies containing coverage pursuant to subdivision four-a of section one hundred sixty-seven of the insurance law relating to every policy providing comprehensive personal liability insurance on a one, two, three or four family owner-occupied dwelling. Disbursements from the vocational rehabilitation fund for the additional compensation provided for by this section shall be paid by the commissioner of taxation and finance on warrants drawn by the state comptroller upon vouchers signed by the commissioner of education or the deputy commissioner of education provided that the compensation claim number of an injured employee undergoing vocational rehabilitation has been verified by the chairman. Disbursements from the vocational rehabilitation fund for administrative expenses of the state education department shall be paid by the commissioner of taxation and finance on warrants drawn by the state comptroller upon vouchers signed by the commissioner of education or the deputy commissioner of education. --- ## WKC § 15-A — Assessment on insolvent group self-insured trusts {#15-A} *N.Y. Workers' Comp. Law § 15-A* Official source: _NYS Open Legislation, revision of 2014-09-22._ § 15-a. Assessment on insolvent group self-insured trusts. The legislature finds that in lieu of the assessments under sections fifteen and one hundred fifty-one of this chapter that shall no longer be imposed on closed group self-insured trusts as a result of the chapter of the laws of two thousand eleven which added this section, the members of group self-insured trusts that were insolvent upon closing, and that fail to pay their obligations within the periods specified by this section, shall be subject to a one time assessment pursuant to this section. Within thirty days of January first, two thousand sixteen, all employers who were members of a closed group self-insured trust that was insolvent at the time the group was closed shall be subject to an assessment under this section, except for those employers that: (1) have entered into a settlement agreement or payment plan with the board under which they have agreed to resolve all liabilities from the membership in such trust, and remain current in their payments; (2) are members of a group self-insurer that has transferred all of its liabilities transferred via a loss portfolio transfer; or (3) have paid all moneys billed them by the board at the time such assessment is due. For purposes of this section, insolvent means the inability of a private group self-insured trust to pay its outstanding lawful obligations under this chapter as they mature in the regular course of business, as may be shown by: (i) the self-insurer being underfunded as defined in subdivision three-a of section fifty of this chapter; and (ii) the sum of the group self-insured trust's assets, as defined by regulation of the chair, plus the available security deposit held by the chair pursuant to subdivision three-a of section fifty of this chapter and regulation of the chair, being less than the total cost of all of the group self-insured trust's anticipated workers' compensation liabilities, as defined by board regulations, that will accrue within the succeeding six months. The total of such assessment shall be determined by the percentage of the assessment levied on all employers under subdivision eight of section fifteen of this article in two thousand ten that was levied on group self-insured trusts multiplied by the total amount of the employer's unpaid pro rata share of any deficit owed by the closed group self-insured employer of which such employer was a member, as determined by the chair. The amount received on such assessment shall be used as an offset against the assessments imposed on other employers under subdivision eight of section fifteen of this article and section one hundred fifty-one of this chapter in the calendar year following the year in which it was received. --- ## WKC § 16 — Death benefits {#16} *N.Y. Workers' Comp. Law § 16* Official source: _NYS Open Legislation, revision of 2021-08-13._ § 16. Death benefits. If the injury causes death, the compensation shall be known as a death benefit and shall be payable in the amount and to or for the benefit of the persons following: 1. Funeral expenses. The chair shall prepare and establish a schedule for the state or schedules limited to defined localities of maximum charges and fees for such funeral expenses, to be determined in accordance with, and to be subject to change pursuant to, rules promulgated by the chair. Before preparing such schedule for the state or schedules for limited localities, the chair shall request the president of the New York state funeral directors' association to submit to the chair a report on the amount of remuneration deemed by such association to be fair and adequate for the types of funeral services rendered under this chapter, but consideration shall also be given to the views of other interested parties. The amounts payable by the employer for such services shall be the actual fees and charges up to the maximum established by such schedule. Provided, however, no such schedule of charges and fees shall apply where a firefighter dies from injuries received in the line of duty as a direct result of firefighting or where a police officer dies from injuries received in the line of duty as a direct result of law enforcement activities, where such funeral expenses are reasonable. If such funeral expenses shall have been paid by the claimants entitled to compensation under this section or by others, the funeral expenses awarded shall be made payable to such claimants or others, otherwise they shall be made payable to the undertaker who shall have provided burial. Funeral expenses shall be awarded in case of all injuries causing death including cases in which there are no persons entitled to other compensation under this chapter. 1-a. For the purpose of this section, (1) the term dependent blind or physically disabled as used herein in relation to dependent children shall be deemed to mean totally blind or physically disabled children whose disablement is total and permanent, (2) the term surviving spouse shall be deemed to mean the legal spouse but shall not include a spouse who has abandoned the deceased, and (3) the term abandoned shall be deemed to mean such an abandonment as would be sufficient under section two hundred of the domestic relations law to sustain a judgment of separation on that ground. 1-b. If there be a surviving spouse and no child of the deceased under the age of eighteen years and no child of any age dependent blind or physically disabled, and the death occurs on or after July first, nineteen hundred forty-eight, and prior to January first, nineteen hundred seventy-eight, to such spouse forty per centum of the average wages of the deceased during widowhood or widowerhood with two years' compensation in one sum, upon remarriage; and where the death occurred prior to July first, nineteen hundred forty-eight, to such wife (or dependent husband) thirty per centum of such wages during widowhood (or dependent widowerhood) with two years' compensation in one sum, upon remarriage. 1-c. If there be a surviving spouse and no child of the deceased under the age of eighteen years or under the age of twenty-three years if enrolled and attending as a full time student in an accredited educational institution and such enrollment and full time attendance is certified by such institution and no child of any age dependent blind or physically disabled, and the death occurs on or after January first, nineteen hundred seventy-eight, to such spouse sixty-six and two-thirds per centum of the average wages of the deceased during widowhood or widowerhood with two years' compensation, in one sum, upon remarriage. Where the death occurs on or after January first, nineteen hundred seventy-eight, and the spouse is receiving the survivors insurance benefits under the social security act, the death benefit payable under this section shall be reduced in accordance with the provisions of table No. 1 below by five per centum of the spouse's share of the survivor's insurance benefits under the social security act for each ten dollars of deceased's average weekly wage in excess of one hundred dollars provided that in no case shall such reduction exceed fifty per centum of said spouse's share of the survivors insurance benefits under the social security act. TABLE No. I Offset provisions applicable in death benefits where there is a sole surviving spouse AVERAGE WEEKLY WAGE PERCENTAGE OF SPOUSE'S SHARE OF SURVIVORS INSURANCE BENEFITS over $100 up to and including $110 ................................... 5 over $110 up to and including $120 .................................. 10 over $120 up to and including $130 .................................. 15 over $130 up to and including $140 .................................. 20 over $140 up to and including $150 .................................. 25 over $150 up to and including $160 .................................. 30 over $160 up to and including $170 .................................. 35 over $170 up to and including $180 .................................. 40 over $180 up to and including $190 .................................. 45 over $190 up to and including $200 .................................. 50 over $200 ........................................................... 50 1-d. If there be a surviving spouse of an employee of a private voluntary hospital killed in a World Trade Center rescue, who passed a physical examination upon employment as a rescue worker that failed to reveal evidence of a condition that was the proximate cause of death, and no child of the deceased under the age of eighteen years, or under the age of twenty-three years if enrolled and attending as a full-time student in an accredited educational institution and such enrollment and full-time attendance is certified by such institution, and no child of any age dependent blind or physically disabled, to such spouse seventy-five per centum of the average wages of the deceased during widowhood or widowerhood, with two years' compensation, in one sum, upon remarriage. Where such death occurs, and the spouse is receiving the survivors insurance benefits under the social security act, the death benefit payable under this section shall be reduced in accordance with the provisions of table No. I in subdivision one-c of this section by five per centum of the spouse's share of the survivor's insurance benefits under the social security act for each ten dollars of deceased's average weekly wage in excess of one hundred dollars; provided that in no case shall such reduction exceed fifty per centum of such spouse's share of the survivors insurance benefits under the social security act. 2. If there be a surviving spouse and a surviving child or children of the deceased under the age of eighteen years or a surviving child or children of any age dependent blind or physically disabled, and the death occurs on or after July first, nineteen hundred forty-eight, and prior to January first, nineteen hundred seventy-eight, to such spouse thirty per centum of the average wages of the deceased during widowhood or widowerhood with two years' compensation in one sum, upon remarriage; and the additional amount of twenty per centum of such wages for each such child until the age of eighteen years or until the removal of the dependency of the blind or physically disabled child or children; in case of the subsequent death or remarriage of such surviving spouse any surviving child of the deceased employee, at the time under eighteen years of age or dependent through mental or physical infirmity, shall have his compensation increased to thirty per centum of such wages, and the same shall be payable until he shall reach the age of eighteen years or until such dependent blind or physically disabled condition shall have been removed; provided that the total amount payable shall in no case exceed sixty-six and two-thirds per centum of such wages. Upon statutory termination of compensation payments to all such children, the compensation of the surviving spouse shall be increased to forty per centum of such wages with two years' compensation, at such rate, in one sum, upon remarriage. If there be a surviving wife (or dependent husband) and any of the aforementioned surviving children, and the death occurred prior to July first, nineteen hundred forty-eight, to such wife (or dependent husband) thirty per centum of the average wages of the deceased during widowhood (or dependent widowerhood) with two years' compensation in one sum, upon remarriage; and the additional amount of ten per centum of such wages for each such child until eighteen years of age or until the removal of the dependency of the blind or physically disabled child or children; in case of the subsequent death or remarriage of such surviving wife (or dependent husband) any surviving child of the deceased shall have his compensation increased to fifteen per centum of such wages until he shall reach the age of eighteen years or until such dependent blind or physically disabled condition shall have been removed; provided that the total amount payable shall in no case exceed sixty-six and two-thirds per centum of such wages. The board may in its discretion require the appointment of a guardian for the purpose of receiving the compensation of a minor child or a dependent blind or physically disabled child. In the absence of such a requirement by the board the appointment of a guardian for such purposes shall not be necessary. 2-a. If there be a surviving spouse and a surviving child under the age of eighteen years or under the age of twenty-three years if enrolled and attending as a full time student in an accredited educational institution and such enrollment and full time attendance is certified by such institution or a surviving child of any age dependent blind or physically disabled and the death occurs on or after January first, nineteen hundred seventy-eight, to such spouse thirty-six and two-thirds per centum of the average wages of the deceased during widowhood or widowerhood with two years' compensation in one sum, upon remarriage; and thirty per centum of such wages to such child under the age of eighteen years or under the age of twenty-three years if enrolled and attending as a full time student in an accredited educational institution and such enrollment and full time attendance is certified by such institution or a surviving child of any age dependent blind or physically disabled; in the case of the subsequent death of such surviving spouse the surviving child shall have his compensation increased to sixty-six and two-thirds per centum of such wages and the same shall be payable so long as he is under the age of eighteen years or under the age of twenty-three years if enrolled and attending as a full time student in an accredited educational institution and such enrollment and full time attendance is certified by such institution or a surviving child of any age dependent blind or physically disabled; upon statutory termination of compensation payable to such child, the compensation of the surviving spouse shall be increased to sixty-six and two-thirds per centum of such wages with two years' compensation, at such rate, in one sum, upon remarriage. Upon remarriage of such surviving spouse, the surviving child shall continue to receive thirty per centum of such wages. Where the death occurs on or after January first, nineteen hundred seventy-eight and the spouse is receiving survivors insurance benefits under the social security act, the death benefit payable under this section shall be reduced by five per centum of the spouse's share of the survivors insurance benefits under the social security act for each ten dollars of deceased's average weekly wage in excess of one hundred dollars provided that in no case shall such reduction exceed fifty per centum of said spouse's share of the survivors insurance benefits under the social security act as set forth in table No. I below. TABLE No. I Offset provisions applicable in death benefits where there is a surviving spouse and one child AVERAGE WEEKLY WAGE PERCENTAGE OF SPOUSE'S SHARE OF SURVIVORS INSURANCE BENEFITS over $100 up to and including $110 ................................... 5 over $110 up to and including $120 .................................. 10 over $120 up to and including $130 .................................. 15 over $130 up to and including $140 .................................. 20 over $140 up to and including $150 .................................. 25 over $150 up to and including $160 .................................. 30 over $160 up to and including $170 .................................. 35 over $170 up to and including $180 .................................. 40 over $180 up to and including $190 .................................. 45 over $190 up to and including $200 .................................. 50 over $200 ........................................................... 50 If there be a surviving spouse and two or more surviving children under the age of eighteen years or under the age of twenty-three years if enrolled and attending as a full time student in an accredited educational institution and such enrollment and full time attendance is certified by such institution or a surviving child or children of any age dependent blind or physically disabled and a death occurs on or after January first, nineteen hundred seventy-eight, to such spouse thirty-six and two-thirds per centum of the average wage of the deceased during widowhood or widowerhood with two years' compensation in one sum upon remarriage; and thirty per centum of such wages to such children under the age of eighteen years or under the age of twenty-three years if enrolled and attending as a full time student in an accredited educational institution and such enrollment and full time attendance is certified by such institution or a surviving child or children of any age dependent blind or physically disabled, share and share alike; in case of the subsequent death of such surviving spouse the surviving children shall have their compensation increased to sixty-six and two-thirds per centum of such wages and the aggregate sum shall be payable, share and share alike, so long as they are under the age of eighteen years or under the age of twenty-three years if enrolled and attending as a full time student in an accredited educational institution and such enrollment and full time attendance is certified by such institution or a surviving child or children of any age dependent blind or physically disabled. Upon remarriage of such surviving spouse, if there be two surviving children each shall receive twenty-five per centum of such wages, and if there are surviving more than two children under the age of eighteen years or under the age of twenty-three if enrolled and attending as a full time student in an accredited educational institution and such enrollment and full time attendance is certified by such institution or a surviving child or children of any age dependent blind or physically disabled sixty-six and two-thirds per centum of such wages share and share alike. Upon statutory termination of compensation payable to such children, the compensation of the surviving spouse shall be increased to sixty-six and two-thirds per centum of such wages with two years' compensation, at such rate, in one sum, upon remarriage. Where the death occurs on or after January first, nineteen hundred seventy-eight, and the spouse is receiving survivors insurance benefits under the social security act, the death benefits payable under this section shall be reduced by five per centum of the spouse's share of the survivors insurance benefits under the social security act for each ten dollars of deceased's average weekly wage in excess of one hundred fifty dollars provided that in no case shall such reduction exceed fifty per centum of said spouse's share of the survivors insurance benefits under the social security act as set forth in table No. II below. TABLE No. II Offset provisions applicable in death benefits where there is a surviving spouse and two or more children AVERAGE WEEKLY WAGE PERCENTAGE OF SPOUSE'S SHARE OF SURVIVORS INSURANCE BENEFITS over $150 up to and including $160 ................................... 5 over $160 up to and including $170 .................................. 10 over $170 up to and including $180 .................................. 15 over $180 up to and including $190 .................................. 20 over $190 up to and including $200 .................................. 25 over $200 up to and including $210 .................................. 30 over $210 up to and including $220 .................................. 35 over $220 up to and including $230 .................................. 40 over $230 up to and including $240 .................................. 45 over $240 up to and including $250 .................................. 50 over $250 ........................................................... 50 2-b. If there be a surviving spouse of an employee of a private voluntary hospital killed in a World Trade Center rescue, who passed a physical examination upon employment as a rescue worker that failed to reveal evidence of a condition that was the proximate cause of death, and a surviving child under the age of eighteen years, or under the age of twenty-three years if enrolled and attending as a full-time student in an accredited educational institution and such enrollment and full-time attendance is certified by such institution, or a surviving child of any age dependent blind or physically disabled, to such spouse forty per centum of the average wages of the deceased during widowhood or widowerhood, with two years' compensation in one sum, upon remarriage; and thirty-five per centum of such wages to such child under the age of eighteen years, or under the age of twenty-three years if enrolled and attending as a full-time student in an accredited educational institution and such enrollment and full-time attendance is certified by such institution, or a surviving child of any age dependent blind or physically disabled; in the case of the subsequent death of such surviving spouse the surviving child shall have his or her compensation increased to seventy-five per centum of such wages and the same shall be payable so long as he or she is under the age of eighteen years, or under the age of twenty-three years if enrolled and attending as a full-time student in an accredited educational institution and such enrollment and full-time attendance is certified by such institution, or a surviving child of any age dependent blind or physically disabled; upon statutory termination of compensation payable to such child, the compensation of the surviving spouse shall be increased to seventy-five per centum of such wages with two years' compensation, at such rate, in one sum, upon remarriage. Upon remarriage of such surviving spouse, the surviving child shall continue to receive thirty-five per centum of such wages. Where such death occurs, and the spouse is receiving survivors insurance benefits under the social security act, the death benefit payable under this section shall be reduced by five per centum of the spouse's share of the survivors insurance benefits under the social security act for each ten dollars of deceased's average weekly wage in excess of one hundred dollars; provided that in no case shall such reduction exceed fifty per centum of such spouse's share of the survivors insurance benefits under the social security act as set forth in table No. I in subdivision one-c of this section. If there be a surviving spouse of an employee of a private voluntary hospital killed in a World Trade Center rescue, who passed a physical examination upon employment as a rescue worker that failed to reveal evidence of a condition that was the proximate cause of death, and two or more surviving children under the age of eighteen years, or under the age of twenty-three years if enrolled and attending as a full-time student in an accredited educational institution and such enrollment and full-time attendance is certified by such institution, or a surviving child or children of any age dependent blind or physically disabled and a death occurs on or after September eleventh, two thousand one, to such spouse forty per centum of the average wage of the deceased during widowhood or widowerhood with two years' compensation in one sum upon remarriage; and thirty-five per centum of such wages to such children under the age of eighteen years, or under the age of twenty-three years if enrolled and attending as a full-time student in an accredited educational institution and such enrollment and full-time attendance is certified by such institution, or a surviving child or children of any age dependent blind or physically disabled, share and share alike; in case of the subsequent death of such surviving spouse the surviving children shall have their compensation increased to seventy-five per centum of such wages and the aggregate sum shall be payable, share and share alike, so long as they are under the age of eighteen years, or under the age of twenty-three years if enrolled and attending as a full-time student in an accredited educational institution and such enrollment and full-time attendance is certified by such institution, or a surviving child or children of any age dependent blind or physically disabled. Upon remarriage of such surviving spouse, if there be two surviving children each shall receive thirty-seven and one-half per centum of such wages, and if there are surviving more than two children under the age of eighteen years, or under the age of twenty-three if enrolled and attending as a full-time student in an accredited educational institution and such enrollment and full-time attendance is certified by such institution, or a surviving child or children of any age dependant blind or physically disabled, seventy-five per centum of such wages share and share alike. Upon statutory termination of compensation payable to such children, the compensation of the surviving spouse shall be increased to seventy-five per centum of such wages with two years' compensation, at such rate, in one sum, upon remarriage. Where the death occurs on or after September eleventh, two thousand one, and the spouse is receiving survivors insurance benefits under the social security act, the death benefits payable under this section shall be reduced by five per centum of the spouse's share of the survivors insurance benefits under the social security act for each ten dollars of deceased's average weekly wage in excess of one hundred fifty dollars; provided that in no case shall such reduction exceed fifty per centum of said spouse's share of the survivors insurance benefits under the social security act as set forth in table No. II in subdivision two-a of this section. 3. If there be a surviving child or children of the deceased under the age of eighteen years or a dependent blind or physically disabled child or children of any age, but no surviving spouse then where the death occurs on or after July first, nineteen hundred forty-eight, and prior to January first, nineteen hundred seventy-eight, for the support of each such child until the age of eighteen years, or until the removal of the dependency of such blind or physically disabled child or children, thirty per centum of the wages of the deceased, and where the death occurred prior to July first, nineteen hundred forty-eight, for the support of each such child until the age of eighteen years, or until the removal of the dependency of such blind or physically disabled child or children, fifteen per centum of the wages of the deceased; provided that the aggregate shall in no case exceed sixty-six and two-thirds per centum of such wages. 3-a. If there be a surviving child or children of the deceased under the age of eighteen years or under the age of twenty-three years if enrolled and attending as a full time student in an accredited educational institution and such enrollment and full time attendance is certified by such institution or a dependent blind or physically disabled child or children of any age, but no surviving spouse then where the death occurs on or after January first, nineteen hundred seventy-eight, for the support of such child or children until the age of eighteen years, or under the age of twenty-three years if enrolled and attending as a full time student in an accredited educational institution and such enrollment and full time attendance is certified by such institution or until the removal of the dependency of such blind or physically disabled child or children, sixty-six and two-thirds per centum of the wages of the deceased. Where there are two or more children, the compensation payable shall be divided among such children share and share alike. 3-b. If there be a surviving child or children, of an employee of a private voluntary hospital killed in a World Trade Center rescue, who passed a physical examination upon employment as a rescue worker that failed to reveal evidence of a condition that was the proximate cause of death, under the age of eighteen years, or under the age of twenty-three years if enrolled and attending as a full-time student in an accredited educational institution and such enrollment and full-time attendance is certified by such institution, or a dependent blind or physically disabled child, or children of any age, but no surviving spouse then, where such death occurs, for the support of each such child until the age of eighteen years, or under the age of twenty-three years if enrolled and attending as a full-time student in an accredited educational institution and such enrollment and full-time attendance is certified by such institution or until the removal of the dependency of such blind or physically disabled child or children, seventy-five per centum of the wages of the deceased. Where there are two or more children, the compensation payable shall be divided among such children share and share alike. 4. If there be no surviving spouse or child under the age of eighteen years, or dependent blind or physically disabled child of any age, or if the amount payable to surviving spouse and to children under the age of eighteen years or such dependent blind or physically disabled children shall be less in the aggregate than sixty-six and two-thirds per centum of the average wages of the deceased, then where the death occurs on or after July first, nineteen hundred forty-eight, and prior to January first, nineteen hundred seventy-eight, for the support of grandchildren or brothers and sisters under the age of eighteen years, if dependent upon the deceased at the time of the accident, twenty-five per centum of such wages for the support of each such person until the age of eighteen years; and for the support of each parent, or grandparent, of the deceased if dependent upon him at the time of the accident, forty per centum of such wages during such dependency; and where the death occurred prior to July first, nineteen hundred forty-eight, to such dependent grandchildren or brothers and sisters, fifteen per centum of such wages until eighteen years of age, and to such dependent parent or grandparent, twenty-five per centum of such wages during dependency. But in no case shall the aggregate amount payable under this subdivision exceed the difference between sixty-six and two-thirds per centum of such wages, and the amount payable as hereinbefore provided to surviving spouse or for the support of surviving child or children. 