WORKERS’ COMPENSATION BOARD COMPARED TO THE CARRIER

Every new WC client who comes into my office gets a quick

lesson about the differences between the carrier and the Board.

It’s crucial that injured workers understand this concept.

“Board” is the term used to quickly refer to the New York State

Workers’ Compensation Board.

“Carrier” is the term most often used to describe the company

that acts on behalf of your employer. (In this book, I use the

term “carriers” to refer to self-insured employers, insurance

companies, and what are known as third party administrators,

which are claims handlers for employers.)

When you are injured at work, you will always be dealing with

and receiving correspondence from both the Board and the

carrier. They are completely different from each other. You need

to know which is which.

The carrier

• is on the side of the employer;

• actually pays out the benefits;

• can only be forced to pay a health provider or injured

worker if ordered to by the Board;

• is not on the side of the injured worker; and

• looks at each claim in monetary terms only and looks to pay

out as little as possible.

The decisions that the carrier makes are not final—they can be

overruled by the Board. When a carrier does something with

no order to do so by the Board, it is called a “voluntary” action;

it didn’t have to do it but did it on its own.

“The decisions that the carrier makes are not final.”

The Board

• is a New York State agency;

• acts as the court in WC cases;

• may hold hearings in the injured worker’s case;

• may determine not to hold hearings in the injured worker’s

case and instead to decide it on paper;

• acts as the “referee” between the injured employee and

employer;

• is impartial; and

• officially decides the