4-a. If there be no surviving spouse or child under the age of eighteen years or under the age of twenty-three years if enrolled and attending as a full time student in an accredited educational institution and such enrollment and full time attendance is certified by such institution or dependent blind or physically disabled child of any age, then where the death occurs on or after January first, nineteen hundred seventy-eight, for the support of grandchildren or brothers and sisters if dependent upon the deceased at the time of the accident, under the age of eighteen years, or under the age of twenty-three years if enrolled and attending as a full time student in an accredited educational institution and such enrollment and full time attendance is certified by such institution, or blind or physically disabled grandchildren or brothers and sisters of any age, twenty-five per centum of such wages for the support of each such person until the age of eighteen years; or until the age of twenty-three years if enrolled and attending as a full time student in an accredited educational institution or until the removal of the dependency of such blind or physically disabled grandchildren or brothers and sisters, and such enrollment and full time attendance is certified by such institution and for the support of each parent, or grandparent, of the deceased if dependent upon him or her at the time of the accident, forty per centum of such wages during such dependency. But in no case shall the aggregate amount payable under this subdivision exceed sixty-six and two-thirds per centum of such wages. 4-b. If there be no surviving spouse or child under the age of eighteen years or under the age of twenty-three years if enrolled and attending as a full time student in an accredited educational institution and such enrollment and full time attendance is certified by such institution or dependent blind or physically disabled child of any age or grandchildren or brothers and sisters if dependent upon the deceased at the time of the accident, under the age of eighteen years, or under the age of twenty-three years if enrolled and attending as a full time student in an accredited educational institution and such enrollment and full time attendance is certified by such institution or disabled blind or physically disabled grandchildren or brothers and sisters of any age, then a sum of fifty thousand dollars shall be paid to the deceased's surviving parents or if there be no surviving parents to the deceased's estate. 4-c. If there be no surviving spouse or child, or children of an employee of a private voluntary hospital killed in a World Trade Center rescue, who passed a physical examination upon employment as a rescue worker that failed to reveal evidence of a condition that was the proximate cause of death, under the age of eighteen years, or under the age of twenty-three years if enrolled and attending as a full-time student in an accredited educational institution and such enrollment and full-time attendance is certified by such institution, or dependent blind or physically disabled child of any age, then where the death occurs on or after September eleventh, two thousand one, for the support of grandchildren or brothers and sisters if dependent upon the deceased at the time of the accident, under the age of eighteen years, or under the age of twenty-three years if enrolled and attending as a full-time student in an accredited educational institution and such enrollment and full-time attendance is certified by such institution, or blind or physically disabled grandchildren or brothers and sisters of any age, twenty-five per centum of such wages for the support of each such person until the age of eighteen years; or until the age of twenty-three years if enrolled and attending as a full-time student in an accredited educational institution, or until the removal of the dependency of such blind or physically disabled grandchildren or brothers and sisters, and such enrollment and full-time attendance is certified by such institution and for the support of each parent, or grandparent, of the deceased if dependent upon him or her at the time of the accident, forty per centum of such wages during such dependency. But in no case shall the aggregate amount payable under this subdivision exceed seventy-five per centum of such wages. 4-d. If there be no surviving spouse or child, or children of an employee of a private voluntary hospital killed in a World Trade Center rescue, who passed a physical examination upon employment as a rescue worker that failed to reveal evidence of a condition that was the proximate cause of death, under the age of eighteen years, or under the age of twenty-three years if enrolled and attending as a full-time student in an accredited educational institution and such enrollment and full-time attendance is certified by such institution, or dependent blind or physically disabled child of any age, or grandchildren or brothers and sisters if dependent upon the deceased at the time of the accident, under the age of eighteen years, or under the age of twenty-three years if enrolled and attending as a full-time student in an accredited educational institution and such enrollment and full-time attendance is certified by such institution, or disabled blind or physically disabled grandchildren or brothers and sisters of any age, then a sum of fifty thousand dollars shall be paid to the deceased's surviving parents or if there be no surviving parents to the deceased's estate. 5. Any excess of wages over: (1) seven hundred fifty dollars shall not be taken into account in computing compensation under this section in cases where the death occurs on or after July first, two thousand seven, (2) eight hundred twenty-five dollars shall not be taken into account in computing compensation under this section in cases where the death occurs on or after July first, two thousand eight, (3) nine hundred dollars shall not be taken into account in computing compensation under this section in cases where the death occurs on or after July first, two thousand nine, and (4) where the death occurs on or after July first, two thousand ten, or when the death occurs on or after July first of each succeeding year, an amount equal to the New York state average weekly wage for the year in which it is reported shall not be taken into account in computing compensation under this section. Any excess of wages over five hundred ten dollars and five cents per week shall not be taken into account in computing compensation under this section in cases where the death occurs on or after July first, nineteen hundred ninety, nor shall any excess of wages over five hundred twenty-five dollars per week be taken into account in computing compensation pursuant to this section in cases where death occurs on or after July first, nineteen hundred ninety-one, nor shall any excess of wages over six hundred dollars per week be taken into account in computing compensation pursuant to this section in cases where death occurs on or after July first, nineteen hundred ninety-two with the exception that wages earned over six hundred dollars per week shall be taken into account in computing compensation under this section in cases involving an employee of a private voluntary hospital resulting from a World Trade Center rescue, who passed a physical examination upon employment as a rescue worker that failed to reveal evidence of a condition that was the proximate cause of death; nor shall any excess of wages over three hundred eighty-two dollars and fifty cents per week be taken into account in computing compensation under this section in cases where the death occurs on or after July first, nineteen hundred eighty-three, nor shall any excess of wages over four hundred twelve dollars and fifty cents per week be taken into account in computing compensation under this section in cases where the death occurs on or after July first, nineteen hundred eighty-four, nor shall any excess of wages over four hundred fifty dollars per week be taken into account in computing compensation under this section in cases where the death occurs on or after July first, nineteen hundred eighty-five; nor shall any excess of wages over one hundred eighty-seven dollars and fifty cents per week on or after January first, nineteen hundred seventy-eight or over two hundred seventy dollars per week on or after July first, nineteen hundred seventy-eight or over three hundred twenty-two dollars and fifty cents per week on or after January first, nineteen hundred seventy-nine, and prior to July first, nineteen hundred eighty-three, be taken into account in computing compensation under this section nor shall any excess of wages over six hundred and seventeen dollars and fifty cents a month be taken into account in computing compensation under this section in cases where the death occurred on or after July first, nineteen hundred seventy-four, and prior to January first, nineteen hundred seventy-eight, nor shall any excess of wages over five hundred and twenty dollars a month be taken into account in computing compensation in cases where death occurred on or after July first, nineteen hundred seventy and prior to July first, nineteen hundred seventy-four, nor shall any excess of wages over four hundred and fifty-five dollars a month be taken into account in computing compensation in cases where death occurred on or after July first, nineteen hundred sixty-eight and prior to July first, nineteen hundred seventy, nor shall any excess of wages over three hundred and ninety dollars a month be taken into account in computing compensation in cases where death occurred on or after July first, nineteen hundred sixty-five and prior to July first, nineteen hundred sixty-eight, nor shall any excess of wages over three hundred and fifty-seven dollars and fifty cents a month be taken into account in computing compensation in cases where death occurred on or after July first, nineteen hundred sixty-two and prior to July first, nineteen hundred sixty-five, nor shall any excess of wages over three hundred and twenty-five dollars a month be taken into account in computing compensation in cases where death occurred on or after July first, nineteen hundred sixty and prior to July first, nineteen hundred sixty-two, nor shall any excess of wages over two hundred and ninety-two dollars and fifty cents a month be taken into account in computing compensation where death occurred on or after July first, nineteen hundred fifty-eight and prior to July first, nineteen hundred sixty, nor shall any excess of wages over two hundred and sixty dollars a month be taken into account in computing compensation where death occurred on or after July first, nineteen hundred fifty-four and prior to July first, nineteen hundred fifty-eight, nor shall any excess of wages over two hundred and twenty-seven dollars and fifty cents a month be taken into account in computing compensation where death occurred on or after July first, nineteen hundred forty-eight and prior to July first, nineteen hundred fifty-four, nor shall any excess of wages over one hundred and eighty-two dollars a month be taken into account in computing compensation where the death occurred on or after June first, nineteen hundred forty-six and prior to July first, nineteen hundred forty-eight. When death occurred on or after July first, nineteen hundred forty-eight and prior to January first, nineteen hundred seventy-eight, computing compensation to the widow or widower and children of a deceased employee in no event shall wages be deemed to be less than one hundred and thirty dollars a month. All questions of dependency shall be determined as of the time of the accident. When death occurred on or after January first, nineteen hundred seventy-eight, in no event shall wages be deemed to be less than forty-five dollars a week in computing compensation to the widow or widower and/or children of the deceased employee. 6. If there be a person entitled to death benefits under the provisions of this section, who shall be under the age of eighteen years, and who shall be an incarcerated individual of any institution and a public charge upon the department of social services of the city of New York, or any other department or body, the benefits allowed hereunder shall be payable to the said department of public welfare of the city of New York or any other department or body to the extent of the reasonable charges for the care and maintenance, during the continuance as a public charge in said institution, of said beneficiary and until the said person shall have attained the age of eighteen years. Any sum or sums remaining after the said payment out of the benefits shall be distributed as provided by the other subdivisions of this section. 7. In computing the offsets under subdivisions one-c and two-a of this section any increase in survivors insurance benefits under social security that occurs after the date of death shall not be considered, and any such offset shall be equally applicable to the survivors insurance benefits under the social security act which are received retroactively but such offset shall not apply to increases of such benefits received retroactively. --- ## WKC § 16-A — Death benefits due to diesel exposure {#16-A} *N.Y. Workers' Comp. Law § 16-A* Official source: _NYS Open Legislation, revision of 2021-11-05._ § 16-a. Death benefits due to diesel exposure. Where death is due in whole or part to any cancer resulting from a hazardous exposure to diesel exhaust, a claim for death benefits shall not be disallowed as barred by section eighteen or section twenty-eight of this article if such claim is filed within one year of the effective date of this section. Such claims may be filed after such period in accordance with section eighteen and section twenty-eight of this article. --- ## WKC § 17 — Noncitizens {#17} *N.Y. Workers' Comp. Law § 17* Official source: _NYS Open Legislation, revision of 2023-01-06._ § 17. Noncitizens. Compensation under this chapter to noncitizens not residents or about to become nonresidents of the United States or Canada, shall be the same in amount as provided for residents, except that dependents in any foreign country shall be limited to surviving spouse and child or children, or, if there is no surviving spouse or child or children, to surviving father or mother whom the employee has supported, either wholly or in part, for the period of one year prior to the date of the accident. --- ## WKC § 17-A — Limited English proficiency {#17-A} *N.Y. Workers' Comp. Law § 17-A* Official source: _NYS Open Legislation, revision of 2023-09-22._ § 17-a. Limited English proficiency. 1. In accordance with section two hundred two-a of the executive law, the board shall provide translation of (a) all documents and forms published by the board that injured employees complete; (b) all board documents that provide general information to injured employees on the process of applying for workers' compensation benefits; and (c) all other vital documents as defined by subdivision five of section two hundred two-a of the executive law relevant to services offered by the agency. 2. The board shall provide interpretation services to injured employees with respect to its provision of services, information and/or benefits. 3. The board shall: (a) develop a language access plan pursuant to subdivision three of section two hundred two-a of the executive law and submit such plan to the office of general services; (b) publish the board's language access plan on the board's website; and (c) designate a language access coordinator who will work with the office of general services to ensure compliance with the requirements of this section and section two hundred two-a of the executive law. 4. The language access coordinator for the board shall monitor the board's compliance with this section by annually collecting data on the provision of language assistance services, the availability of translated materials, whether signage is properly posted, and any other relevant measures. --- ## WKC § 18 — Notice of injury or death {#18} *N.Y. Workers' Comp. Law § 18* Official source: _NYS Open Legislation, revision of 2014-09-22._ § 18. Notice of injury or death. Notice of an injury or death for which compensation is payable under this chapter shall be given to the employer within thirty days after the accident causing such injury, and also in case of the death of the employee resulting from such injury, within thirty days after such death. Such notice may be given by any person claiming to be entitled to compensation, or by some one in his behalf. The notice shall be in writing, and contain the name and address of the employee, and state in ordinary language the time, place, nature and cause of the injury, and be signed by him or by a person on his behalf or, in case of death, by any one or more of his dependents, or by a person, on their behalf. It shall be given to the employer by delivering it to him or sending it by mail, by registered letter, addressed to the employer at his or its last known place of business; provided that, if the employer be a partnership then such notice may be so given to any one of the partners, and if the employer be a corporation, then such notice may be given to any agent or officer thereof upon whom legal process may be served, or any agent in charge of his business in the place where the injury occurred. The failure to give notice of injury or notice of death unless excused by the board either on the ground that notice for some sufficient reason could not have been given, or on the ground that the employer, or his or its agents in charge of the business in the place where the accident occurred or having immediate supervision of the employee to whom the accident happened, had knowledge of the accident or death, or on the ground that the employer has not been prejudiced thereby, shall be a bar to any claim under this chapter, but the employer and the insurance carrier shall be deemed to have waived such notice unless the objection to the failure to give such notice or the insufficiency thereof, is raised before the board on the first hearing of the claim field by such injured employee, or his or her dependents at which all parties in interest are present, or represented, and at which the claimant, or principal beneficiary, testifies. --- ## WKC § 18-A — Notice: The New York Jockey Injury Compensation Fund, Inc {#18-A} *N.Y. Workers' Comp. Law § 18-A* Official source: _NYS Open Legislation, revision of 2017-04-14._ § 18-a. Notice: The New York Jockey Injury Compensation Fund, Inc. Wherever in this chapter it shall be required that notice be given to an employer, except for claims involving section fourteen-a of the workers' compensation law such notice requirement shall be deemed satisfied by giving notice to the New York Jockey Injury Compensation Fund, Inc., in connection with an injury to a jockey, apprentice jockey or exercise person licensed under article two or four of the racing, pari-mutuel wagering and breeding law, and at the election of the New York Jockey Injury Compensation Fund, Inc., with the approval of the New York state gaming commission, an employee of a licensed trainer or owner, who, pursuant to section two of this chapter, is an employee of all owners and trainers licensed or required to be licensed under article two or four of the racing, pari-mutuel wagering and breeding law and of the fund. In a claim involving section fourteen-a of the workers' compensation law such required notice shall be given to the employing owner and/or trainer of the fund. --- ## WKC § 18-B — Notice; the New York black car operators' injury compensation fund, inc {#18-B} *N.Y. Workers' Comp. Law § 18-B* Official source: _NYS Open Legislation, revision of 2014-09-22._ § 18-b. Notice; the New York black car operators' injury compensation fund, inc. Whenever notice is required to be given to an employer pursuant to this chapter, such requirement shall be satisfied, with respect to an accident or injury to a black car operator, as defined in article six-F of the executive law, occurring on or after the fund liability date, as defined in such article, by giving such notice to the New York black car operators' injury compensation fund, inc., except that in the case of a claim arising under section fourteen-a of this article, notice must be given to the fund and to the central dispatch facility, as defined in article six-F of the executive law, for which the black car operator was performing services at the time of the accident. --- ## WKC § 18-C — Independent livery bases {#18-C} *N.Y. Workers' Comp. Law § 18-C* Official source: _NYS Open Legislation, revision of 2015-11-27._ § 18-c. Independent livery bases. 1. For purposes of this section, "covered services," "livery," "livery driver," "livery registrant," "livery base," "local taxi and limousine commission" and "responsible person" shall have the meanings set forth in article six-G of the executive law. 2. The board shall designate a livery base as an independent livery base, only if the base meets each of the following criteria: (a) The base submits an affirmation sworn under penalty of perjury by an officer or director and such other individuals as the chair may direct, on such form as is provided by the board, which attests to the truth of such criteria as are set by the chair by regulation, or in the absence of such regulation attests to the truth of the following: (i) the base is not, directly or indirectly, including through any director or officer, the owner or registrant of any livery dispatched by the base; (ii) all livery drivers dispatched by the base provide and select their own clothing; (iii) all livery drivers dispatched by the base set their own hours and days of work; (iv) all livery drivers choose which dispatches or fares to accept, and no livery driver suffers any consequence by the livery base for failing to respond to its dispatch; (v) livery drivers dispatched by the base may enter into a contractual relationship with one or more other bases; (vi) no livery driver dispatched by the base receives an internal revenue service form W-2 from such base, or is subject to the withholding of any federal income taxes by the base; (vii) the base does not pay for the fuel or maintenance of any liveries; (viii) the base does not impose any fines and penalties on any livery drivers, except that it may decline to provide further dispatches for misconduct during any dispatch; and (ix) no livery driver is subject to being fired or discharged by the livery base. The base shall agree to provide the board with immediate notice of any inaccuracies in the affirmation, including any failure to adhere to any of the matters set forth on its affirmation. (b) The board shall alter the criteria set forth in paragraph (a) of this subdivision to conform to any statutory definition for employer or independent contractor applicable to livery drivers. (c) The livery shall provide the board and local taxi and limousine commission, and all livery registrants or drivers whose liveries may be dispatched by the livery base, with a copy of a written policy in plain language, in the primary language spoken by each registrant or driver, setting forth all matters to which it has attested on the affirmation provided for in paragraph (a) of this subdivision. The failure to distribute such a policy shall not have any legal consequence except in accordance with section one hundred sixty-hhh of the executive law. (d) The base shall pay into the independent livery fund such payments as are directed by the independent livery driver benefit fund pursuant to article six-G of the executive law. (e) The base may not owe any payments into the fund established under section twenty-six-a of this article, or otherwise owe any moneys under this chapter, unless it has an agreement with the board to repay the money owed, or to relieve it of the obligation to make any such payments. (f) The base shall maintain such records as are provided for by regulation of the chair. (g) The base shall permit the local taxi and limousine commission, the independent livery fund and any carrier providing compensation under this title for the independent livery fund to audit its books and records during regular business hours solely as necessary to determine compliance with this section, or to determine the amount owed to the fund. (h) No responsible persons of the livery base may have been a responsible person of a base whose status as an independent livery base was revoked within the previous five years, or which has no agreement on moneys owed in as required by paragraph (e) of this subdivision, unless such criteria are waived in the discretion of the board. 3. The board may revoke any livery base's status as an independent livery base if it determines that the base is in violation of any of the criteria set forth in subdivision one of this section, or may suspend the livery base's status as an independent livery base pending the base's compliance with any such criteria. 4. An independent livery base's obligations under this chapter regarding the securing and provision of workers' compensation benefits for any livery driver it dispatches shall be satisfied in full by compliance with the requirements imposed upon an independent livery base by this section and article six-G of the executive law. Insurance coverage directly procured by any independent livery base for the purpose of satisfying the requirements of this chapter with respect to employees of the central livery dispatch facility shall not include coverage of any livery driver to the extent that the livery driver is covered under coverage secured by the New York livery drivers' injury compensation fund pursuant to the requirements of article six-G of the executive law except as provided in that article. 5. Any livery base that is not an independent livery base shall be deemed an employer of any livery driver it dispatches for purposes of this article. 6. A livery base's designation as an employer or independent livery base in accordance with this section shall not be considered in any determination as to whether a livery base is an employer or independent contractor under any other provision of law. The livery base's designation under this section shall not be admissible in any court or administrative proceeding in this state, except any proceeding under this article or article six-G of the executive law, to demonstrate the base's status as an employer or independent contractor. 7. For all injuries or illnesses resulting to a livery driver arising out of covered services for an independent livery base, and for which compensation must be paid in accordance with section one hundred sixty-ddd of the executive law, the independent livery driver benefit fund shall be deemed the employer for all purposes of this chapter. 8. An independent livery driver that sustains injury as a result of the use or operation of an automobile during a dispatch by an independent livery base may obtain recovery in accordance with article fifty-one of the insurance law, and shall not be entitled to workers' compensation benefits except as set forth in section one hundred sixty-ddd of the executive law. 9. An independent livery driver who submits a claim for recovery in accordance with article fifty-one of the insurance law pursuant to subdivision eight of this section shall be subject to local taxi and limousine commission rules prohibiting driving until he or she has recovered from his or her injury. Any authorized insurer required to accept such claims shall be entitled to apply the pre-authorized procedures, medical treatment guidelines and other applicable provisions of this article. --- ## WKC § 19 — Physical examination {#19} *N.Y. Workers' Comp. Law § 19* Official source: _NYS Open Legislation, revision of 2014-09-22._ § 19. Physical examination. An injured employee claiming or entitled to compensation shall submit to such physical examination as the chairman or the board may require. The place, or places, shall be reasonably convenient for him. No physician selected by the employer, carrier or employee shall be present at or participate in any manner in such examination, but such employer or carrier shall, upon request, be entitled to have the employee examined immediately thereafter and upon the same premises by a qualified physician or physicians in the presence of such physician as the employee may select, if any. Proceedings shall be suspended and no compensation shall be payable for any period during which the employee may refuse to submit to examination. --- ## WKC § 19-A — Physicians not to accept fees from carriers {#19-A} *N.Y. Workers' Comp. Law § 19-A* Official source: _NYS Open Legislation, revision of 2014-09-22._ § 19-a. Physicians not to accept fees from carriers. No physician or surgeon in the employ of the board for the purpose of making the examinations required by section nineteen of this chapter, shall, during such employment, be employed by or accept or participate in any fee from any insurance company authorized to write workmen's compensation insurance in this state or from any self-insurer, if such employment or fee relates to a workmen's compensation claim or otherwise except as herein provided. Any physician or surgeon so employed by the board who violates the provisions of this section shall be guilty of a misdemeanor. The foregoing provisions of this section limiting and restricting the employment of physicians or surgeons in the employ of the board and their acceptance or participation in fees shall not be applicable to medical treatment rendered to their patients who are or may be claimants under article nine of this chapter, provided, however, that any such physician or surgeon shall be disqualified from testifying as a witness in any proceeding before the board or its referees in connection with such claims. --- ## WKC § 19-B — Treatment by physicians in employ of board {#19-B} *N.Y. Workers' Comp. Law § 19-B* Official source: _NYS Open Legislation, revision of 2014-09-22._ § 19-b. Treatment by physicians in employ of board. No doctor, physician or surgeon in the employ of the board shall solicit or treat any claimant under this chapter, or own or operate any clinic, giving baking and massage, physio-therapy, or other treatment to such claimants. Such doctors, physicians and surgeons shall not recommend that a claimant be treated by any particular physician or surgeon, or receive baking and massage, physio-therapy or other treatment from any particular person, clinic or hospital. Any such physician or surgeon may recommend the necessary treatment needed and the board shall direct the employer or carrier to provide such treatment, but the board shall not designate a particular physician, surgeon, clinic or hospital to provide the treatment. The employer or carrier shall furnish the prescribed treatment and upon their failure so to do within five days after the direction is made, the claimant may secure the same at the expense of the employer or carrier. Any physician or surgeon so employed by the board who violates the provisions of this section shall be guilty of a misdemeanor. The foregoing provisions of this section prohibiting physicians or surgeons in the employ of the board from recommending that a claimant be treated by any particular physician or surgeon shall not be applicable to recommendations for specialist care of their patients who are or may be claimants under article nine of this chapter. --- ## WKC § 19-C — Actions against health services personnel; defense and indemnification {#19-C} *N.Y. Workers' Comp. Law § 19-C* Official source: _NYS Open Legislation, revision of 2019-01-11._ § 19-c. Actions against health services personnel; defense and indemnification. The provisions of section seventeen of the public officers law shall apply to actions and proceedings, against physicians, nurses and other employees of the board whose duties involve medical examinations under this chapter and the volunteer firefighters' benefit law or other health services, arising out of emergency medical treatment given to board employees while at work or to claimants, their attorneys, licensed representatives, witnesses, employers, their representatives and representatives of carriers, while visiting the offices of the board or the hearing points at which proceedings are conducted or any other person properly on board premises. --- ## WKC § 20 — Determination of claims for compensation {#20} *N.Y. Workers' Comp. Law § 20* Official source: _NYS Open Legislation, revision of 2014-09-22._ § 20. Determination of claims for compensation. 1. At any time after the expiration of the first seven days of disability on the part of an injured employee, or at any time after the employee's death, a claim for compensation may be presented to the employer or to the chair. The board shall have full power and authority to determine all questions in relation to the payment of claims presented to it for compensation under the provisions of this chapter. The chair or board shall make or cause to be made such investigation as it deems necessary, and upon application of either party, shall order a hearing, and within thirty days after a claim for compensation is submitted under this section, or such hearing closed, shall make or deny an award, determining such claim for compensation, and file the same in the office of the chair. Immediately after such filing the chair shall send to the parties a copy of the decision. Upon a hearing pursuant to this section either party may present evidence and be represented by counsel. The decision of the board shall be final as to all questions of fact, and, except as provided in section twenty-three of this article, as to all questions of law. Except as provided in section twenty-seven of this article, all awards of the board shall draw simple interest from thirty days after the making thereof at the rate provided in section five thousand four of the civil practice law and rules. Whenever a hearing or proceeding for the determination of a claim for compensation is begun before a referee, pursuant to the provisions of this chapter, such hearing or proceeding or any adjourned hearing thereon shall continue before the same referee until a final determination awarding or denying compensation, except in the absence, inability or disqualification to act of such referee, or for other good cause, in which event such hearing or proceeding may be continued before another referee by order of the chair or board. 2. (a) Notwithstanding subdivision one of this section, any claim for compensation by (i) judges, conciliators, and managerial or confidential employees of the workers' compensation board and state insurance fund who are allocated to a grade M1 or above pursuant to section one hundred thirty of the civil service law, (ii) the chair, vice-chair and members of the workers' compensation board, and (iii) the executive director, deputy executive directors and members of the board of commissioners of the state insurance fund shall not be within the jurisdiction of the workers' compensation board but instead shall be determined by a neutral outside arbitration process as provided by regulations promulgated by the chair. Such claims shall be filed in the same manner as any other claim for compensation under this chapter. (b) All issues and questions of law or fact pertaining to such claims shall be resolved by the arbitrator appointed pursuant to this paragraph. Arbitrators shall be appointed by the chair to adjudicate claims under this paragraph. Such arbitrators shall have the same powers and duties as those accorded referees under this chapter, including powers delegated by the chair. The provisions of this chapter shall be applicable to claims under this paragraph insofar as they are not inconsistent herewith. (c) An award or decision by an arbitrator pursuant to this paragraph is deemed to be a final decision of the board except if review of such decision is sought as provided in paragraph (d) of this subdivision. No modification, rescission or review of such award or decision may be entertained by the board, notwithstanding any provision of this chapter to the contrary. (d) Within thirty days after notice of the filing of an award or decision by an arbitrator, any party in interest may request review of the arbitrator's decision by a panel of three arbitrators in the same manner and to the same extent as the decision by a referee may be reviewed by the board pursuant to section twenty-three of this article. The arbitration panel shall consist of one arbitrator nominated by the chair, one arbitrator nominated by a recognized alternative dispute resolution organization and one arbitrator nominated by an employee organization certified pursuant to article fourteen of the civil service law to represent the collective bargaining unit of the injured employee or, if the injured employee is not represented by a collective bargaining unit, by the recognized alternative dispute resolution organization. A party in interest may seek review of such award or decision of an arbitration panel only by taking appeal therefrom to the appellate division of the supreme court, third department and the court of appeals as provided for decisions of the board pursuant to section twenty-three of this chapter. (e) The powers and jurisdiction of the arbitration panel established pursuant to this subdivision shall be continuing in the same manner and to the same extent as provided under this chapter to the board. (f) All fees, costs and expenses of arbitration shall be borne by the board and the state insurance fund as administration expenses pursuant to sections eighty-eight and one hundred fifty-one of this chapter. (g) Any claim for compensation by an officer or employee of the board or state insurance fund not required to be determined by a neutral outside arbitration process pursuant to paragraph (a) of this subdivision shall be determined initially by a referee with review of such determination available pursuant to section twenty-three of this chapter. (h) For any claim for compensation by an officer or employee of the workers' compensation board or the state insurance fund whether or not such claim is required to be determined by a neutral outside arbitration process pursuant to paragraph (a) of this subdivision, the referee or arbitrator making the initial finding of fact concerning any medical issue present in the case shall develop the record with opinion evidence from an impartial specialist who is an expert in the appropriate medical specialty. Such impartial specialist shall be subject to cross-examination at the request of any party in interest. (i) The state insurance fund shall administer the claim of any officer or employee of the state insurance fund at an office of the state insurance fund other than the office which was, at the time of injury, disablement or death of such officer or employee, his or her principal workplace. (j) The chair shall promulgate regulations necessary to implement this subdivision. Such regulations shall include provisions in relation to this subdivision for a single arbitrator to determine a claim in the first instance and a panel of three arbitrators to review such decision upon the application of any party in interest prior to judicial review. Such regulations shall also include all special procedures relating to the handling of claims of officers or employees of the workers' compensation board and the state insurance fund pursuant to paragraph (f) of this subdivision. 3. Notwithstanding any other provision of law to the contrary, a member of the workers' compensation board, a referee or any arbitrator in connection with the adjudication of any claim arising under this chapter shall recuse himself or herself on any ground a judge may be disqualified pursuant to section fourteen of the judiciary law. --- ## WKC § 21 — Presumptions {#21} *N.Y. Workers' Comp. Law § 21* Official source: _NYS Open Legislation, revision of 2014-09-22._ § 21. Presumptions. In any proceeding for the enforcement of a claim for compensation under this chapter, it shall be presumed in the absence of substantial evidence to the contrary 1. That the claim comes within the provision of this chapter; 2. That sufficient notice thereof was given; 3. That the injury was not occasioned by the willful intention of the injured employee to bring about the injury or death of himself or of another; 4. That the injury did not result solely from the intoxication of the injured employee while on duty. 5. That the contents of medical and surgical reports introduced in evidence by claimants for compensation shall constitute prima facie evidence of fact as to the matter contained therein. --- ## WKC § 21-A — Temporary payment of compensation {#21-A} *N.Y. Workers' Comp. Law § 21-A* Official source: _NYS Open Legislation, revision of 2025-05-23._ § 21-a. Temporary payment of compensation. * 1. Notwithstanding any other provision of this chapter to the contrary, in any instance in which an employer is unsure of the extent of its liability for a claim for compensation by an injured employee pursuant to this chapter, such employer may initiate compensation payments and payments for prescribed medicine and continue such payments for one year, without prejudice and without admitting liability, in accordance with a notice of temporary payment of compensation, on a form prescribed by the board. * NB Effective until January 1, 2027 * 1. Notwithstanding any other provision of this chapter to the contrary, in any instance in which an employer is unsure of the extent of its liability for a claim for compensation by an injured employee pursuant to this chapter, such employer may initiate compensation payments and payments for medical treatment and care, including prescribed medicine and continue such payments for one year, without prejudice and without admitting liability, in accordance with a notice of temporary payment of compensation, on a form prescribed by the board. * NB Effective January 1, 2027 * 2. The notice of temporary payment of compensation authorized by subdivision one of this section shall be delivered to the injured employee and the board. Such notice shall notify the injured employee that the temporary payment of compensation and prescribed medicine shall not be deemed to be an admission of liability by the employer for the injury or injuries to the employee. The board, upon receipt of a notice of temporary payment of compensation, shall send a notice to the injured employee stating that: (a) the board has received a notice of temporary payment of compensation relating to such injured employee; (b) the payment of temporary compensation and prescribed medicine and the injured employee's acceptance of such temporary compensation and prescribed medicine shall not be an admission of liability by the employer, nor prejudice the claim of the injured employee; (c) the payment of temporary compensation and prescribed medicine shall terminate on the elapse of: one year, or the employer's contesting of the injured employee's claim for compensation and prescribed medicine, or the board determination of the injured employee's claim, whichever is first; and (d) the injured employee may be required to enter into an agreement with the employer to ensure the continuation of payments of temporary compensation and prescribed medicine. * NB Effective until January 1, 2027 * 2. The notice of temporary payment of compensation authorized by subdivision one of this section shall be delivered to the injured employee and the board. Such notice shall notify the injured employee that the temporary payment of compensation and medical treatment and care, including prescribed medicine shall not be deemed to be an admission of liability by the employer for the injury or injuries to the employee. The board, upon receipt of a notice of temporary payment of compensation, shall send a notice to the injured employee stating that: (a) the board has received a notice of temporary payment of compensation relating to such injured employee; (b) the payment of temporary compensation and medical treatment and care, including prescribed medicine and the injured employee's acceptance of such temporary compensation and medical treatment and care, including prescribed medicine shall not be an admission of liability by the employer, nor prejudice the claim of the injured employee; (c) the payment of temporary compensation and medical treatment and care, including prescribed medicine shall terminate on the elapse of: one year, or the employer's contesting of the injured employee's claim for compensation and medical treatment and care, including prescribed medicine, or the board determination of the injured employee's claim, whichever is first; and (d) the injured employee may be required to enter into an agreement with the employer to ensure the continuation of payments of temporary compensation and medical treatment and care, including prescribed medicine. * NB Effective January 1, 2027 * 3. An employer may cease making temporary payments of compensation and prescribed medicine if such employer delivers within five days after the last payment, to the injured employee and the board, a notice of termination of temporary payments of compensation on a form prescribed by the board. Such notice shall inform the injured employee that the employer is ceasing temporary payment of compensation and prescribed medicine. Upon the cessation of temporary payments of compensation and prescribed medicine, all parties to any action pursuant to this chapter shall retain all rights, defenses and obligations they would otherwise have pursuant to this chapter without regard for the temporary payment of compensation and prescribed medicine. * NB Effective until January 1, 2027 * 3. An employer may cease making temporary payments of compensation and medical treatment and care, including prescribed medicine if such employer delivers within five days after the last payment, to the injured employee and the board, a notice of termination of temporary payments of compensation on a form prescribed by the board. Such notice shall inform the injured employee that the employer is ceasing temporary payment of compensation and medical treatment and care, including prescribed medicine. Upon the cessation of temporary payments of compensation and medical treatment and care, including prescribed medicine, all parties to any action pursuant to this chapter shall retain all rights, defenses and obligations they would otherwise have pursuant to this chapter without regard for the temporary payment of compensation and medical treatment and care, including prescribed medicine. * NB Effective January 1, 2027 4. The failure of an employer to provide the notice of termination, pursuant to subdivision three of this section, within one year of the commencement of temporary payment of compensation shall be deemed to be an admission of liability by the employer and the notice of temporary payment of compensation shall be converted to a notice of compensation payable. --- ## WKC § 22 — Modification of awards, decisions or orders {#22} *N.Y. Workers' Comp. Law § 22* Official source: _NYS Open Legislation, revision of 2014-09-22._ § 22. Modification of awards, decisions or orders. Upon its own motion or upon the application of any party in interest, on the ground of a change in conditions or proof of erroneous wage rate, the board may at any time, subject to the limitations set forth in sections twenty-five-a and one hundred and twenty-three of this chapter, review any award, decision or order and, on such review, may make an award ending, diminishing or increasing the compensation previously awarded, subject to the maximum or minimum provided in this chapter, and shall immediately send to the parties a copy of its decision, which shall include a statement of the facts which formed the basis of its action. No such review shall affect such award as regards any moneys already paid, except that an award increasing the compensation rate may be made effective from date of injury, and except that if any part of the compensation due or to become due is unpaid, an award decreasing the compensation rate may be made effective from the date of injury, and any payments made prior thereto in excess of such decreased rate shall be deducted from any unpaid compensation, in such manner and by such methods as may be determined by the board. --- ## WKC § 23 — Appeals {#23} *N.Y. Workers' Comp. Law § 23* Official source: _NYS Open Legislation, revision of 2017-04-21._ § 23. Appeals. An award or decision of the board shall be final and conclusive upon all questions within its jurisdiction, as against the state fund or between the parties, unless reversed or modified on appeal therefrom as hereinafter provided. Any party may within thirty days after notice of the filing of an award or decision of a referee, file with the board an application in writing for a modification or rescission or review of such award or decision, as provided in this chapter. The board shall render its decision upon such application in writing and shall include in such decision a statement of the facts which formed the basis of its action on the issues raised before it on such application. Within thirty days after notice of the decision of the board upon such application has been served upon the parties, or within thirty days after notice of an administrative redetermination review decision by the chair pursuant to subdivision five of section fifty-two, section one hundred thirty-one or section one hundred forty-one-a of this chapter has been served upon any party in interest, an appeal may be taken therefrom to the appellate division of the supreme court, third department, by any party in interest, including an employer insured in the state fund; provided, however, that any party in interest may within thirty days after notice of the filing of the board panel's decision with the secretary of the board, make application in writing for review thereof by the full board. If the decision or determination was that of a panel of the board and there was a dissent from such decision or determination other than a dissent the sole basis of which is to refer the case to an impartial specialist, or if there was a decision or determination by the panel which reduced the loss of wage earning capacity finding made by a compensation claims referee pursuant to subparagraph w of subdivision three of section fifteen of this article from a percentage at or above the percentage set forth in subdivision three of section thirty-five of this article whereby a claimant would be eligible to apply for an extreme hardship redetermination to a percentage below the threshold, the full board shall review and affirm, modify or rescind such decision or determination in the same manner as herein above provided for an award or decision of a referee. If the decision or determination was that of a unanimous panel of the board, or there was a dissent from such decision or determination the sole basis of which is to refer the case to an impartial specialist, the board may in its sole discretion review and affirm, modify or rescind such decision or determination in the same manner as herein above provided for an award or decision of a referee. Failure to apply for review by the full board shall not bar any party in interest from taking an appeal directly to the court as above provided. The board may also, in its discretion certify to such appellate division of the supreme court, questions of law involved in its decision. Such appeals and the question so certified shall be heard in a summary manner and shall have precedence over all other civil cases in such court. The board shall be deemed a party to every such appeal from its decision upon such application, and the chair shall be deemed a party to every such appeal from an administrative redetermination review decision pursuant to subdivision five of section fifty-two of this chapter. The attorney general shall represent the board and the chair thereon. An appeal may also be taken to the court of appeals in the same manner and subject to the same limitations not inconsistent herewith as is now provided in the civil practice law and rules. It shall not be necessary to file exceptions to the rulings of the board. An appeal to the appellate division of the supreme court, third department, or to the court of appeals, shall not operate as a stay of the payment of compensation required by the terms of the award or of the payment of the cost of such medical, dental, surgical, optometric or other attendance, treatment, devices, apparatus or other necessary items the employer is required to provide pursuant to section thirteen of this article which are found to be fair and reasonable. Where such award is modified or rescinded upon appeal, the appellant shall be entitled to reimbursement in a sum equal to the compensation in dispute paid to the respondent in addition to a sum equal to the cost of such medical, dental, surgical, optometric or other attendance, treatment, devices, apparatus or other necessary items the employer is required to provide pursuant to section thirteen of this article paid by the appellant pending adjudication of the appeal. Such reimbursement shall be paid from administration expenses as provided in section one hundred fifty-one of this chapter upon audit and warrant of the comptroller upon vouchers approved by the chair. Where such award is subject to the provisions of section twenty-seven of this article, the appellant shall pay directly to the claimant all compensation as it becomes due during the pendency of the appeal, and upon affirmance shall be entitled to credit for such payments. Neither the chair, the board, the commissioners of the state insurance fund nor the claimant shall be required to file a bond upon an appeal to the court of appeals. Upon final determination of such an appeal, the board or chair, as the case may be, shall enter an order in accordance therewith. Whenever a notice of appeal is served or an application made to the board by the employer or insurance carrier for a modification or rescission or review of an award or decision, and the board shall find that such notice of appeal was served or such application was made for the purpose of delay or upon frivolous grounds, the board shall impose a penalty in the amount of five hundred dollars upon the employer or insurance carrier, which penalty shall be added to the compensation and paid to the claimant. The penalties provided herein shall be collected in like manner as compensation. A party against whom an award of compensation shall be made may appeal from a part of such award. In such a case the payment of such part of the award as is not appealed from shall not prejudice any rights of such party on appeal, nor be taken as an admission against such party. Any appeal by an employer from an administrative redetermination review decision pursuant to subdivision five of section fifty-two of this chapter shall in no way serve to relieve the employer from the obligation to timely pay compensation and benefits otherwise payable in accordance with the provisions of this chapter. Nothing contained in this section shall be construed to inhibit the continuing jurisdiction of the board as provided in section one hundred twenty-three of this chapter. --- ## WKC § 23-A — Mistakes, defects and irregularities {#23-A} *N.Y. Workers' Comp. Law § 23-A* Official source: _NYS Open Legislation, revision of 2021-12-24._ § 23-a. Mistakes, defects and irregularities. 1. Notwithstanding anything contained in 12 NYCRR 300.13 (b) as or further defined in Subject Number 046-878 and Subject Number 046-940 issued by the board, a mistake, omission, defect and/or other irregularity in a cover sheet (currently known as form RB-89) accompanying an application for administrative review or a cover sheet (currently known as RB-89.2) accompanying an application for full board review shall not be grounds for denial of said application for administrative review or full board review. 2. Notwithstanding anything contained in 12 NYCRR 300.13 (b) or (c) as or further defined in Subject Number 046-878 and Subject Number 046-940 issued by the board, a mistake, omission, defect and/or other irregularity in a cover sheet (currently known as form RB-89.1) accompanying a rebuttal to an application for administrative review or a cover sheet (currently known as RB-89.3) accompanying a rebuttal to an application for full board review shall not be grounds for denial of said rebuttal to an application for administrative review or an application for full board review. 3. The board shall permit any such mistake, omission, defect and/or other irregularity to be corrected within twenty days of written notice by the board of such mistake, omission, defect and/or other irregularity or if a substantial right of either the party filing the application or the party filing the rebuttal is not prejudiced, such mistake, omission, defect and/or other irregularity shall be disregarded. 4. This section shall apply to any and all forms prescribed by the board with respect to said applications for board review or full board review or rebuttals to said applications subsequent to the effective date of this section. --- ## WKC § 24 — Costs and fees {#24} *N.Y. Workers' Comp. Law § 24* Official source: _NYS Open Legislation, revision of 2023-01-06._ § 24. Costs and fees. 1. If the court before which any proceedings for compensation or concerning an award of compensation have been brought, under this chapter, determine that such proceedings have not been so brought upon reasonable ground, it shall assess the cost of the proceedings upon the party who has so brought them. 2. Claims of attorneys and counselors-at-law for legal services in connection with any claim arising under this chapter, and claims for services or treatment rendered or supplies furnished pursuant to subdivision (b) of section thirteen of this article, shall not be enforceable unless approved by the board. A written fee application on a form prescribed by the board shall be filed for all legal fees in excess of one thousand dollars ($1,000.00.) In the fee application the attorney shall set forth the calculation used to determine the fee and certify that the amount is in accordance with the following provisions. The form prescribed by the board shall not require a description of the services rendered or time records in conjunction with such written application. The attorney shall set forth on the record the same calculation and certification in all oral fee applications of one thousand dollars ($1,000.00) or less. The board shall approve such written and submitted fee application in an amount commensurate with the services rendered and the amount of compensation awarded, having due regard for the financial state of the claimant in accordance with each applicable provision of the following schedule: (a) When an award is made directing the continuation of weekly compensation benefits for temporary total or partial disability, the attorney's fee shall be one-third of one week's compensation. (b) When an award is made that increases the amount of compensation awarded or paid for a previous period or periods of temporary total or temporary partial disability, the attorney's fee shall be fifteen percent of the increased compensation. (c) When an award is made for schedule loss of use or permanent facial disfigurement pursuant to paragraphs a through t of subdivision three of section fifteen of this article, the attorney's fee shall be fifteen percent of the compensation due in excess of the employer or carrier's previous payments. (d) When an award is made for permanent total disability pursuant to subdivision one of section fifteen of this article or permanent partial disability pursuant to paragraph w of subdivision three of section fifteen of this article, the attorney's fee shall be equivalent to fifteen percent of the compensation due in excess of the employer or carrier's previous payments, plus a sum equivalent to fifteen weeks of compensation at the rate fixed by the board. (e) When an award is made for death benefits pursuant to section sixteen of this article, the attorney's fee shall be equivalent to fifteen percent of the compensation due in excess of the employer or carrier's previous payments, plus a sum equivalent to fifteen weeks of compensation at the rate fixed by the board. (f) When an award is made pursuant to section thirty-two of this article, the attorney's fee shall be fifteen percent of benefits to be paid by the employer or carrier under the approved agreement, except that benefits allocated for future medical expenses shall not be included in the calculation of the fee. However, if the attorney has previously been awarded a fee pursuant to this subdivision, any un-accrued balance of any attorney fees under the foregoing paragraphs shall be waived. 3. If a prior attorney has been substituted in a manner prescribed by the board, and has submitted a fee request, the board shall determine the amount of fees allocated to any prior attorney out of the total fees awarded. 4. When so approved, such claim or claims shall become a lien upon the compensation awarded, and upon any moneys ordered paid under an award by the board into the special funds provided for in subdivision nine of section fifteen and section twenty-five-a of this article, and any other section of this chapter, but shall be paid therefrom only in the manner fixed by the board. Any other person, firm or corporation who shall exact or receive fee or gratuity for any services rendered on behalf of a claimant except in an amount determined by the board, shall be guilty of a misdemeanor. Any person, firm or corporation who shall solicit the business of appearing before the board on behalf of a claimant, or who shall make it a business to solicit employment for a lawyer in connection with any claim for compensation under this chapter shall be guilty of a misdemeanor. In case an award is affirmed upon an appeal to the appellate division, the same shall be payable with interest thereon from the date when said award was made by the board except as provided in section twenty-seven of this article. --- ## WKC § 24-A — Representation before the workers' compensation board {#24-A} *N.Y. Workers' Comp. Law § 24-A* Official source: _NYS Open Legislation, revision of 2022-12-16._ § 24-a. Representation before the workers' compensation board. 1. No person, firm or corporation, other than an attorney and counsellor-at-law, shall appear on behalf of any claimant or person entitled to the benefits of this chapter, before the board or any officer, agent or employee of the board assigned to conduct any hearing, investigation or inquiry relative to a claim for compensation or benefits under this chapter, unless he or she shall be a citizen of the United States or a noncitizen lawfully admitted for permanent residence in the United States, and shall have obtained from the board a license authorizing him or her to appear in matters or proceedings before the board. Such license shall be issued by the board in accordance with the rules established by it. Any person, firm or corporation violating the aforesaid provisions shall be guilty of a misdemeanor. The board, in its rules, shall provide for the issuance of licenses to representatives of charitable and welfare organizations, and to associations who employ a representative to appear for members of such association, upon certification of the proper officer of such association or organization, which licenses shall issue without charge; and may provide for a license without fee in the case of all other persons, firms or corporations in an amount to be fixed by said rules. The board shall have such tests of character and fitness with respect to applicants for licenses, and such rules governing the conduct of those licensed, as aforesaid, as it may deem necessary. 2. There shall be maintained in each office of the board a registry or list of persons to whom licenses have been issued as provided herein, which list shall be corrected as often as licenses are issued or revoked. Absence of a record of a license issued as herein provided shall be prima facie evidence that a person, firm or corporation is not licensed to represent claimants. Any such license may be revoked by the board, for cause, after a hearing before the board. No license hereunder shall be issued for a period longer than three years from the date of its issuance. 3. Refusal by any person to whom a license has been issued authorizing him to appear on behalf of any claimant to answer, upon request of the board, or other duly authorized officer, board or committee of the state, any legal question or to produce any relevant book or paper concerning his conduct under such license, shall constitute adequate cause for revocation thereof. 4. Only an attorney, or a representative licensed in accordance with rules established by the board pursuant to subdivisions three-b and three-d of section fifty of this chapter, shall appear on behalf of an employer or an insurance carrier regarding a claim for compensation or any benefits under this chapter before the board or any officer, agent or employee of the board assigned to conduct any hearing relative to a claim for compensation or benefits under this chapter. The provisions of this subdivision shall not apply to a designated regular employee of a self-insured employer, or of an insurance carrier appearing on behalf of his or her employer, but the board may prohibit the appearance of any such employee for cause. --- ## WKC § 25 — Compensation, how payable {#25} *N.Y. Workers' Comp. Law § 25* Official source: _NYS Open Legislation, revision of 2021-07-02._ § 25. Compensation, how payable. 1. When no controversy; penalties: failure to notify of cessation of payment; late payment of installment. (a) The compensation herein provided for shall be paid periodically and promptly in like manner as wages, and as it accrues, and directly to the person entitled thereto without waiting for an award by the board, including those cases previously established and closed by the board upon receipt of an application to reopen such case, except in those cases in which the right to compensation is controverted by the employer. (b) The first payment of compensation shall become due on the fourteenth day of disability on which date or within four days thereafter all compensation then due shall be paid, and the compensation payable bi-weekly thereafter; but the board may determine that any payments may be made monthly or at any other period, as it may deem advisable. An award of compensation payable for permanent partial disability under paragraphs a through t, inclusive, of subdivision three of section fifteen of this article, shall be payable in one lump sum, without commutation to present value upon the request of the injured employee. (c) If the employer or insurance carrier does not controvert the injured worker's right to compensation such employer or insurance carrier shall, either on or before the eighteenth day after disability, or within ten days after the employer first has knowledge of the alleged accident, whichever period is the greater, begin paying compensation and shall immediately notify the chair in accordance with a form to be prescribed by him, that the payment of compensation has begun, accompanied by the further statement that the employer or insurance carrier, as the case may be, will notify the chair when the payment of compensation has been stopped. (d) Whenever for any reason compensation payments cease, the employer or its insurance carrier shall within sixteen days thereafter, send to the chair a notice on a form prescribed by the chair that such payment has been stopped, which notice shall contain the name of the injured employee or his or her principle dependent, the date of accident, the date to which compensation has been paid and the whole amount of compensation paid. In case the employer or its insurance carrier fails so to notify the chair of the cessation of payments within sixteen days after the date on which compensation has been paid, the board may impose a penalty upon such employer or its insurance carrier in the amount of three hundred dollars, which shall be paid to the claimant. Such penalty shall be collected in like manner as an award of compensation. (e) If the employer or insurance carrier shall fail to pay any installments of compensation within twenty-five days after the same become due, there shall be paid by the employer or, if insured, its insurance carrier, an additional amount of twenty percent of the compensation then due which shall accrue for the benefit of the injured worker or his or her dependents and shall be paid to him or her or them with the compensation, unless such delay or default is excused by the board upon the application of the employer or insurance carrier upon the ground that owing to conditions over which the employer or insurance carrier had no control, such payment could not be made. The employer in each such instance shall also be assessed the sum of three hundred dollars, which shall be paid to the claimant. (f) Whenever compensation is withheld solely because a controversy exists on the question of liability as between insurance carriers, surety companies, the special disability fund, the special fund for reopened cases, or an employer, the board may direct that any carrier, surety company, the special disability fund, the special fund for reopened cases shall immediately pay compensation and bills for medical care to the extent payable in accordance with sections thirteen-g, thirteen-k, thirteen-l and thirteen-m of this chapter, pending determination of such issue. Any such payment or payments shall not be deemed an admission against interest by the carrier, surety company, special disability fund or the special fund for reopened cases. After final determination, the parties shall make the necessary and proper reimbursement including the payment of simple interest at the rate established by section five thousand four of the civil practice law and rules in conformity with such determination. 2. Procedure when compensation controverted; penalties: late filing; controversy without just cause. (a) In case the employer decides to controvert the right to compensation, it shall, either on or before the eighteenth day after disability or within ten days after it has knowledge of the alleged accident, whichever period is the greater, file a notice with the chair, on a form prescribed by the chair, that compensation is not being paid, giving the name of the claimant, name of the employer, date of the alleged accident and the reason why compensation is not being paid. When a claim for compensation is filed with medical evidence of work related injury or illness, and the claimant is disabled and not working, and the claimant is otherwise entitled to compensation, and the employer is not making payment to the claimant as required herein, and the employer has not controverted the claim, and the efforts to resolve the issue with the carrier have not been successful, the claimant may request, in the format prescribed by the chair, a hearing to be held within forty-five days of the board's receipt of such request. If the insurance carrier shall fail either to file notice of controversy or begin payment of compensation within the prescribed period or within ten days after receipt of a copy of the notice required in section one hundred ten of this chapter, whichever period is the greater, the board may impose a penalty in the amount of three hundred dollars, which shall be in addition to all other penalties provided for in this chapter and shall be paid to the claimant. Such penalty shall be collected in like manner as an award of compensation. (b) In the event the board shall notify an employer or his insurance carrier that a workers' compensation case has been indexed against such employer, and the employer or insurance carrier decides to controvert the right to compensation, a notice of controversy shall be filed with the chair within twenty-five days from the date of mailing of a notice that the case has been indexed. Failure to file the notice of controversy within the prescribed twenty-five day time limit shall bar the employer and its insurance carrier from pleading that the injured person was not at the time of the accident an employee of the employer, or that the employee did not sustain an accidental injury, or that the injury did not arise out of and in the course of the employment. However, the board, in the interest of justice, shall, upon the showing of good cause therefor, permit the filing or the amendment of a notice of controversy to raise an issue not theretofore raised because of mistake, inadvertence, omission, irregularity, defect or surprise, or based upon newly discovered evidence. (c) If the board shall upon a hearing determine that objections to an award of compensation by the employer or insurance carrier were interposed without just cause, it shall state the grounds for such determination and shall require the employer or the insurance carrier to pay to the claimant, in addition to the amount presently due under the award, the sum of three hundred dollars. 2-a. Pre-hearing conference. (a) In any controverted case, upon receipt of the notice of controversy, the board shall schedule a pre-hearing conference before a referee or conciliator as soon as practicable but not to exceed forty-five days after receipt of notice of controversy and a medical report referencing an injury. The board shall give notice of the pre-hearing conference to all parties. A party may appear at such conference pro se, or by an attorney or licensed representative or other representative authorized by the board to appear on behalf of such party. (b) The purpose of the conference shall be to consider the following: (i) confirmation that all appropriate forms, including medical reports, have been submitted and a verification that all information on the forms is accurate; (ii) addition of any other necessary parties, where appropriate; (iii) simplification and limitation of factual and legal issues, where appropriate; (iv) presentation of a list of proposed witnesses, where appropriate; (v) scheduling the case for a hearing; and (vi) entering into a stipulation. (c) The referee or conciliator may continue the conference and order the production of any necessary reports, including, where appropriate, an examination by a carrier's consultant. At the conclusion of the conference, the referee or conciliator may issue a written order. The referee or conciliator may, upon agreement of all parties, issue a decision which shall constitute a decision of the board for all purposes. If a claimant shall be unrepresented, a decision issued by a referee upon agreement of all parties at a pre-hearing conference shall not become final until it shall have reviewed and approved by the chair or a referee of the board designated by the chair. Such review by the chair or an employee of the board so designated shall occur no later than fourteen days from the date the proposed decision is submitted for review and approval. The unrepresented claimant shall have ten days from receipt of notice of such approval to withdraw from the agreement. If not withdrawn, such agreement shall constitute an award of the board for all purposes. Upon receipt of written notification of such withdrawal by the unrepresented claimant, the board shall rescind the decision made by the referee and restore the case to the regular hearing calendar process. Such decision shall constitute a decision of the board for the purposes of section twenty-three of this article. (d) In cases where the claimant is represented by an attorney or a licensed representative, ten days before the conference, each party shall file a conference statement noting the specific issues in dispute, including the information required in paragraph (b) of this subdivision. Discovery shall close at the end of the pre-hearing conference. Evidence not disclosed or obtained thereafter shall not be admissible unless the proponent of the evidence can demonstrate that it was not available or could not have been discovered by the exercise of due diligence prior to the conference. If a claimant is unrepresented, the carrier shall file such a statement. (e) Proceedings in the pre-hearing part shall be conducted in accordance with the rules promulgated by the chair or the board. 2-b. Conciliation. (a) 1. There is hereby created within the board a conciliation process. The conciliation process will permit claims to be handled on a more expeditious and informal basis and provide a mechanism for claims to be addressed without undue controversy. 2. Conciliation may also address requests by hospitals, physicians or other health care providers for payment of bills rendered by them in any case, regardless of the expected duration of benefits, pursuant to sections thirteen-g, thirteen-k, thirteen-l and thirteen-m of this article, and regardless of the dollar amount of the bill. (b) Each claim that is filed shall be reviewed for possible transfer for conciliation. Claims where the expected duration of benefits is fifty-two weeks or less shall be transferred for conciliation within thirty days of receipt of a carrier's response to notice of index required under this section, except uncontested claims where there have been only temporary or minor injuries and where board appearance by the claimant is unnecessary. Such minor and uncontested claims shall be handled through a motion calendar as prescribed by the rules and regulations promulgated pursuant to this section. (c) Upon receipt of a claim for conciliation, a meeting shall be scheduled, if necessary, within thirty days with all concerned parties before a conciliation counsel. (d) All information relative to the claim shall be made available to all parties no later than five days before the meeting. This information shall include, but not be limited to medical records, wage information, date of accident or injury and the amount of time lost from work as a result of such accident or injury. (e) At such meeting the conciliation counsel shall promptly and prior to any other proceeding authorized under this section inform any claimant participating in the meeting without benefit of a counsel or licensed representative of their right to have representation present, their right to a reasonable adjournment to procure representation, of their right to withdraw from any agreement at such meeting in accordance with subdivision (g) of this section and such other and further information as the chair may require to insure that an uncounselled claimant fully understands the conciliation process. After informing claimant in accordance with this subdivision, conciliation counsel shall request a written consent to participate in the conciliation process from claimant, and if such claimant declines to continue, shall immediately cease the conciliation process and cause the claim to be restored to the regular hearing calendar process. (f) After reviewing all relevant information, conciliation counsel shall prepare a proposed decision which shall be sent to all parties. Any party may object to the proposed decision and request a hearing within thirty days of the receipt of the proposed decision. If no objection is made during such thirty day period the proposed decision shall constitute a final award of the board for all purposes except that it shall not be reviewable under sections twenty-two and twenty-three of this article. If any party objects to the proposed decision, the case shall be transferred to the regular hearing calendar process. (g) If a claimant shall be unrepresented, the case shall not be agreed to until it shall have been reviewed and approved by the chair or a referee of the board designated by the chair. Such decision shall be rendered within fifteen days of receipt of the agreement from the conciliation bureau; provided, however, that a claimant shall have ten days from receipt of notice of such approval to withdraw from the agreement. If approved, such agreement shall constitute an award of the board for all purposes except that it shall not be reviewable under sections twenty-two and twenty-three of this article. Should the agreement be disapproved or should the claimant withdraw from the agreement as provided herein, the case shall be transferred to the regular hearing calendar process. (h) After the proposed decision has become final, the carrier shall make payments of any award as required in the decision within ten days. If, however, the carrier does not make the payments as required in the decision within ten days of the date in which the proposed decision becomes final, the chair shall impose of a fine of five hundred dollars for failure to live up to the terms of the decision upon verification that payment has not been timely made. Of that amount, three hundred dollars shall be made payable to the claimant and two hundred dollars shall be payable to the board for the operation and administration of this chapter. (i) If, in any case which has been addressed by conciliation, the claimant requires additional medical care beyond that agreed to or requires benefit payments beyond that agreed to, the meeting, if necessary, shall be reconvened within thirty days from the receipt of information demonstrating the need for additional medical care or benefit payments. If it is determined that the claimant's condition may continue for a period of time which is more than six months, such case shall be reopened and transferred to the regular hearing calendar. If, however, it is determined, based on medical evidence, that the claimant's condition will improve in less than six months, the case shall remain in conciliation. 2-c. Collective bargaining; alternative dispute resolution. (a) For the purposes of employments classified under sections two hundred twenty, two hundred forty and two hundred forty-one of the labor law, an employer and a recognized or certified exclusive bargaining representative of its employees may include within their collective bargaining agreement provisions to establish an alternative dispute resolution system to resolve claims arising under this chapter. Any collective bargaining agreement or agreement entered into by the employee and an employer which purports to preempt any provision of this chapter or in any way diminishes or changes rights and benefits provided under this chapter, except as expressly provided herein, shall be null, void and unenforceable. (b) Except as specifically provided in this subdivision, nothing in this section or any collective bargaining agreement providing for an alternative dispute resolution system for the resolution of claims arising under this chapter shall preempt any provision of this chapter or in any way diminish or change any benefits to which an employee, or his or her dependents, or survivors may be entitled pursuant to the provisions of this chapter. (c) The collective bargaining agreement may establish the following obligations and procedures: (i) an alternative dispute resolution process to resolve claims arising under this chapter, which may include but is not limited to mediation or arbitration; (ii) the use of an agreed managed care organization as defined in section one hundred twenty-six of this chapter or a list of authorized providers for medical treatment, which may be the exclusive source of all medical and related treatment provided under this chapter; (iii) the use of an agreed list of authorized providers for the purpose of providing medical opinions and testimony, which may be the exclusive source of all such medical opinions and testimony under this chapter; (iv) benefits for injured workers, their dependents or their survivors supplemental to those provided under this chapter; (v) a light duty, modified job, or return to work program; (vi) a vocational rehabilitation or retraining program; and (vii) worker injury and illness prevention programs and procedures. (d) The determination of an arbitrator or mediator pursuant to an alternative dispute resolution procedure pertaining to the resolution of claims arising under this chapter shall not be reviewable by the workers' compensation board, and the venue for any appeal shall be to a court of competent jurisdiction in accordance with section twenty-three of this chapter. (e) (i) Determinations rendered as a result of an alternative dispute resolution procedure shall remain in force during a period in which the employer and a recognized or certified exclusive bargaining representative are renegotiating a collective bargaining agreement. (ii) Upon the expiration of a collective bargaining agreement which contains a provision for an alternative dispute resolution procedure for workers' compensation claims, the resolution of claims relating to injuries sustained as a result of a work-related accident or occupational disease may, if the collective bargaining agreement so provides, be subject to the terms and conditions set forth in the expired collective bargaining agreement until the employer and a recognized or certified exclusive bargaining representative negotiate a new collective bargaining agreement. (iii) Upon the termination of a collective bargaining agreement which is not subject to renegotiation, the employer and its employees shall become fully subject to the provisions of this chapter to the same extent as they were prior to the implementation of the collective bargaining agreement provided, however, that when a claim has been adjudicated under the alternative dispute resolution procedure, the claimant or employer to such claim or matter shall be estopped from raising identical issues before the board. (f) Commencing January first, nineteen hundred ninety-six, and annually thereafter, a copy of the collective bargaining agreement shall be filed with the chair. The employer shall report the number of employees subject to the collective bargaining agreement. The chair or the chair's designee shall review the collective bargaining agreements for compliance with the provisions of this section, shall notify the parties to the agreement if the agreement is not in compliance, and shall recommend appropriate action to bring the agreement into compliance. 3. Hearings; procedure; penalty for late payment of award and for dilatory tactics or unjustified lack of preparedness of a carrier or employer. (a) The chairman may in the interest of justice at any time refer a case in which payments are being made as above to the board for a hearing, and shall immediately upon receipt of notice from the injured worker, from the employer, or from the insurance carrier that the employee's right to compensation is controverted, or that payments of compensation have stopped or been suspended, make such investigations, or cause such medical examinations to be made, or refer the case for such hearings, as will properly protect the rights of both parties, either as to any compensation then due or as to any compensation that may become due in the future for temporary or permanent disability, and shall promptly cause the resumption of payments in case the injured person is entitled thereto. (b) Nothing herein shall limit the right of the board in a particular case to hold a hearing and make an award in accordance with other provisions of this chapter. No case shall be closed without notice to all parties interested and without giving to all such parties an opportunity to be heard. (c) The board shall keep an accurate record of all hearings held. Whenever a hearing must be continued or adjourned because the carrier or employer has engaged in dilatory tactics or exhibited unjustified lack of preparedness, the board shall impose a penalty of twenty-five dollars to be paid to the fund created by subdivision two of section one hundred fifty-one of this chapter and shall in addition make an award of seventy-five dollars payable to the injured worker or his or her dependants. Dilatory tactics may include but shall not be limited to: failing to subpoena medical witnesses or to secure an order to show cause as directed by the referee, failing to bring proper files, failing to appear, failing to produce witnesses or documents after they have been requested by the referee or examiner or as directed by the hearing notice, unnecessarily protracting the production of evidence, or engaging in a pattern of delay which unduly delays resolution, except that no penalty shall be imposed nor award made under this subdivision if the carrier or employer produces evidence sufficient to excuse its conduct to the satisfaction of the referee. (d) If, in any case, the issues have not been resolved within one year after such issues have been raised before the board, or if multiple claims arise from the same accident or occurrence, or if all parties agree to an expedited hearing, or if a notice of controversy is filed, or if the chair otherwise deems it necessary, the chair may order that the case be transferred to a special part for expedited hearings. Proceedings in such part shall be conducted in an expedited manner. Cases in such special part shall be scheduled in such a manner so that, where appropriate, any and all outstanding issues may be addressed at one hearing. An adjourned case shall be rescheduled as soon as practicable, but no later than thirty days following such adjournment. If a request for an adjournment is made by a carrier or employer which is not an emergency and is deemed to be frivolous by the chair, a penalty of one thousand dollars shall be imposed by the chair. If such employer or carrier is represented by an attorney or licensed representative who is not an employee of the carrier or employer, the attorney or licensed representative shall be responsible for the payment of such penalty. If a request for an adjournment is made by a claimant who is represented by an attorney or a licensed representative which is not an emergency and is deemed to be frivolous by the chair, a penalty of five hundred dollars shall be imposed by the chair on the attorney or licensed representative. Such penalty shall be paid by the attorney or licensed representative and shall not come out of the claimant's award. No penalty shall be imposed on an unrepresented claimant who requests an adjournment. (e) If the employer or its insurance carrier fails to file a notice or report requested or required by the board or chair or otherwise required within the specified time period or within ten days if no time period is specified, the board may impose a penalty in the amount of fifty dollars unless the employer or carrier produces evidence sufficient to excuse its conduct to the satisfaction of the board. Such penalty shall be in addition to all other penalties provided for in this chapter and shall be paid into the state treasury. (f) If the employer or its insurance carrier shall fail to make payments of compensation according to the terms of the award within ten days or the uninsured employers' fund shall fail to make payments of compensation according to the terms of the award within thirty days after such ten day period except in case of an application to the board for a modification, rescission or review of such award, there shall be imposed a penalty equal to twenty percent of the unpaid compensation which shall be paid to the injured worker or his or her dependents, and there shall also be imposed an assessment of fifty dollars, which shall be paid into the state treasury. (g) Notwithstanding any other provision in this chapter, the chair may by regulation elect to establish a performance standard concerning the subject of any penalty or assessment provision applicable to an insurance carrier or self-insured employer, where such penalty or assessment is remittable to the New York state treasury, or chair, but not to claimants or any other payee or fund, and impose a single penalty or assessment upon the failure to meet that promulgated standard, with notice to the carrier or self-insured employer. The penalty or assessment imposed in the aggregate shall be payable to the chair. Such aggregate penalty or assessment shall be based upon the number of violations as multiplied against the applicable penalty or assessment, but may be negotiated by the chair's designee in full satisfaction of the penalty or assessment. A final agreement between the chair's designee and the carrier or self-insured employer may be submitted and approved subject to section thirty-two of this article, without notice to any claimant. Any aggregate penalty or assessment issued herein shall be issued administratively, and the board, and the chair may, by regulation, specify the method of review or redetermination, and the presentment of evidence and objections shall occur solely upon the documentation. The carrier or self-insured employer shall receive credit for any instances in which the aggregate penalty or assessment is inclusive of a penalty or assessment previously issued and paid in an individual claim or proceeding. A final determination is subject to review under section twenty-three of this article, except that no stay in payment of the penalty or assessment shall apply pending the outcome of the application for administrative review. Failure to pay the finally determined penalty or assessment, or the penalty or assessment agreed upon pursuant to section thirty-two of this article, within ten days of filing, shall result in the imposition of a twenty-percent penalty, payable to the chair. In the event of the carrier or self-insured employer instituting or continuing an issue without reasonable grounds, the provisions of subdivision three of section one hundred fourteen-a of this chapter shall be applicable. Aggregate penalties shall be borne exclusively by insurance carriers and licensed representatives pursuant to subdivision three-b of section fifty of this article and the costs shall not be passed to insured employers. 4. Advance payments of compensation; employer reimbursements; receipts for payment. (a) If the employer has made advance payments of compensation, or has made payments to an employee in like manner as wages during any period of disability, he shall be entitled to be reimbursed out of an unpaid instalment or instalments of compensation due, provided his claim for reimbursement is filed before award of compensation is made, or if insured, by the insurance carrier at the direction of the board, unless he shall file a waiver of reimbursement with the chairman, in which event compensation shall be paid to the claimant notwithstanding the advanced payments. (b) An injured employee, or in case of death his dependents or personal representative, shall give receipts for payment of compensation to the employer paying the same and such employer shall produce the same for inspection by the chairman, whenever required. (c) If the employer or comptroller of the state or city of New York or trustees duly constituted under any welfare, pension or benefit plan, agreement or trust to which the injured employee is a party or of which he or she is a beneficiary, and which plan, agreement or trust shall provide that the injured employee shall not be entitled to or shall be limited in the amount of benefits or payments thereunder if he or she shall be entitled to benefits under this chapter, shall have advanced or paid benefits or payments thereunder to the injured employee during any period in which his or her right to benefits under this chapter was not determined, then and in such event such employer or comptroller of the state or city of New York or trustees shall be entitled to be reimbursed out of the unpaid instalment or instalments of compensation due, provided claim therefor is filed together with proof of the terms of said plan, agreement or trust and of the fact and amount of payment with the board before award of compensation is made. The New York city employees' retirement system shall provide to the board on a monthly basis a listing in an electronic format including the names and social security numbers of injured employees to whom benefit payments were paid or advanced by such system and whose benefit payments are limited by workers' compensation benefits awarded under this chapter. The board shall verify which injured employees have been awarded workers' compensation benefits and return the listing to the New York city employees' retirement system including, but not limited to, the following information relating to the award for each injured employee: date of accident, board case number, carrier identification number, carrier case number, beginning and ending dates of disability, payment interval, and payment amount. The board shall return the listing to the New York city employees' retirement system no later than fourteen days after its receipt. 4-a. Public employee welfare fund; wage replacement payment; lien. a. For the purposes of this subdivision, the following terms shall have the following meanings: (i) "Public employer" shall mean the state, a municipal corporation, a local government agency or other political subdivision, a public authority, a public benefit corporation, or any other political subdivision of the state. (ii) "Public employee" shall mean all employees of a public employer. (iii) "Public employee welfare fund" shall mean any trust fund or other fund established or maintained unilaterally or jointly by one or more labor organizations which represent the relevant public employees and/or one or more public employers whether directly or through trustees, to provide employee welfare benefits for public employees or their families or dependents, or for both, including, but not limited to, medical, surgical or hospital care or benefits, and benefits in the event of sickness, accident, disability, or death. b. Where a public employee who is ineligible for benefits under section two hundred three or two hundred seven of this chapter by reason of his public employer's failure to voluntarily elect coverage under section two hundred twelve of this chapter, is disabled and has claimed or subsequently claims and is entitled to workers' compensation benefits under this article, and that public employee is covered by a public employee welfare fund which voluntarily provides a wage replacement benefit in the event of disability, the following provision shall apply: Where such an employee receives a wage replacement benefit from such a public employee welfare fund in respect of the disability which forms the basis of the workers' compensation claim, the public employee welfare plan making such payment may, at any time before an award of workers' compensation benefits is made, file with the board a claim for reimbursement out of the proceeds of such award to the public employee for the period for which the wage replacement benefit was paid to the public employee under the rules of the public employee welfare fund, and shall have a lien against the award for reimbursement, provided that the insurance carrier or other entity liable for payment of the award receives, before such award is made, a copy of the claim for reimbursement from the public employee welfare fund which paid the wage replacement benefit, or provided that the board's decision and award directs such reimbursement. 5. Deposits for security; lump sum payments in certain cases. (a) Whenever the chair may deem it advisable any employer or insurance carrier may be required to make a deposit with the chair to secure the prompt and convenient payment of such compensation, and the chair, shall have power to make payments therefrom upon any awards. The interest on all funds on deposit with the chair pursuant to this paragraph, may be transferred to the uninsured employers' fund whenever the chair shall determine that the net assets of the uninsured employers fund are less than two million dollars or the amount expended by that fund in the prior year whichever is greater. (b) The board, whenever it shall so deem advisable, may commute such periodical payments to one or more lump sum payments to the injured employee, or, in case of death, his or her dependents, provided the same shall be in the interests of justice. Such commutation shall be made according to the method prescribed in section twenty-seven of this article. 6. At the request of a person legally responsible for a minor claimant, the board may, after a hearing, direct that payment be made to the legally responsible person, to be used for the benefit of such claimant. A person who is so designated shall report to the chairman annually with respect to the use of such payments. The chairman may require that a report be made more often than annually if there is reason to believe that the person receiving such payments is using the payments for purposes other than the benefit of the claimant. Should the chairman or the board find that the payee is using the payment for purposes other than the benefit of the claimant the board shall after a hearing revoke the payee's designation and appoint a new payee. The chairman shall take such action as is necessary to recover from the payee any funds improperly used. 7. Payments and awards to minors. All awards of compensation required to be made to minors under this chapter shall be paid to or for the benefit of such minors. The board may in its discretion require the appointment of a guardian, before making payments not otherwise directed to be paid by action of such board, where such award exceeds two hundred and fifty dollars. The board may, when such course seems advisable, direct that funds, payable to or for the benefit of a minor, be paid for vocational training or maintenance of such minor supplementing payments made under subdivision nine of section fifteen of this chapter. 8. Rules. The board may adopt rules to carry out the provisions of this section, including provision for reports to the chairman by a guardian of the use of moneys paid to minors and reports to the chairman by a designated payee of compensation to a minor, in accordance with this section. 9. Direct deposit. (a) Compensation payments shall be required, upon the written request from an injured worker or a person entitled to a death benefit provided by this chapter, to be deposited directly in a bank for any purpose to an account in the name of such injured worker or person entitled to death benefits, and duly filed in accordance with such regulations. Each person eligible to receive payment of compensation or death benefits under this section shall be notified of the option to receive such payment in the form of direct deposit from the carrier or self-insured employer, such notice to be promulgated by the board. Such eligible person shall also be provided the means necessary to enroll in direct deposit pursuant to this paragraph in a manner specified by regulations of the board at the same time as notice is given pursuant to this paragraph. (b) The board is hereby authorized to promulgate reasonable rules and regulations, as may be necessary, to administer the direct deposit of compensation payments. Such regulations shall permit the deposit of compensation payments to be split between multiple accounts by either a dollar amount or exact percentage, provided, however, such regulations may establish a minimum dollar amount and may limit the maximum number of partial deposits allowed. (c) As used in this subdivision, the term "bank" includes any financial institution which is a member of the New York automated clearinghouse or any financial institution designated by the board. (d) Notwithstanding any provision in this subdivision to the contrary, direct deposit of any compensation payment may not be made if such payment would be in violation of any federal or state law or regulation. --- ## WKC § 25-A — Procedure and payment of compensation in certain claims; limitation of right to compensation {#25-A} *N.Y. Workers' Comp. Law § 25-A* Official source: _NYS Open Legislation, revision of 2014-09-22._ § 25-a. Procedure and payment of compensation in certain claims; limitation of right to compensation. 1. Notwithstanding other provisions of this chapter, when an application for compensation is made by an employee or for death benefits in behalf of the dependents of a deceased employee, and the employer has secured the payment of compensation in accordance with section fifty of this chapter, (1) after a lapse of seven years from the date of the injury or death and claim for compensation previously has been disallowed or claim has been otherwise disposed of without an award of compensation, or (2) after a lapse of seven years from the date of the injury or death and also a lapse of three years from the date of the last payment of compensation, or (3) where death resulting from the injury shall occur after the time limited by the foregoing provisions of (1) or (2) shall have elapsed, subject to the provisions of section one hundred twenty-three of this chapter, testimony may be taken, either directly or through a referee and if an award is made it shall be against the special fund provided by this section. Such an application for compensation or death benefits must be made on a form prescribed by the chair for that purpose and must, if a change in condition is claimed, be accompanied by a verified medical or surgical report setting forth facts on which the board may order a hearing. 1-a. Any award which shall be made against such special fund after the effective date of this act upon such an application for compensation or death benefits shall not be retroactive for a period of disability or for death benefits longer than the two years immediately preceding the date of filing of such application. No application by a self-insured employer or an insurance carrier for transfer of liability of a claim to the fund for reopened cases shall be accepted by the board on or after the first day of January, two thousand fourteen except that the board may make a finding after such date pursuant to section twenty-three of this article upon a timely application for review. 2. Claims for further services or treatment rendered or supplies furnished as required by section thirteen hereof shall be paid from such fund when such service, treatment or supplies shall be authorized by the chairman. In cases where a surgical operation has previously been authorized by the board pursuant to the provisions of subdivision five of section thirteen-a of this chapter, no further authorization therefor by the chairman under this section shall be required. The provisions of this chapter with respect to procedure and the right to appeal shall be preserved to the claimant and to the employer originally liable for the payment of compensation and to such fund through its representative as hereinafter provided. 3. Any awards so made shall be payable out of the special fund heretofore created for such purpose, which fund is hereby continued and shall be known as the fund for reopened cases. The employer, or, if insured, his insurance carrier shall pay into such fund, or, in the case of awards made on or after July first, nineteen hundred sixty-nine, either into such fund or the uninsured employers' fund under section twenty-six-a of this article in accordance with the provisions thereof, for every case of injury causing death for which there are no persons entitled to compensation the sum of three hundred dollars where such injury occurred prior to July first, nineteen hundred forty and the sum of one thousand dollars where such injury shall occur on or after said date and prior to April first, nineteen hundred forty-five, and the sum of fifteen hundred dollars where such injury shall occur on or after April first, nineteen hundred forty-five and prior to September first, nineteen hundred seventy-eight and the sum of three thousand dollars where such injury shall occur on or after September first, nineteen hundred seventy-eight, and in each case of death resulting from injury sustained on or after July first, nineteen hundred forty and prior to September first, nineteen hundred seventy-eight, where there are persons entitled to compensation but the total amount of such compensation is less than two thousand dollars exclusive of funeral benefits, the employer, or, if insured, his insurance carrier, shall pay into such fund, or, in the case of awards made on or after July first, nineteen hundred sixty-nine and prior to September first, nineteen hundred seventy-eight, either into such fund or the uninsured employers' fund under section twenty-six-a of this article in accordance with the provisions thereof, the difference between the sum of two thousand dollars and the compensation, exclusive of funeral benefits, and in each case of death resulting from injury sustained on or after September first, nineteen hundred seventy-eight, the employer, or if insured, his insurance carrier shall pay into such fund or the uninsured employers' fund under section twenty-six-a of this article in accordance with the provisions thereof, the difference between the sum of five thousand dollars and the compensation, exclusive of funeral benefits actually paid to or for the dependents of the deceased employee together with any expense charge required by section twenty-seven of this article; provided, however, that where death shall occur subsequent to the periods limited by subdivision one of this section no payment into such special fund nor to the special fund provided by subdivision nine of section fifteen nor to the uninsured employers' fund provided by section twenty-six-a of this article shall be required. In addition to the assessments made against all insurance carriers for the expenses of administering this chapter provided for under the provisions of section one hundred fifty-one of this chapter, and the payments above provided, the employer, or, if insured, his insurance carrier, shall pay the sum of five dollars into said fund for each case in which an award is made pursuant to the provisions of paragraphs a to s inclusive of subdivision three of section fifteen of this chapter, by reason of injury sustained between July first, nineteen hundred forty and June thirtieth, nineteen hundred forty-two, both dates inclusive, and the sum of ten dollars for each such case by reason of injury sustained between July first, nineteen hundred forty-two and June thirtieth, nineteen hundred fifty, both dates inclusive, which payment shall be in addition to any payment of compensation to the injured employee as provided in this chapter. There shall be maintained in the special fund at all times assets at least equal in value to the sum of (1) the value of awards charged against such fund, (2) the value of all claims that have been reopened by the board as a charge against such fund but as to which awards have not yet been made, (3) effective January first, nineteen hundred seventy-one, the value of total supplemental benefits to be paid from such fund as reimbursement pursuant to subdivision nine of this section, and (4) a reserve equal to ten per cent of the sum of items (1), (2) and (3) of this paragraph. Annually, as soon as practicable after January first in each year, the chair shall ascertain the condition of the fund and whenever the assets shall fall below the prescribed minimum as herein provided the chair shall collect an amount sufficient to restore the fund to the prescribed minimum. Commencing on the first of January, two thousand fourteen, the amount collected from all employers required to obtain workers' compensation coverage to maintain the financial integrity of the fund may be paid over a period of time at the discretion of the chair based upon an analysis of the financial condition of the fund. Such payment as determined by the chair shall be included in the assessment rate established pursuant to subdivision two of section one hundred fifty-one of this chapter. The chair shall promulgate regulations to administer claims whose liability has been transferred to the fund for reopened cases. Such regulations may include exercise of the chair's authority to administer existing claims, to procure management for those claims, or to sell such liability. The chair may examine into the condition of the fund at any time on his or her own initiative or on request of the attorney of the fund. The provisions of this subdivision shall not apply with respect to policies containing coverage pursuant to section thirty-four hundred twenty of the insurance law relating to every policy providing comprehensive personal liability insurance on a one, two, three or four family owner-occupied dwelling. 4. The commissioner of taxation and finance shall be the custodian of such special fund for reopened cases and shall invest any surplus monies thereof in securities which constitute legal investments for savings banks under the laws of this state and in interest bearing certificates of deposit of a bank or trust company located and authorized to do business in this state or of a national bank located in this state secured by a pledge of direct obligations of the United States or of the state of New York in an amount equal to the amount of such certificates of deposit, and may sell any of the securities or certificates of deposit in which such fund is invested, if necessary for the proper administration or in the best interest of such fund. Disbursements from such fund for compensation provided by this section shall be paid by the commissioner of taxation and finance upon vouchers signed by the chairman. The commissioner of taxation and finance, as custodian of such fund, annually as soon as practicable after January first, shall furnish to the chairman a statement of the fund, setting forth the balance of monies in the said fund as of the beginning of the year, the income of the fund, a summary of payments out of the fund on account of compensation ordered to be paid by the board, medical and other expense, and all other charges against the fund, and setting forth the balance of the fund remaining to its credit on December thirty-first. Such statement shall be open to public inspection in the office of the chairman, and a copy thereof shall be transmitted by the chairman to the superintendent of financial services. The superintendent of financial services may examine into the condition of such fund at any time on his own initiative or on request of the chairman or representative of the fund. He shall verify the receipts and disbursements of the fund, and shall ascertain the liability of the fund upon all cases in which awards of compensation have been made and charged against said fund and shall render a report of such facts to the chairman. Such report shall also be open to public inspection in the office of the chairman. 5. For applications by self-insured employers or insurance carriers for transfer of liability for compensation to the fund for reopened cases under this section, received by the board prior to the first day of January, two thousand fourteen, the chair shall appoint an attorney in such proceedings to represent such fund in proceedings brought to enforce a claim against such fund. Such attorney may apply to the chair for authority to hire such medical or other experts and to defray the expense thereof and of such witnesses as are necessary to a proper defense of the application within an amount in the discretion of the chair and, if authorized, it shall be a charge against the special fund provided herein. 6. Notwithstanding any other provision of this chapter, no award of compensation or death benefits shall be made against said special fund or against an employer or an insurance carrier where application therefor is made after a lapse of eighteen years from the date of the injury or death and also a lapse of eight years from the date of the last payment of compensation. 7. For the purposes of this section the date of the last payment of compensation shall be deemed to mean the date of actual payment of the last installment of compensation previously awarded; provided, however, that where the case is disposed of by the payment of a lump sum, the date of last payment for the purpose of this section shall be considered as the date to which the amount paid in the lump sum settlement would extend if the award had been made on the date the lump sum payment was approved at the maximum compensation rate which is warranted by the employee's earning capacity as determined by the board under section fifteen of this chapter. 8. The provisions of this section shall not apply to any open case pending before the board on April twenty-fourth, nineteen hundred thirty-three or to any closed case in which an application for reopening was received prior to such date, or to awards for deficiency compensation made pursuant to section twenty-nine of this chapter, nor shall it apply during the pendency of an appeal provided for by section twenty-three of this chapter; provided, however, that such provisions shall be retroactive in effect except as to payments into the special fund provided for an employer or his insurance carrier, and except as otherwise herein provided. 9. (a) Notwithstanding any other provision of this chapter, every employee who is receiving workers' compensation under this chapter for a permanent and total disability resulting from an accidental injury or occupational disablement which occurred prior to January first, nineteen hundred seventy-nine and every widow or widower who is receiving death benefits under this chapter on account of the death of his or her spouse prior to January first, nineteen hundred seventy-nine shall receive supplemental benefits upon application therefor to the board, which shall be payable in the first instance by the employer or its insurance carrier in accordance with the provisions of this subdivision. These supplemental benefits shall commence on July first, nineteen hundred ninety and shall continue during the period of such permanent total disability or entitlement to death benefits. (b) If such employee, widow or widower is receiving the statutory maximum benefit in effect at the time of the accidental injury or death, the supplemental benefit shall be an amount which, when added to the regular benefit established for the case, shall equal the maximum weekly benefit in effect for a permanently totally disabled employee, widow or widower whose claim arose on January first, nineteen hundred seventy-nine. (c) If such employee, widow or widower is receiving a weekly benefit which is less than the statutory maximum benefit which was in effect on the date of the accidental injury or death, the supplemental benefit shall be an amount equal to the difference between the regular benefit being received and a percentage of the maximum benefit in effect on January first, nineteen hundred seventy-nine, determined by multiplying the latter benefit by a fraction, the numerator of which is the regular benefit and the denominator of which is the statutory maximum benefit in effect at the time of the accidental injury or death. (d) In the event the supplemental benefit computed under this subdivision amounts to less than five dollars, then the supplemental benefit allowed shall be a minimum of five dollars, less the amount, if any, by which the combination of such supplemental benefit and the regular benefit exceeds the maximum weekly benefit in effect for a permanently totally disabled employee, widow or widower whose claim arose on January first, nineteen hundred seventy-nine. (e) The employer or his insurance carrier paying the supplemental benefits required under this subdivision shall claim reimbursement for each such case from the reopened cases fund under this section, commencing one year from the date of the first such payment and annually thereafter while such supplemental payments continued, on a form prescribed by the chairman. (f) The special disability fund created under subdivision eight of section fifteen and the reopened cases fund created under section twenty-five-a and the aggregate trust fund created under section twenty-seven of this chapter shall be deemed to be insurance carriers for purposes of this subdivision, other than the payment of the assessment under the provisions of subdivision three of this section. (g) Whenever payment of the supplemental benefits prescribed hereunder is not made by the insurance carrier by reason of the insolvency of such insurance carrier, or in the case of a self-insurer, by reason of the insolvency of such self-insurer or the discontinuance of its operations, such payment shall be made directly out of the reopened cases fund under this section by the commissioner of taxation and finance upon vouchers approved by the chairman of the workmen's compensation board. --- ## WKC § 25-B — Awards to non-residents: Non-resident compensation fund {#25-B} *N.Y. Workers' Comp. Law § 25-B* Official source: _NYS Open Legislation, revision of 2022-12-16._ § 25-b. Awards to non-residents: Non-resident compensation fund. 1. There is hereby created a fund to be known as the non-resident compensation fund. Whenever an award is made to or on behalf of noncitizen dependents, non-residents of the United States, Canada or Newfoundland, or an award is made to a non-resident citizen of the United States, which calls for the payment of compensation or death benefits, or where there is outstanding an unpaid balance of compensation or death benefits payable to such non-resident, and it shall appear that the person or persons to whom the award has been made or any balance of such award is payable, would not have the full benefit or use or control of the money payable under such award, or where other special circumstances made it desirable that present payment of the award shall be withheld, the employer, or if insured, his insurance carrier, or any special fund liable for such payment, may, by order of the board, be required to pay to the comptroller of the state of New York all amounts then due or thereafter to become due under the terms of the award to such non-resident. The moneys so paid in shall be held by the comptroller in the non-residents compensation fund. 2. All computations for the commutation of any such award for payment into the said fund shall be made in accordance with the tables specified in section twenty-seven of this chapter. 3. The payment of the amount of any such award into the non-resident compensation fund shall constitute a complete discharge of the employer or insurance carrier from all liability for such award. 4. If at any time there shall be created by any act of the congress of the United States or by any lawful rule or regulation of the president any agency or fund for the safekeeping or custody of moneys belonging to or payable to any non-resident noncitizen, and if such act or rule shall require the payment into such agency or fund of any moneys theretofore paid into the fund for foreign dependents, the board may make its findings and issue its order thereon directing the transfer of such moneys by the comptroller to such other agency or fund. 5. Any moneys so paid into such fund shall be held by the comptroller until the further order of the board. Whenever the board shall find that the reasons and conditions which made it desirable that payment into the fund be made have changed and that the cause for such withholding shall no longer exist, the board may make findings and issue its order thereon directing the payment without interest of the whole or any part thereof then due by the comptroller to the person or persons for whose benefit the award was made. 6. If the board, at any time, upon evidence presented to it, shall find that all or any part of the funds so deposited in such fund are not due and payable to the non-resident for whose benefit they were deposited, it shall direct the repayment of such amount so deposited, without interest, by the comptroller to the party required to make the deposit as aforesaid. 7. If no evidence shall be presented to the board of the present existence of any such non-resident within eight years from the date when the board has found that the precedent conditions set forth in paragraph one hereof have changed and that direct payments could be made to such person or persons if such person or persons are alive, it shall be presumed in the absence of substantial evidence to the contrary, that such person or persons are non-existent and the board shall thereupon order the payment without interest of the amount deposited for the benefit of such person or persons to the party required to make such deposit as aforesaid, provided however, that thereafter such employer, carrier or fund receiving such repayment shall continue to be liable for any compensation subsequently found by the board to be due, notwithstanding any other provisions of this chapter. --- ## WKC § 26 — Enforcement of payment in default {#26} *N.Y. Workers' Comp. Law § 26* Official source: _NYS Open Legislation, revision of 2014-09-22._ § 26. Enforcement of payment in default. In case of default by the employer in the payment of any compensation due under an award for the period of thirty days after payment is due and payable, or in case of failure or refusal by the employer to deposit with the chairman within ten days after demand the commuted or estimated value of the compensation payable under an award made in accordance with the provisions of section fourteen-a of this chapter as security for prompt and convenient payment of such compensation periodically as it accrues, or where the employer has failed to secure the payment of compensation to his employees as required by section fifty hereof and there is such default in payment for a period of ten days after same is due or there is default or refusal of such employer to deposit with the chairman within ten days after demand the commuted or estimated value of compensation not presently payable, as security for prompt and convenient payment of such compensation periodically as it accrues in accordance with the provisions of section twenty-five of this chapter, or in case of failure by an employer, within twenty days after it is due, to pay an assessment imposed by the chairman pursuant to subdivision five of section fifty-two of this chapter, the chairman in any such case or on the chairman's consent any party to an award may file with the county clerk for the county in which the injury occurred or the county in which the employer has his principal place of business, (1) a certified copy of the decision of the workmen's compensation board awarding compensation or ending, diminishing or increasing compensation previously awarded, from which no appeal has been taken within the time allowed therefor, or if an appeal has been taken by an employer who has not complied with the provisions of section fifty hereof, where he fails to deposit with the chairman the amount of the award as security for its payment within ten days after the same is due and payable, or (2) a certified copy of the demand for deposit of security, or (3) a certified copy of the chairman's order imposing, and the demand for payment of, such assessment, and thereupon judgment must be entered in the supreme court by the clerk of such county in conformity therewith immediately upon such filing. If the payment in default be an instalment, the board may declare the entire award due and judgment may be entered in accordance with the provisions of this section. Such judgment shall be entered in the same manner, have the same effect and be subject to the same proceedings as though rendered in a suit duly heard and determined by the supreme court, except that no appeal may be taken therefrom. The court shall vacate or modify such judgment to conform to any later award or decision of the board upon presentation of a certified copy of such award or decision. The award may be so compromised by the board as in the discretion of the board may best serve the interest of the persons entitled to receive the compensation or benefits. Where an award has been made against the employer in accordance with the provisions of section fifteen, subdivision nine, or of section twenty-five-a, or of section twenty-six-a, such an award may be similarly compromised by the board, upon notice to a representative of the fund to which the award is payable, but if there be no representative of any such fund, notice shall be given to such representative as may be designated by the chairman of the board; and notwithstanding any other provision of law, such compromise shall be effective without the necessity of any approval by the state comptroller. Neither the chairman nor any party in interest shall be required to pay any fee to any public officer for filing or recording any paper or instrument or for issuing a transcript of any judgment executed in pursuance of this section. Whenever the term employer is used in this section it shall be deemed to include without limitation a contractor liable for the payment of compensation pursuant to section fifty-six of the workmen's compensation law. --- ## WKC § 26-A — Procedure and payment of compensation in claims against uninsured defaulting employers {#26-A} *N.Y. Workers' Comp. Law § 26-A* Official source: _NYS Open Legislation, revision of 2022-03-04._ § 26-a. Procedure and payment of compensation in claims against uninsured defaulting employers. 1. (a) Notwithstanding any other provision of this chapter, when a claim for compensation is filed by an employee, or in case of death by the employee's dependents, and the employer has failed to secure the payment of compensation in accordance with section fifty of this chapter, to make deposit of security in accordance with section twenty-six of this chapter and to make payment of compensation into the fund created under this section according to the terms of any award including, without limitation, awards made pursuant to subdivision five of section thirteen-g, subdivision two of section thirteen-f, subdivision five of section thirteen-k, subdivision five of section thirteen-l and subdivision six of section thirteen-m of this article, payment of the award shall be promptly made from the fund created under this section in accordance with the terms thereof and the provisions of subdivision three of this section. The employer shall be liable with the fund for payment of the award. Where the employer is a corporation the president, secretary and treasurer thereof shall also be personally, jointly and severally liable with the corporation for payment of the award. The employer shall pay the award into the fund, in accordance with the time limitations contained in section twenty-five of this article. (b) No such award, however, for any service specified in subdivision five of section thirteen-a of this article requiring advance authorization of the employer in accordance with the provisions of such subdivision, shall be payable from the fund unless advance authorization therefor was secured from the representative of the fund or is determined by the board to be necessary. Notwithstanding any other provision under this section, awards made pursuant to section fourteen-a of this article shall not be the liability of the fund and shall not be payable therefrom nor shall payment of the present value of benefits be required to be paid into the aggregate trust fund pursuant to section twenty-seven of this article in any case in which the uninsured employers' fund is liable. 2. Uninsured employers' fund. (a) There is hereby created a fund which shall be known as the "uninsured employers' fund" to provide for the payment of awards against uninsured employers in accordance with the provisions of this section and shall be available only for the purposes stated in this subdivision, and the assets thereof shall not at any time be appropriated or directed to any other use or purpose, except as set forth in section fifty-a of this chapter. (b) For the purpose of establishing and maintaining this fund, the board, upon rendering a decision with respect to any claim for compensation under this chapter that the employer liable therefor has failed to secure the payment of compensation with respect thereto in accordance with section fifty of this chapter, shall impose an assessment in the sum of one thousand dollars for each ten day period of non-compliance or a sum not in excess of two times the amount of the cost of compensation for its payroll for the period of such failure against the employer and direct its payment into the fund in connection with each such claim wherein injury shall have occurred on or after the first of May, nineteen hundred fifty-nine, or in death cases where death as the result of injury shall have occurred on or after said date. (c) If the employer shall fail to pay these assessments into the fund within ten days after date of mailing of notice thereof to him or her, such default shall constitute a default in payment of compensation due pursuant to the provisions of section twenty-six of this article and judgment therefor shall be entered in accordance therewith, all other provisions of said section to be deemed applicable with respect thereto, except to the extent that said provisions may be clearly inconsistent with the provisions of this section. All sums collected from an uninsured employer with respect to any claim for compensation referred to in this section but not payable from the fund, except fines collected from such employer pursuant to section fifty-two of this chapter whether such collection is made prior or subsequent to entry of judgment against such employer, shall be deemed in payment of an applicable first in satisfaction of any compensation and benefits due from such employer with respect to such claim and security demand, if any, in connection therewith and only when such obligations are satisfied in full shall the balance of said sums collected, if any, be deemed payment in satisfaction of and applicable to the assessments above prescribed in this section. (d) All sums recovered from uninsured employers on judgments entered for failure to pay assessments as hereinbefore provided and for failure to pay compensation and benefits which were paid from the fund herein created, shall upon such recovery be paid into said fund. (e) All awards made on or after July first, nineteen hundred sixty-nine for every case of injury causing death for which there are no persons entitled to compensation, and where there are persons entitled to compensation but the total amount of such compensation is less than two or five thousand dollars as the case may be exclusive of funeral benefits, pursuant to the provisions of subdivision three of section twenty-five-a of this article shall be paid into the uninsured employers' fund. (f) As promptly as practicable after July first, nineteen hundred ninety-one and annually thereafter as soon as practicable after January first in each succeeding year, the chair shall ascertain the condition of the uninsured employers' fund. The chair shall transfer to the fund out of the moneys collected pursuant to subdivision two of section one hundred fifty-one of this chapter an amount which will raise the net cash assets of the fund to the level of either the amount spent by the fund in the prior year, or the amount estimated to be expended by the fund in the succeeding year, whichever is greater, except that such requirement shall not apply between August first, two thousand eight and August first, two thousand fifteen to the extent that section fifty-a of this chapter permits the fund to be at a different level. 3. The commissioner of taxation and finance shall be the custodian of the uninsured employers' fund and shall invest any surplus moneys thereof in securities which constitute legal investments for savings banks under the laws of this state and in interest bearing certificates of deposit of a bank or trust company located and authorized to do business in this state or of a national bank located in this state secured by a pledge of direct obligations of the United States or of the state of New York, or in accordance with the provisions of section ninety-eight-a of the state finance law, in an amount equal to the amount of such certificates of deposit, and may sell any of the securities or certificates of deposit in which such fund is invested, if necessary for the proper administration or in the best interest of such fund. Disbursements from such fund as provided by this section shall be paid by the commissioner of taxation and finance upon vouchers signed by the chairman. The commissioner of taxation and finance, as custodian of such fund, as soon as practicable after August first, nineteen hundred sixty-two and annually thereafter, shall furnish to the chairman of the board a statement of the fund, setting forth the balance of moneys in the said fund as of the time of the preceding statement, the income of the fund, a summary of payments out of the fund on account of compensation ordered to be paid therefrom by the board, medical and other expenses, and all other charges against the fund in the interim and setting forth the balance of the fund remaining to its credit as of the end of the period being reported. Such statement shall be open to public inspection in the office of the chairman, and a copy thereof shall be transmitted by the chairman to the superintendent of financial services. The superintendent of financial services may examine into the condition of such fund at any time on his own initiative or on request of the chairman. He shall verify the receipts and disbursements of the fund, and shall ascertain the liability of the fund upon all cases in which awards of compensation have been made and charged against said fund and shall render a report of such facts to the chairman. Such report shall also be open to public inspection in the office of the chairman. 4. Upon notice to the representative of the fund, the board, if in its discretion it deems the interests of the fund will be best served thereby, may compromise the amount for which judgment has been entered against an employer pursuant to this section and the judgment entered may be modified accordingly. Such compromise shall be effective without the necessity of obtaining the approval of any other state official thereto, but shall not reduce the amount of benefits payable to or on behalf of any claimant under this section. 5. The chairman of the workmen's compensation board shall appoint an employee of the board who is an attorney at law duly admitted to practice in the state of New York to serve as the representative of the fund created under this section and shall assign to assist him in the discharge of his duties as such representative under the provisions of this section, such other employees of the board as the chairman deems necessary for this purpose. Such representative may apply to the chairman for authority to hire such medical and other experts and to defray the expense thereof and of such witnesses as are necessary to a proper defense of the claim within an amount in the discretion of the chairman and, if authorized, such amount shall be a charge against said fund. The representative of the fund may appear for and represent the interest of the fund in any case in court involving the rights of the fund against another not in the same employ as the employee who received benefits under this chapter and whose injury or death was caused by the negligence or wrong of such other. 6. Whenever it appears, in a claim for benefits under this chapter, that the employer may have failed to secure the payment of compensation in accordance with section fifty of this chapter, the fund shall be given notice of all proceedings in the claim. In such event, the provisions of this chapter with respect to procedure, the right to be heard and the right to apply to the board for review of a referee's decision and to appeal to the courts shall be reserved to the claimant, to the uninsured employer, and to the fund. Upon the application of the representative of the fund for a modification or rescission or review of an award, the board may review any award, decision or order and, on such review, may affirm, reverse, or modify any decision or award as the law and the facts may require, or take such other action as may be in the interest of justice. An appeal to the appellate division of the supreme court, third department, or to the court of appeals shall not operate as a stay of the payments by the uninsured employer or by the fund of the compensation required by the terms of the award or of the payment of the doctor's bills found to be fair and reasonable. Where such award is reduced or rescinded upon appeal, the uninsured employer or the fund, whichever made payment, shall be entitled to reimbursement in a sum equal to the compensation in dispute paid by such party to the respondent pending adjudication of the appeal, and, if the claim for workers' compensation is disallowed, to a sum equal to the amount of the doctor's bills paid by such party pending adjudication of the appeal. Such reimbursement shall be paid from administration expenses as provided in section one hundred fifty-one of this chapter upon vouchers approved by the chair. To the extent of any reimbursement to the fund, the uninsured employer shall be entitled to reimbursement from the fund for payments made into the fund in accordance with subdivision one of this section. 6-a. In the event that the board is unable to determine the identity of the responsible insurance carrier for the employer within thirty days of the filing of a new claim, the board shall: (a) appoint the uninsured employers' fund as the responsible party until such time as the identity of the responsible insurance carrier for the employer is determined. Upon such appointment, the uninsured employers' fund shall immediately commence payments and provide medical care in accordance with the provisions of this chapter; (b) schedule a hearing to determine the identity of the responsible insurance carrier for the employer and to determine such claim for compensation in accordance with the provisions of subdivision one of this section; and (c) provide notice of such claim and hearing to the employer by certified mail, return receipt requested, with a direction that the employer provide proof of having insurance in effect as provided by section ten of this article. 7. All the rights, powers, and benefits of the employer under section twenty-nine of this chapter shall become the rights, powers and benefits of the fund in any case in which the fund has paid or is paying compensation to an injured employee or his dependents under this section. If the employer has also paid compensation to or on behalf of the injured employee or his dependents in such case any recovery by the fund pursuant to subdivision one of section twenty-nine shall first be applied to repayment of any awards paid by the fund to or on behalf of the injured employee or his dependents in such case, the balance then applied to any outstanding unsatisfied demand for security in said case and assessments imposed against the employer pursuant to the provisions of this section, the remainder, if any, to be returned to the employer. If the employer has also paid compensation to or on behalf of the injured employee or his dependents in such case, that portion, if any, of a recovery by the fund pursuant to subdivision two of section twenty-nine which is in excess of the total amount of compensation awarded to or on behalf of such injured employee or his dependents and the reasonable and necessary expenditures incurred in effecting such recovery shall be apportioned between the injured employee or his dependents and the fund in the manner provided in said subdivision two. The balance of said recovery shall first be applied to reimburse the fund for its reasonable and necessary expenditures in effecting such recovery and the remainder shall be applied to repayment of any award paid by the fund to or on behalf of the injured employee or his dependents in such case. If there still remains a balance it shall first be applied to the outstanding unsatisfied demand for security, if any, in said case and assessments, if any, imposed against the employer pursuant to the provisions of this section; the remainder, if any, to be returned to the employer. 7-a. Notwithstanding any other provision of section twenty-nine of this article to the contrary, a compromise by the claimant of his or her cause of action as set forth in said section twenty-nine of this article, in an amount less than the sum paid to or on behalf of the claimant from the uninsured employers' fund, shall be made only with the written consent of the chair. 8. The provisions of this section with respect to the liability of the uninsured employers' fund to pay awards against uninsured defaulting employers shall apply only to claims wherein the injury shall occur on or after the first day of October, nineteen hundred sixty-two, or wherein death shall occur as the result of an injury sustained on or after the aforesaid first day of October. 9. The chairman may make reasonable regulations for the processing and payment of compensation out of the uninsured employers' fund. 10. The liability of the chairman, the commissioner of taxation and finance, the fund and the state of New York with respect to payment of any compensation, benefits, expenses, fees or disbursements properly chargeable against the uninsured employers' fund shall be limited to the assets in said fund and they shall not otherwise in any way or manner be liable for the making of any such payment. 11. All assessments payable pursuant to the provisions of this section shall be liens against the assets of the employer liable therefor without limit of amount, subordinate, however, to claims for unpaid wages and prior recorded liens. 12. Whenever the term employer is used in this section it shall be deemed to include without limitation a contractor liable for the payment of compensation pursuant to section fifty-six of the workmen's compensation law. 13. Notwithstanding any other provision of this chapter, in any case of injury or death to the president, secretary, treasurer or any other officer charged with the obligation of obtaining workers' compensation insurance, of a corporation, any awards of compensation or medical expenses payable to or on behalf of such officer or to his surviving spouse, children and dependents as defined by section sixteen of this article made against the corporation as an uninsured employer solely because of the injury or death of such officer, shall in no event be the liability of the uninsured employers' fund and shall not be payable therefrom. 14. Notwithstanding any other provision of this chapter, in any case of injury or death to a self-employed person or to a partner of a partnership as defined in section ten of the partnership law, any awards of compensation or medical expenses payable to or on behalf of such self-employed person or partner of a partnership or to his surviving spouse, children and dependents as defined by section sixteen of this article made against the self-employed person or partnership as an uninsured employer solely because of the injury or death of such self-employed person or partner, shall in no event be the liability of the uninsured employers' fund and shall not be payable therefrom. --- ## WKC § 27 — Depositing future payments in the aggregate trust fund {#27} *N.Y. Workers' Comp. Law § 27* Official source: _NYS Open Legislation, revision of 2014-09-22._ § 27. Depositing future payments in the aggregate trust fund. 1. All payments made into the fund pursuant to the provisions of this section shall constitute an indivisible and aggregate trust fund except as hereinafter provided. 2. If an award under this chapter requires payment of death benefits or other compensation by an insurance carrier or employer in periodical payments, the board may, in its discretion, at any time, any provision of this chapter to the contrary notwithstanding, compute and permit or require to be paid into the aggregate trust fund an amount equal to the present value of all unpaid death benefits or other compensation in cases in which awards are made for total permanent or permanent partial disability for a period of one hundred and four weeks or more, for which liability exists, together with such additional sum as the board may deem necessary for a proportionate payment of expenses of administering the fund so created, including the cost of the actuarial computation by or on behalf of the board of the present value of the award, and for the purposes of this section such cases shall be known as discretionary type cases. If any such award made on or after July first, nineteen hundred thirty-five, requires payment for total permanent disability resulting from the loss of both hands, or both arms, or both feet, or both legs, or both eyes, or of any two thereof, or for permanent partial disability resulting from loss of an arm, leg, hand, foot or eye, or of death benefits by an insurance carrier which is a stock corporation or mutual association, or if any such award made on or after July first, two thousand seven requires payment for permanent partial disability under paragraph w of subdivision three of section fifteen of this article by an insurance carrier which is a stock corporation or mutual association, which for the purposes of this section shall be known as mandatory type cases, the board shall immediately compute the present value thereof and require payment of such amount into the aggregate trust fund, together with such additional sum as the board may deem necessary for a proportionate payment of expenses of administering such trust fund including the cost of the actuarial computation by or on behalf of the board of the present value of the award provided, however, that where an employer or his insurance carrier is found to be entitled to reimbursement from the special disability fund of subdivision eight of section fifteen, the computation of the present value of the award and the requirement for payment of such amount into the said trust fund shall not be mandatory and such cases shall be deemed to be discretionary type cases; further provided that where an employee entitled to compensation under this chapter be injured or killed by the negligence or wrong of another not in the same employ, the computation of the present value and the requirement for payment of such amount into the said trust fund shall be held in abeyance until (1) six months have elapsed from the award of compensation, or in any event not more than one year after the date of the accident, if the injured employee, or in case of death, his personal representatives, spouse, parents, dependents or next of kin, or anyone otherwise entitled to recover damages at common law or otherwise, on account of such injury or death, have failed to commence such action, (2) the termination of any such action brought by the injured employee, or in case of death, his personal representatives, spouse, parents, dependents or next of kin, or anyone otherwise entitled to recover damages, at common law or otherwise, on account of such injury or death, under the provisions of section twenty-nine of this article. 3. Upon payment by an employer or insurance carrier into the aggregate trust fund of an amount equal to the present value of all unpaid death benefits or other compensation under any such award together with such additional sum as the board may deem necessary for a proportionate payment of expenses of administering such trust fund including the cost of the actuarial computation by or on behalf of the board of the present value of the award, such employer or insurance carrier shall be discharged from any further liability for payment of such death benefits or other compensation, and payment of the same as provided by this chapter shall be assumed by the fund so created. 4. In the event of a review or appeal of any such award the value of which has not been paid into the aggregate trust fund, if the amount of award is modified or changed, the employer or insurance carrier shall pay directly to the claimant compensation due to the date as of which the present value of future benefits is payable into such fund, and to the said fund the present value of future benefits, but if the original award is affirmed, the employer or insurance carrier shall pay to such fund the present value of the award computed as of the effective date of the original award and simple interest on such amount at the industry standard rate, as determined by the superintendent of financial services by regulation, computed from the date of the original award to the date that payment is made into such fund, plus simple interest at the rate provided in section five thousand four of the civil practice law and rules, on past due payments of compensation to the date of the affirmance of such award, which past due payment and interest shall be made directly to the claimant. The foregoing provision shall apply in the event of such review or appeal regardless of whether the widow or widower or other parties in interest have died or the widow or widower remarried subsequent to the date as of which the present value of the original award was computed. If any award, the present value of which has been paid into the aggregate trust fund, is subsequently modified or changed by the board for any reason other than because of subsequent death or remarriage, the amount equal to the present value of the unpaid death benefits or other compensation at the effective date of such modification or change shall be computed on the basis both of the original award and of the modified or changed award. If such amount is greater on the basis of the original award, the difference shall be paid by said trust fund to the employer or insurance carrier minus the cost, if any, of the actuarial computation made by or on behalf of the board. If such amount is greater on the basis of the modified or changed award, the difference shall be paid to said trust fund by such employer or insurance carrier in addition to the cost, if any, of the actuarial computation made by or on behalf of the board. In the case of an accident, occurring on or subsequent to July first, nineteen hundred thirty-nine, where the present value of an award for permanent total or permanent partial disability other than award for a definite number of weeks has been paid into the aggregate trust fund, if an award is made for death resulting from the injury causing the said disability, the employer or insurance carrier which paid the present value of said disability award into such fund shall be entitled to the difference between the amount paid into such fund and the sum disbursed from such fund to the injured employee prior to his or her death, plus simple interest on such difference at the industry standard rate. In the case of an accident occurring on or subsequent to July first, nineteen hundred thirty-nine, where the present value of an award for permanent partial disability for a definite number of weeks has been paid into the aggregate trust fund, if the injured employee dies prior to the end of such definite number of weeks, the employer or insurance carrier which made the said payment into such fund shall be entitled to the present value of the unexpended disability benefits not payable to beneficiaries computed on the basis of annuities certain with interest at the industry standard rate, minus however the cost, if any, of the actuarial computation made by or on behalf of the board. In the case of a claim for the death of an employee resulting from an accident occurring on or subsequent to January first, two thousand one, the present value of an award paid into the aggregate trust fund shall be calculated based on the assumption that any child while under the age of twenty-three years will be enrolled and attending as a full time student in an accredited educational institution and would thereby be entitled to benefits for all periods while under the age of twenty-three years. After all such children reach the age of twenty-three, the aggregate trust fund shall refund to the carrier which paid such present value into such fund the portion of such present value representing benefits for which such children were not actually entitled because they were not enrolled and attending as a full time student in an accredited educational institution plus simple interest on such difference at the industry standard rate. 5. All computations made by the board shall be upon the basis of the survivorship annuitants table of mortality, the remarriage tables of the Dutch Royal Insurance Institution and interest at three and one-half per centum per annum on claims based on accidents occurring up to and including June thirtieth, nineteen hundred thirty-nine, at three per centum per annum on claims based on accidents occurring from July first, nineteen hundred thirty-nine up to and including August thirty-first, nineteen hundred eighty-three, at six per centum per annum on claims based on accidents occurring from September first, nineteen hundred eighty-three up to and including December thirty-first, two thousand and at the industry standard rate on claims based on accidents occurring thereafter, except (a) that computations of present values of death benefits required to be paid into the aggregate trust fund by an insurance carrier which is a stock corporation or a mutual association shall be based, in the case of a dependent parent, grandparent, blind or physically disabled child or spouse, upon said table of mortality disregarding possible change in or termination of dependency, with interest at three and one-half per centum per annum on claims based on accidents occurring up to and including June thirtieth, nineteen hundred thirty-nine, at three per centum per annum on claims based on accidents occurring from July first, nineteen hundred thirty-nine up to and including August thirty-first, nineteen hundred eighty-three, at six per centum per annum on claims based on accidents occurring from September first, nineteen hundred eighty-three up to and including December thirty-first, two thousand and at the industry standard rate on claims based on accidents occurring thereafter and (b) that computations of present values of permanent partial disability benefits awarded for a definite number of weeks shall be on the basis of annuities certain with interest at three and one-half per centum per annum on claims based on accidents occurring up to and including June thirtieth, nineteen hundred thirty-nine, at three per centum per annum on claims based on accidents occurring from July first, nineteen hundred thirty-nine up to and including August thirty-first, nineteen hundred eighty-three, at six per centum per annum on claims based on accidents occurring from September first, nineteen hundred eighty-three up to and including December thirty-first, two thousand and at the industry standard rate on claims based on accidents occurring thereafter. 6. Such aggregate trust fund shall be kept separate and apart from all other moneys of the state insurance fund, and shall not be liable for any losses or expenses of administration of the state insurance fund other than the expenses involved in the administration of such trust fund including the cost, if any, of the actuarial computations made on behalf of the board, nor shall the state insurance fund be charged with the losses or expenses of the aggregate trust fund beyond the amount of such trust fund. Any portion of such aggregate trust fund may, by order of the commissioners of the state insurance fund, approved by the superintendent of financial services, be invested in or loaned on the pledge of the same securities as provided in section eighty-seven of this chapter for the investment of the state insurance fund, and the commissioners may, upon like approval of the superintendent of financial services, also sell any such securities. Any securities belonging to the aggregate trust fund may be loaned by the commissioners of the state insurance fund, with the approval of the superintendent of financial services, under a security loan agreement as provided by section eighty-seven of this chapter for securities belonging to the state insurance fund. 7. For the purpose of securing the solvency of the aggregate trust fund, there shall be required, in addition to the payments hereinbefore provided for, a payment on each award, as follows: (a) In the mandatory type cases based on an accident occurring on or subsequent to July first, nineteen hundred forty-one up to and including June thirtieth, nineteen hundred forty-three an amount equal to six per centum of the present value of each such case paid into such fund; (b) In the mandatory type cases based on an accident occurring on or subsequent to July first, nineteen hundred forty-three an amount equal to ten per centum of the present value of each such case paid into such fund; (c) In the discretionary type cases based on an accident occurring up to and including June thirtieth, nineteen hundred thirty-nine an amount equal to sixteen per centum of the present value of each such case paid into such fund; (d) In the discretionary type cases based on an accident occurring on or subsequent to July first, nineteen hundred thirty-nine an amount equal to ten per centum of the present value of each such case paid into such fund. Such additional payments shall be required until the surplus of the fund equals or exceeds one per centum of the total outstanding loss reserves as shown by three successive annual reports of the fund to the superintendent of financial services and such additional payment shall be required as a payment upon each award based on an accident occurring prior to July first next succeeding the third such annual report, but not as a payment upon any award based on an accident occurring on or after said July first; provided, however, that if and when the surplus of the fund as shown by any annual report thereafter shall be less than one per centum of the total outstanding loss reserves, then the additional payments as provided in paragraphs (a), (b), (c) and (d) of this subdivision shall be resumed and shall be payable upon any award based on an accident occurring on or after July first next succeeding the close of the year for which such annual report is made. Thereafter, the suspension or resumption of additional payments as required by this subdivision shall be governed by the foregoing provisions. Such loss reserves shall be computed based upon the tables specified in subdivision five of this section and interest at a standard to be determined by the superintendent of financial services by regulation. 8. In the case of a claim concerning which the aggregate trust fund enters a waiver agreement pursuant to section thirty-two of this article, the insurance carrier, as defined in subdivision twelve of section two of this chapter, which paid the present value of the award for such claim, shall not be entitled to a refund of any portion of the present value of such award. --- ## WKC § 27-A — Investments in obligations of designated public benefit corporations; indemnifications {#27-A} *N.Y. Workers' Comp. Law § 27-A* Official source: _NYS Open Legislation, revision of 2014-09-22._ § 27-a. Investments in obligations of designated public benefit corporations; indemnifications. 1. The aggregate trust fund, and all state officers with responsibility for the custody or investment of such fund or of its assets, are authorized and directed to take any and all actions necessary or appropriate to cause such fund to make purchases, in accordance with a schedule to be established, subject to amendment from time to time, by the state director of the budget in the aggregate principal amount of seventy-five million dollars, of obligations of the state of New York and of any one or more of the following public benefit corporations: the New York state housing finance agency, including, but not limited to, obligations secured by second mortgages on housing projects insured by the Federal government or an agency thereof, the New York state medical care facilities finance agency, the dormitory authority and the New York state environmental facilities corporation. The schedule of obligations to be purchased pursuant to this section may include, but shall not be limited to, short term obligations of the housing finance agency for purposes of proviving a bridge loan for the financing of housing projects, in anticipation of the receipt of proceeds from Federal mortgage insurance on such housing projects or such other proceeds as may become available. Such schedule may be amended from time to time to provide for the renewal, refunding, redemption or repayment of notes purchased by the aggregate trust fund in accordance with the schedule, or for the conversion of such notes into bonds or other long term obligations, provided that at no time shall the total aggregate amount of obligations held by the aggregate trust fund pursuant to the provisions of this section exceed seventy-five million dollars. The terms and conditions of such obligations, including the times of purchase and maturities thereof and the rates of interest thereon, shall be determined by the state comptroller in the case of state obligations or by the public benefit corporation issuing the obligations, provided such terms and obligations are found to be fair and reasonable by the state superintendent of financial services. 2. Notwithstanding any general or special provision of law to the contrary, in order to obtain the monies necessary to purchase the obligations required by subdivision one of this section, the commissioners of the state insurance fund, in accordance with rules and regulations adopted by such commissioners, shall have the right (i) to borrow an amount not exceeding the obligation incurred by the aggregate trust fund pursuant to this section, and to pledge as collateral therefor such assets as they may deem advisable, (ii) to sell any fund assets under an agreement or option for the repurchase thereof from monies or assets in the fund or (iii) to sell fund assets on such terms and conditions as are found to be fair and reasonable by the state superintendent of financial services. 3. It is hereby found and declared that any and all obligations of the state of New York, the New York state housing finance agency, the New York state medical care facilities finance agency, the dormitory authority and the New York state environmental facilities corporation, are reasonable, prudent, proper and legal investments for the aggregate trust fund and for all state officers with responsibility for the custody or investment of such fund or of its assets. 4. Notwithstanding any other provision of law, no state officer with responsibility for the custody or investment of the aggregate trust fund or of its assets, or for the approval of the sale or investment of such assets, nor any investment advisor, attorney, accountant or actuary who shall have been employed by or shall have advised such officer, shall incur or suffer any liability whatsoever to any person by reason of actions taken pursuant to the authorization and direction of subdivision one or two of this section. Any action which could have been brought against any aforementioned state officer, investment advisor, attorney, accountant or actuary, except for the provisions of this subdivision, may be brought against the aggregate trust fund. 5. a. Notwithstanding any other provision of law, including the provisions of section seventeen of the public officers law, the aggregate trust fund and the state, jointly and severally, shall save harmless and indemnify each and every state officer with responsibility for the custody or investment of such fund or of its assets or for the approval of the sale or investment of such assets, and any investment advisor, attorney, accountant or actuary who shall have been employed by or who shall have advised such officer, and the state shall save harmless and indemnify the aggregate trust fund, from any and all financial loss and expense arising out of or in connection with any claim, demand, suit, action, proceeding or judgment for alleged negligence, gross negligence, waste or breach of fiduciary duty, or incapacity of any kind by reason of any transaction pursuant to the authorization and direction of subdivision one or two of this section, provided that such officer, investment advisor, attorney, accountant or actuary shall, within five days after the date on which he is personally served with, or receives actual notice of, any summons, complaint, process, notice, demand, claim or pleading, give notice thereof to such fund or the attorney general. Upon such notice the aggregate trust fund and the attorney general shall, if so requested, assume control of the representation of such officer or investment advisor, attorney, accountant or actuary, in connection with such claim, demand, suit, action or proceeding. Each person so represented shall cooperate fully with the fund and the attorney general or any other person designated to assume such defense in respect of such representation or defense. b. Notwithstanding any provision of law to the contrary, the state shall also save harmless and indemnify the aggregate trust fund for any and all financial loss and expense arising out of or in connection with any claim, demand, suit, action, proceeding or judgment rendered thereupon against such fund pursuant to subdivision four hereof, provided that such fund shall, within five days after the date on which it is served with, or receives actual notice of, any summons, complaint, process, notice, demand, claim or pleading, give notice thereof to the attorney general. Upon such notice the attorney general shall assume control of the representation of such fund in connection with such claim, demand, suit, action or proceeding. The fund shall cooperate fully with the attorney general or any other person designated to assume such defense in respect of such representation or defense. --- ## WKC § 27-B — Amortization of gains or losses {#27-B} *N.Y. Workers' Comp. Law § 27-B* Official source: _NYS Open Legislation, revision of 2014-09-22._ § 27-b. Amortization of gains or losses. Gains or losses realized by the aggregate trust fund as a result of transactions made pursuant to subdivision two of section twenty-seven-a, or section twenty-seven-c of this chapter, shall be transferred to a special asset account to be known as the deferred charge on account of security transactions and shall be amortized within such account on a basis which matches as nearly as possible all gains or losses so realized against any increase or decrease in income resulting from the reinvestment of the proceeds of such transactions, provided that the period of amortization of the gain or loss resulting from the disposition of each investment shall not be longer than the unexpired period from the date of such disposition to the maturity of the investment so disposed of, or on such other basis as the superintendent of financial services may authorize in his discretion. --- ## WKC § 27-C — Appropriations to the aggregate trust fund {#27-C} *N.Y. Workers' Comp. Law § 27-C* Official source: _NYS Open Legislation, revision of 2014-09-22._ § 27-c. Appropriations to the aggregate trust fund. 1. Notwithstanding any other provision of law, the aggregate trust fund, hereinafter referred to as the fund, and all state officers with responsibility for the custody or investment of such fund or of its assets, shall annually, no later than November first in each year, submit to the director of the budget a request for an appropriation of one hundred sixty million dollars. The governor shall include such amount in a budget bill for the next state fiscal year. The state comptroller shall encumber the amount so appropriated before the end of the fiscal year for which any such appropriation is made. If for any fiscal year commencing on or after April first, nineteen hundred eighty-three, the governor fails to submit a budget bill containing an appropriation in the amount requested by the fund or the legislature fails to appropriate the amount in a budget bill submitted by the governor for such fiscal year, the amount appropriated for and encumbered during the preceding fiscal year shall be payable forthwith to the fund on the first day of July of such year in the manner prescribed by law, provided, however, that such amount shall not exceed the amount of moneys transferred to the general fund by the fund pursuant to the provisions of chapter fifty-five of the laws of nineteen hundred eighty-two and chapter seven of the laws of nineteen hundred eighty-nine. 2. Notwithstanding any other provision of law, the fund and all state officers with responsibility for the custody or investment of such fund or of its assets shall annually, no later than November first in each year, submit to the director of the budget the fund's additional request for an appropriation of sixty million dollars and the governor shall include such additional amount in a budget bill for the next state fiscal year. The state comptroller shall encumber the amount so appropriated before the end of the fiscal year for which any such appropriation is made. If for any fiscal year commencing on or after April first, nineteen hundred ninety the governor fails to submit a budget bill containing an appropriation in the amount requested by the fund or the legislature fails to appropriate the amount in a budget bill submitted by the governor for such fiscal year, the amount appropriated for and encumbered during the preceding fiscal year shall be payable forthwith to the fund on the first day of July of such year in the manner prescribed by law, provided, however, that such amount shall not exceed the amount of moneys transferred to the general fund by the fund pursuant to the provisions of a chapter of the laws of nineteen hundred eighty-nine. 3. It is hereby found and declared that any appropriation made as provided for in subdivision one or two of this section shall be deemed an admitted asset of the aggregate trust fund, and that any transfer of moneys by the fund to the general fund in accordance with the provisions of chapter fifty-five of the laws of nineteen hundred eighty-two, chapter seven of the laws of nineteen hundred eighty-nine or a chapter of the laws of nineteen hundred eighty-nine is deemed a proper and prudent legal undertaking for any state officer with the responsibility for the custody or the investment of the assets of the fund, notwithstanding any other provision of law to the contrary. --- ## WKC § 28 — Limitation of right to compensation {#28} *N.Y. Workers' Comp. Law § 28* Official source: _NYS Open Legislation, revision of 2014-09-22._ § 28. Limitation of right to compensation. The right to claim compensation under this chapter shall be barred, except as hereinafter provided, unless within two years after the accident, or if death results therefrom within two years after such death, a claim for compensation shall be filed with the chairman, but the employer and insurance carrier shall be deemed to have waived the bar of the statute unless the objection to the failure to file the claim within two years is raised on the first hearing on such claim at which all parties in interest are present. The right of an employee to claim compensation under this chapter for disablement caused by any occupational disease including but not limited to compressed air illness or its sequelae, silicosis or other dust disease, latent or delayed pathological bone, blood or lung changes or malignancies due to occupational exposure to or contact with arsenic, benzol, beryllium, zirconium, cadmium, chrome, lead or fluorine or to exposure to x-rays, radium, ionizing radiation, radio-active substances, or any other chemical compound shall not be barred by the failure of the employee to file a claim within such period of two years, provided such claim shall be filed after such period of two years and within two years after disablement and after the claimant knew or should have known that the disease is or was due to the nature of the employment. No case in which an advance payment is made to an employee or to his dependents in case of death shall be barred by the failure of the employee or his dependents to file a claim, and the board may at any time order a hearing on any such case in the same manner as though a claim for compensation had been filed. --- ## WKC § 29 — Remedies of employees; subrogation {#29} *N.Y. Workers' Comp. Law § 29* Official source: _NYS Open Legislation, revision of 2014-09-22._ § 29. Remedies of employees; subrogation. 1. If an employee entitled to compensation under this chapter be injured or killed by the negligence or wrong of another not in the same employ, such injured employee, or in case of death, his dependents, need not elect whether to take compensation and medical benefits under this chapter or to pursue his remedy against such other but may take such compensation and medical benefits and at any time either prior thereto or within six months after the awarding of compensation or within nine months after the enactment of a law or laws creating, establishing or affording a new or additional remedy or remedies, pursue his remedy against such other subject to the provisions of this chapter. If such injured employee, or in case of death, his dependents, take or intend to take compensation, and medical benefits in the case of an employee, under this chapter and desire to bring action against such other, such action must be commenced not later than six months after the awarding of compensation or not later than nine months after the enactment of such law or laws creating, establishing or affording a new or additional remedy or remedies and in any event before the expiration of one year from the date such action accrues. In such case, the state insurance fund, if compensation be payable therefrom, and otherwise the person, association, corporation or insurance carrier liable for the payment of such compensation, as the case may be, shall have a lien on the proceeds of any recovery from such other, whether by judgment, settlement or otherwise, after the deduction of the reasonable and necessary expenditures, including attorney's fees, incurred in effecting such recovery, to the extent of the total amount of compensation awarded under or provided or estimated by this chapter for such case and the expenses for medical treatment paid or to be paid by it and to such extent such recovery shall be deemed for the benefit of such fund, person, association, corporation or carrier. Should the employee or his dependents secure a recovery from such other, whether by judgment, settlement or otherwise, such employee or dependents may apply on notice to such lienor to the court in which the third party action was instituted, or to a court of competent jurisdiction if no action was instituted, for an order apportioning the reasonable and necessary expenditures, including attorneys' fees, incurred in effecting such recovery. Such expenditures shall be equitably apportioned by the court between the employee or his dependents and the lienor. Notice of the commencement of such action shall be given within thirty days thereafter to the chairman, the employer and the insurance carrier upon a form prescribed by the chairman. Any of the foregoing providers of compensation and/or medical benefits which has recovered a lien pursuant to the provisions hereof against the recovery of a person injured on or after February first, nineteen hundred seventy-four and before July first, nineteen hundred seventy-eight, through the use or operation of a motor vehicle in this state, shall notify such person by certified mail in a manner to be approved by the chairman and the superintendent of financial services of the responsibility of an "insurer" (as defined in subsection (g) of section five thousand one hundred two of the insurance law), to reimburse such person under such circumstances to the extent that the recovered lien represent first party benefits as defined in article fifty-one of the insurance law. 1-a. Notwithstanding any other provision of this chapter, the state insurance fund, if compensation and/or medical benefits be payable therefrom, or otherwise the person, association, corporation, insurance carrier or statutory fund liable for the payment of such compensation and/or medical benefits shall not have a lien on the proceeds of any recovery received pursuant to subsection (a) of section five thousand one hundred four of the insurance law, whether by judgment, settlement or otherwise for compensation and/or medical benefits paid which were in lieu of first party benefits which another insurer would have otherwise been obligated to pay under article fifty-one of the insurance law. The sole remedy of any of the foregoing providers to recover the payments specified in the preceding sentence shall be pursuant to the settlement procedures contained in section five thousand one hundred five of the insurance law. 1-b. Notwithstanding any other provision of this chapter to the contrary, the state insurance fund, if compensation and/or medical benefits be payable therefrom, or otherwise the person, association, corporation, insurance carrier or statutory fund liable for the payment of such compensation and/or medical benefits: (a) shall not have a lien on the proceeds of any award from the September eleventh victim compensation fund of two thousand one established pursuant to title IV of the federal air transportation safety and system stabilization act, public law 107-42, as amended; and (b) shall not terminate or reduce such compensation and/or medical benefits based upon the submission of a claim for an award from such federal fund, and/or the waiver or compromise of any cause of action resulting from such submission. 2. If such injured employee, or in case of death, his dependents, has taken compensation under this chapter but has failed to commence action against such other within the time limited therefor by subdivision one, such failure shall operate as an assignment of the cause of action against such other to the state for the benefit of the state insurance fund, if compensation be payable therefrom, and otherwise to the person, association, corporation, or insurance carrier liable for the payment of such compensation. Except as hereinafter provided, the failure of the injured employee or his dependents to commence an action pursuant to the provisions of subdivision one of this section, shall not operate as an assignment of the cause of action as provided herein, unless the insurance carrier shall have notified the claimant in writing by personal service or by certified or registered mail, return receipt requested, at least thirty days prior to the expiration of the time limited for the commencement of an action by subdivision one, that such failure to commence such action shall operate as an assignment of whatever cause of action may exist to such insurance carrier. If the insurance carrier shall fail to give such notice, the time limited for the commencement of an action by subdivision one shall be extended until thirty days after the insurance carrier shall have notified the claimant in writing that failure to commence an action within thirty days after the mailing of such notice shall operate as an assignment of the cause of action to such carrier, and in the event the claimant fails to commence such action within thirty days after the mailing of such notice, such failure shall operate as an assignment of such cause of action to such carrier. If such fund, person, association, corporation or carrier, as such an assignee, recover from such other, either by judgment, settlement or otherwise, a sum in excess of the total amount of compensation awarded to such injured employee or his dependents and the expenses for medical treatment paid by it, together with the reasonable and necessary expenditures incurred in effecting such recovery, it shall forthwith pay to such injured employee or his dependents, as the case may be, two-thirds of such excess, and to the extent of two-thirds of any such excess such recovery shall be deemed for the benefit of such employee or his dependents. When the compensation awarded requires periodical payments the number of which cannot be determined at the time of such award, the board shall, when the injury or death was caused by the negligence or wrong of another not in the same employ, estimate the probable total amount thereof upon the basis of the survivorship annuitants table of mortality, the remarriage tables of the Dutch Royal Insurance Institution and such facts as it may deem pertinent, and such estimate shall be deemed the amount of the compensation awarded in such case, for the purpose of computing the amount of such excess recovery, subject to the modification thereof as hereinafter provided. If any of the foregoing providers, having paid benefits under this chapter to an injured employee, who is also a "covered person" (as defined in subsection (j) of section five thousand one hundred two of the insurance law), and who was injured in a motor vehicle accident in this state on and after February first, nineteen hundred seventy-four and before July first, nineteen hundred seventy-eight, maintains an action, as assignee, against such third party, who is also a "covered person", and recovers, whether by judgment, settlement or otherwise, it shall advise the injured employee, by certified mail, in a manner to be approved by the chairman and the superintendent of financial services, of the responsibility of an "insurer" (as defined in subsection (g) of section five thousand one hundred two of the insurance law) to further compensate such injured employee. 2-a. Notwithstanding any other provisions of this chapter, the failure of a "covered person" (as defined in subsection (j) of section five thousand one hundred two of the insurance law), who has taken compensation and/or medical benefits under this chapter for injuries arising out of the use or operation of a motor vehicle in this state, to commence an action against such other within the time limited therefor by subdivision one of this section shall not operate as an assignment of the cause of action to the provider thereof for their recovery when such benefits were paid in lieu of first party benefits which another insurer would have otherwise been obligated to pay under article fifty-one of the insurance law, unless such other is not a "covered person". The sole remedy of any of the foregoing providers to recover the payments specified in the preceding sentence when the other party is a "covered person" shall be pursuant to the settlement procedures contained in section five thousand one hundred five of the insurance law. 3. In the event of a modification of an award increasing the compensation previously awarded or in the event that the total amount of periodical payments made pursuant to an award under which the number of such payments could not be determined at the time of the award, shall exceed the total thereof as estimated by the board, the principal of any of such excess recovery theretofore paid to such injured employee or his dependents shall be credited against such increase or such excess. In the event of a modification of an award ending or diminishing the compensation previously awarded or in the event that the total amount of periodical payments made pursuant to an award under which the number of such payments could not be determined at the time of the award, shall be less than the total thereof as estimated by the board, such fund, person, association, corporation or carrier shall forthwith pay to such injured employee or his dependents, as the case may be, any additional amount of such excess recovery to which such injured employee or his dependents may be entitled by reason of such modification or such deficiency, determined as hereinbefore provided. 4. If such injured employee, or in case of death, his dependents, proceed against such other, the state insurance fund, person, association, corporation, or insurance carrier, as the case may be, shall contribute only the deficiency, if any, between the amount of the recovery against such other person actually collected, and the compensation provided or estimated by this chapter for such case. 5. In case of the payment of an award to the commissioner of taxation and finance in accordance with subdivisions eight and nine of section fifteen and in accordance with section twenty-five-a such payment shall operate to give to the employer or insurance carrier liable for the award a cause of action for the amount of such payment together with the reasonable funeral expenses and the expense of medical treatment which shall be in addition to any cause of action by the legal representatives of the deceased. Such a cause of action assigned to the state may be prosecuted or compromised in the name of the state insurance fund by the commissioners of the state insurance fund. A compromise of any such cause of action by the employee or his dependents at an amount less than the compensation provided for by this chapter shall be made only with the written approval of the commissioners of the state insurance fund or such officer thereof designated by them, if the deficiency of compensation would be payable from the state insurance fund, and otherwise with the written approval of the person, association, corporation, or insurance carrier liable to pay the same. However, written approval of the commissioners of the state insurance fund or such officer thereof designated by them or written approval of the person, association, corporation, or the insurance carrier need not be obtained if the employee or his dependents obtain a compromise order from a justice of the court in which the third-party action was pending. The papers upon an application to compromise and settle such a claim shall consist of the petition, the affidavit of the attorney, and the affidavit of one or more physicians. The petition shall contain the following: a. The name and residence of the petitioner if the employee, or petitioner's relationship to the deceased; b. The date of accident and a general description thereof; c. The nature and extent of the damages sustained, including the name of the physician or physicians attending or consulting in the treatment and the medical expenses incurred, the period of disability resulting from the accident, the total amount of wages lost thereby, and the present physical condition; d. The terms of the attorney's retainer and of the proposed settlement and petitioner's approval thereof; and e. Whether any previous application for the settlement of the claim has been made, and if so, the time and the court or justice thereof and the disposition made of same. The affidavit of the attorney shall set forth by whom, on what date and under what terms he was retained, the services rendered by him, his fee if the settlement is approved, the acts complained of, the terms of the proposed settlement with a statement of his reasons for recommending the same, and shall state that he has not become concerned in the application or its subject matter at the instance of such defendant directly or indirectly and that he has not received and is not to receive any compensation from such defendant directly or indirectly. The affidavit of the physician in a claim arising from personal injury to the employee, shall set forth his connection with the case; the period covered by the treatment and the nature, duration and extent of the injuries; the date of his last examination and the condition of the employee at that time; whether or not the employee is still suffering any disability or inconvenience as the result of the injury, giving the details thereof; whether or not the accident has left the employee with any permanent disability, defect, scar or impairment; the cost of the treatment and whether or not he expects to be paid or has been paid by the defendant or by anyone acting on the defendant's behalf. Where the affidavit as to the present condition is not made by the attending physician, the latter's affidavit setting forth the character of the injuries and treatment should also be attached, or the failure to obtain it explained. Where the employee was confined to a hospital, the court may require the production of hospital records. A copy of the papers to be used on the application to compromise and settle the claim must be served as directed by the court or in the same manner as provided in the civil practice law and rules for a notice of motion upon the commissioners of the state insurance fund or such officer thereof designated by them or upon the person, association, corporation, or insurance carrier, whose written approval would have been required to compromise such cause of action by the employee or his dependents. This notice shall afford them the opportunity to submit affidavits and to be heard by the court on the application. If the third-party action is on trial at the time the offer of settlement which is acceptable to the plaintiff, is made and either such written approval or order as provided in this subdivision is required, the action may be marked settled subject to the securing of such written approval or such order. If such written approval or such order is not subsequently secured within three months the action shall be restored to the head of the trial day calendar. 6. The right to compensation or benefits under this chapter, shall be the exclusive remedy to an employee, or in case of death his or her dependents, when such employee is injured or killed by the negligence or wrong of another in the same employ, the employer's insurer or any collective bargaining agent of the employer's employees or any employee, of such insurer or such collective bargaining agent (while acting within the scope of his or her employment). The limitation of liability of an employer set forth in section eleven of this article for the injury or death of an employee shall be applicable to another in the same employ, the employer's insurer, any collective bargaining agent of the employer's employees or any employee of the employer's insurer or such collective bargaining agent (while acting within the scope of his or her employment). The option to maintain an action in the courts for damages based on the employer's failure to secure compensation for injured employees and their dependents as set forth in section eleven of this article shall not be construed to include the right to maintain an action against another in the same employ, the employer's insurer, any collective bargaining agent of the employer's employees or any employee of the employer's insurer or such collective bargaining agent (while acting within the scope of his or her employment). --- ## WKC § 30 — Revenues or benefits from other sources not to affect compensation {#30} *N.Y. Workers' Comp. Law § 30* Official source: _NYS Open Legislation, revision of 2019-01-11._ * § 30. Revenues or benefits from other sources not to affect compensation. No benefits, savings or insurance of the injured employee, independent of the provisions of this chapter, shall be considered in determining the compensation or benefits to be paid under this chapter, except that (1) in case of the death of an employee of the state, a municipal corporation or any other political subdivision of the state, any benefit payable under a pension system or any other statutory benefit which is not sustained or provided for in whole or in part by the contribution of the employee, may be applied toward the payment of the death benefit provided by this chapter; (2) in case of an award of compensation to a paid firefighter of a fire company or fire department of a city of less than one million population, or town, village or fire district any salary or wages paid to, or the cost of any medical treatment and hospital care provided for, such paid firefighter under and pursuant to the provisions of section two hundred seven-a of the general municipal law shall be credited against any award of compensation to such paid firefighter under this chapter where the injury occurred or disablement arose on or after May first, nineteen hundred fifty-one; and (3) in case of an award of compensation to a member of a police force of any county, city of less than one million population, town or village, or of any district, agency, board, body or commission thereof, any salary or wages paid to, or the cost of any medical treatment or hospital care provided for, such member under and pursuant to the provisions of section two hundred seven-c of the general municipal law shall be credited against any award of compensation to such member under this chapter where the injury occurred or the disablement arose on or after May first, nineteen hundred sixty-three. * NB Effective until the first day of the calendar month following receipt by the comptroller of the election by The Long Island Rail Road Company * § 30. Revenues or benefits from other sources not to affect compensation. No benefits, savings or insurance of the injured employee, independent of the provisions of this chapter, shall be considered in determining the compensation or benefits to be paid under this chapter, except that (1) in case of the death of an employee of the state, a municipal corporation, any other political subdivision of the state, including for this purpose The Long Island Rail Road Company, any benefit payable under a pension system or any other statutory benefit which is not sustained or provided for in whole or in part by the contribution of the employee, may be applied toward the payment of the death benefit provided by this chapter; (2) in case of an award of compensation to a paid firefighter of a fire company or fire department of a city of less than one million population, or town, village or fire district any salary or wages paid to, or the cost of any medical treatment and hospital care provided for, such paid firefighter under and pursuant to the provisions of section two hundred seven-a of the general municipal law shall be credited against any award of compensation to such paid firefighter under this chapter where the injury occurred or disablement arose on or after May first, nineteen hundred fifty-one; and (3) in case of an award of compensation to a member of a police force of any county, city of less than one million population, town or village, any district, agency, board, body or commission thereof, or of The Long Island Rail Road Company, any salary or wages paid to, or the cost of any medical treatment or hospital care provided for, such member under and pursuant to the provisions of section two hundred seven-c of the general municipal law shall be credited against any award of compensation to such member under this chapter where the injury occurred or the disablement arose on or after May first, nineteen hundred sixty-three, or in the case of The Long Island Rail Road Company, on or after the date this section is effective with respect to members of its police force. * NB Effective the first day of the calendar month following receipt by the comptroller of the election by The Long Island Rail Road Company --- ## WKC § 31 — Agreement for contribution by employee void {#31} *N.Y. Workers' Comp. Law § 31* Official source: _NYS Open Legislation, revision of 2014-09-22._ § 31. Agreement for contribution by employee void. No agreement by an employee to pay any portion of the premium paid by his employer to the state insurance fund or to contribute to a benefit fund or department maintained by such employer or to the cost of mutual insurance or other insurance, maintained for or carried for the purpose of providing compensation as herein required, shall be valid, and any employer who makes a deduction for such purpose from the wages or salary of any employee entitled to the benefits of this chapter shall be guilty of a misdemeanor. --- ## WKC § 32 — Waiver agreements {#32} *N.Y. Workers' Comp. Law § 32* Official source: _NYS Open Legislation, revision of 2017-04-21._ § 32. Waiver agreements. No agreement or release except as otherwise provided in this chapter by an employee to waive his right to compensation under this chapter shall be valid. (a) Whenever a claim has been filed, the claimant or the deceased claimant's dependents and the employer, its carrier, the special disability fund as set forth in subdivision (e) of this section, or the aggregate trust fund, if the board has directed that the present value of any unpaid compensation be paid into such fund pursuant to section twenty-seven of this article, may enter into an agreement settling upon and determining the compensation and other benefits due to the claimant or his or her dependents. The agreement shall not bind the parties to it, unless it is approved by the board. Such agreements, when so approved, notwithstanding any other provisions, shall be final and conclusive upon the claimant, the claimant's dependents, the employer, its insurance carrier, the aggregate trust fund and the special disability fund. Every insurance carrier as defined in subdivision twelve of section two of this chapter shall offer each claimant the opportunity to enter into an agreement settling upon and determining the compensation and other benefits due, in the case of disability, within two years after the date the claim was indexed by the board or six months after the claimant is classified with a permanent disability, whichever is later, and in the case of death, within six months after entitlement to benefits is established for all beneficiaries. The offer made by the insurance carrier shall clearly state what portion of the offer is (i) for compensation as defined in subdivision six of section two of this chapter, if any; (ii) for medical benefits, including prescription medicine, if any; and (iii) for the fee of the attorney or licensed representative, if any. If a claimant is represented by an attorney or licensed representative, the insurance carrier shall present such offer to such legal representative. If a claimant is not represented by an attorney or a licensed representative, the insurance carrier shall, in addition to the offer to enter into a settlement agreement, provide the claimant with a statement of his or her rights, obligations and potential liability if the offer is accepted. (b) The agreement shall be approved by the board in a decision duly filed and served unless: (1) the board finds the proposed agreement unfair, unconscionable, or improper as a matter of law; (2) the board finds that the proposed agreement is the result of an intentional misrepresentation of material fact; or, (3) within ten days of submitting the agreement one of the interested parties requests that the board disapprove the agreement. (c) A decision duly filed and served approving an agreement submitted to the board shall not be subject to review pursuant to section twenty-three of this article. However, a decision duly filed and served disapproving an agreement submitted to the board is subject to review pursuant to section twenty-three of this article. If the board disapproves of an agreement it shall duly file and serve a notice of decision setting aside the proposed agreement. (d) An agreement for compensation and other benefits covered by this chapter may be modified at anytime by agreement of all interested parties provided it is approved by the board. (e) The chair shall establish an office under his or her supervision to be known as the "waiver agreement management office," to negotiate and seek board approval for waiver agreements on behalf of the special disability fund. The office shall operate in accordance with guidelines or directives that the chair may issue, as approved by the special disability fund advisory committee, or in the absence of such guidelines or directives, using such discounting factors as the office determines are in the financial interest of the special disability fund. The waiver agreement management office on behalf of the special disability fund may enter into a waiver agreement with a claimant only when the special disability fund has been found liable by the board to reimburse the claimant's employer, insurance carrier or the state insurance fund. Notwithstanding any other provisions of law, no consultation or approval of any employer, insurance carrier, self-insurer or the state insurance fund shall be required before such office may enter into any waiver agreement, or before the board may approve such waiver agreement. The chair may, in his or her discretion, and as approved by the special disability fund advisory committee, terminate the operation of the waiver agreement management office, if he or she believes it no longer serves the interest of the special disability fund. (f) A claimant's executed waiver agreement with the waiver agreement management office shall be final and conclusive upon the claimant, the claimant's dependents, and any employer, self-insurer, insurance carrier, the state insurance fund and the special disability fund as to all claims by the claimant, and as to any claim or request for reimbursement from the special disability fund for payments not yet made. The waiver agreement management office shall give written notice to any employer, insurance carrier or the state insurance fund entitled to receive reimbursement from the special disability fund in regard to any claimant, of any waiver agreement signed by the office with such claimant within fourteen days of submitting the waiver agreement to the board for approval. (g) Nothing in this section shall prohibit any insurance carrier, employer, the state insurance fund, or the waiver agreement management office on behalf of the special disability fund from jointly entering into a waiver agreement with a claimant, by which the joint signatories may apportion responsibility for making any payments required under the agreement. The agreement shall set forth the obligations of the signatories to make such payments, and shall identify, as to each obligation thereunder: (1) the signatory that has the legal obligation to carry out that provision, or (2) that all signatories are jointly and severally liable under the provision. (h) Neither the establishment of the waiver agreement management office, nor any action taken by that office, shall serve as grounds for the board's disapproval of any waiver agreement to which the office is not a party, or otherwise permit any party to withdraw from such a waiver agreement. (i) (1) The waiver agreement management office may contract with an insurance carrier, self-insured employer, state insurance fund or any third party to assume liability for, manage, administer, or settle claims on its behalf, so long as (A) such contract is approved by the special disability fund advisory committee and (B) such party shall agree to be subject to any guidelines or directives as the chair may issue. (2) The chair may, with approval of the special disability fund advisory committee and on such terms as the committee deems appropriate, procure one or more private entities to assume the liability for and manage, administer, or settle all or a portion of the claims in the special disability fund including, without limitation, by obtaining "an assumption of workers' compensation liability insurance policy" as defined in subdivision three of section fifty of this chapter. Any such policy shall expressly provide and, notwithstanding any other provision of law, operate to release from any further liability (i) the special disability fund and (ii) the insurance carrier, including as the case may be the state insurance fund, originally liable for any claim covered by the assumption of workers' compensation liability insurance policy securing such further and future contingent liability as may arise from any such claim, including from prior injuries to employees and be incurred by reason of any change in the condition of such employees for payment of additional compensation. Notwithstanding any other provisions of law, no consultation or approval of any employer, insurance carrier, self-insurer or the state insurance fund shall be required before such office may enter into any such policy of waiver agreement, or before the board may approve such waiver agreement. Any such procurement shall be conducted in accordance with state finance law, except as otherwise set forth below. The chair shall not award any contract that has not been approved by the special disability fund advisory committee. Notwithstanding the foregoing, the chair of the workers' compensation board may, if approved by the special disability fund advisory committee, and on such terms as the committee deems appropriate: (A) waive any informality in a bid, and either reject all bids and again advertise for bids, or interview at least two responsible qualified bidders and negotiate and enter into a contract with one or more of such bidders; or (B) group claims to be assigned, in whole or in part, based on the insurance carrier, self-insured employer or state insurance fund that is receiving or will receive reimbursement on those claims from the second disability fund. Such grouping shall be permissible notwithstanding that any insurance carrier may have greater access to information, or may be able to provide better terms, in regard to claims so grouped. (3) Any policy executed by the chair pursuant to this section shall be in the form of an assumption of workers' compensation liability insurance policy securing such further and future contingent liability as may arise from any claim covered by such policy, including prior injuries to workers and be incurred by reason of any change in the condition of such workers warranting the board making subsequent awards for payment of additional compensation. Such policy shall be in a form approved by the superintendent of financial services and issued by the state insurance fund or any insurance company licensed to issue this class of insurance in this state, or deemed acceptable as an issuer upon application by the chair to the superintendent as specified in subdivision three of section fifty of this chapter. In the event that such policy is issued by an insurance company other than the state insurance fund, then said policy shall be deemed of the kind specified in paragraph fifteen of subsection (a) of section one thousand one hundred thirteen of the insurance law and covered by the workers' compensation security fund as created and governed by article six-a of this chapter. Such policy shall only be issued for a single complete premium paid in advance and in an amount deemed acceptable by the chair and the superintendent of financial services. When issued such policy shall be noncancellable without recourse for any cause during the continuance of the liability secured and so covered. (4) Notwithstanding any other provision of this article, the waiver agreement management office may request in writing any information relevant to its entry into or management of waiver agreements from (A) any insurance carrier, employer, or the state insurance fund, if that entity has submitted a claim for reimbursement from the special disability fund as to the claimant to whom the information relates; or (B) the special funds conservation committee. The party to whom the request is made shall provide the requested information within fourteen days of the request, unless before that date it files an objection with the board to any information which is subject to a recognized privilege or whose production is otherwise barred by law. The objecting party shall provide the requested information within five business days of the board's rejection of its objection. (5) No carrier, self-insured employer or the state insurance fund shall assume the liability for, or management, administration or settlement of any claims under this section on which it holds reserves, beyond such reserves as are permitted by regulation of the superintendent of financial services for purposes of this provision. No carrier may assume liability for any claims in the special disability fund under this paragraph unless the carrier maintains, on a stand alone basis, separate from its parent or any affiliated entities, an interactive financial strength rating from a nationally recognized statistical rating organization that is considered secure or deemed acceptable by the special disability fund advisory committee. (6) The director of the budget shall notify in writing the chairs of the senate finance committee and the assembly ways and means committee of any plans to transfer all or a portion of the portfolio of claims determined to be eligible for reimbursement from the special disability fund or to enter into an assumption of workers' compensation liability insurance policy, not less than forty-five days prior to the commencement of such process. At any time borrowing is anticipated to settle claims, the chief executive officer of the dormitory authority of the state of New York and the director of the budget shall provide a report to the chairs of the senate finance committee and the assembly ways and means committee on a planned bond sale of the authority and such report shall include, but not be limited to: (A) the maximum amount of bonds expected to be sold by the authority in connection with a sale agreement; (B) the expected maximum interest rate and maturity date of such bonds; (C) the expected amount of the bonds that will be fixed and/or variable interest rate; (D) the estimated costs of issuance; (E) the estimated level or levels of reserve fund or funds, if any; (F) the estimated cost of bond issuance, if any; (G) the anticipated use or uses of the proceeds; (H) the maximum expected net proceeds that will be paid to the state as a result of the issuance of such bonds; and (I) the process to be used to select parties to the transaction. Any such expectations and estimates in the report shall not be deemed a substantive limitation on the authority of the dormitory authority of the state of New York. --- ## WKC § 32-A — Waivers of specific coverage prohibited {#32-A} *N.Y. Workers' Comp. Law § 32-A* Official source: _NYS Open Legislation, revision of 2014-09-22._ § 32-a. Waivers of specific coverage prohibited. All employers doing business in this state shall ensure that their employees working in New York state are insured for all protections required under this chapter. Waivers of coverage shall not be available to out of state employers. --- ## WKC § 33 — Assignments; exemptions {#33} *N.Y. Workers' Comp. Law § 33* Official source: _NYS Open Legislation, revision of 2014-09-22._ § 33. Assignments; exemptions. Compensation or benefits due under this chapter shall not be assigned, released or commuted except as provided by this chapter, and shall be exempt from all claims of creditors and from levy, execution and attachment or other remedy for recovery or collection of a debt, which exemption may not be waived provided, however, that compensation or benefits other than payments pursuant to section thirteen of this chapter shall be subject to application to an income execution or order for support enforcement pursuant to section fifty-two hundred forty-one or fifty-two hundred forty-two of the civil practice law and rules. Compensation and benefits shall be paid only to employees or their dependents, except as hereinafter in this chapter provided. In the case of the death of an injured employee to whom there was due at the time of his or her death any compensation under the provisions of this chapter, the amount of such compensation shall be payable to the surviving spouse, if there be one, or, if none, to the surviving child or children of the deceased under the age of eighteen years, and if there be no surviving spouse or children, then to the dependents of such deceased employee or to any of them as the board may direct, and if there be no surviving spouse, children or dependents of such deceased employee, then to his estate. An award for disability may be made after the death of the injured employee. --- ## WKC § 34 — Preferences {#34} *N.Y. Workers' Comp. Law § 34* Official source: _NYS Open Legislation, revision of 2014-09-22._ § 34. Preferences. Compensation shall be a lien against the assets of the carrier of employer without limit of amount subordinate, however, to claims for unpaid wages and prior recorded liens. The provisions of this section shall not apply to the state insurance fund with respect to those liabilities and obligations assumed by the state pursuant to section eighty-seven-d of this chapter or as the result of any insuring agreement between the state insurance fund and the department of civil service pursuant to section eighty-eight-c of this chapter. In such instances compensation shall be alien against the assets of the state as the employer. --- ## WKC § 35 — Safety net {#35} *N.Y. Workers' Comp. Law § 35* Official source: _NYS Open Legislation, revision of 2017-04-21._ § 35. Safety net. 1. Return to work. (a) The commissioner of labor will issue a report to the governor, the speaker of the assembly, the majority leader of the senate, and the chairs of the labor, ways and means and finance committees of the assembly and senate on or before December first, two thousand seven, making recommendations as to how to assure that workers categorized by the board as permanently partially disabled return to gainful employment to the greatest extent practicable. Such commissioner will consider administrative and legislative remedies, and shall include estimates of cost in the report. The report shall examine best practices and the laws of other jurisdictions, as well as any relevant programs authorized by New York law. The report shall additionally examine return to work practices as implemented by carriers, the state insurance fund, employers, and the board. It shall also examine the relationship of vocational rehabilitation to ultimate return to work. (b) The commissioner of labor will be assisted by an advisory council constituted of six persons appointed by the governor as follows: (i) a representative of organized labor appointed upon recommendation of the New York State American Federation of Labor-Congress of Industrial Organizations; (ii) a representative of the business community appointed upon recommendation of the Business Council of New York State, Incorporated; (iii) one person upon recommendation of the majority leader of the senate; (iv) one person upon recommendation of the speaker of the assembly; and (v) two other persons in the governor's discretion. 2. Total industrial disability. No provision of this article shall in any way be read to derogate or impair current or future claimants' existing rights to apply at any time to obtain the status of total industrial disability under current case law. 3. Extreme hardship redetermination. In cases where the loss of wage-earning capacity is greater than seventy-five percent, a claimant may request, within the year prior to the scheduled exhaustion of indemnity benefits under paragraph w of subdivision three of section fifteen of this article, that the board reclassify the claimant to permanent total disability or total industrial disability due to factors reflecting extreme hardship. 4. Annual safety net reporting. The board, in conjunction with the commissioner of labor and the superintendent of financial services, shall track all claimants who have been awarded permanent partial disability status and report annually on December first, beginning in two thousand eight, to the governor, the speaker of the assembly, the majority leader of the senate, and the chairs of the labor, ways and means and finance committees of the assembly and senate: (i) The number of said claimants who have: (1) returned to gainful employment; (2) been recategorized as being totally industrially disabled; (3) remain subject to duration limitations set forth in paragraph w of subdivision three of section fifteen of this article; and (4) not returned to work, and whose indemnity payments have expired. (ii) The additional steps the commissioner contemplates are necessary to minimize the number of workers who have neither returned to work nor been recategorized from permanent partial disability.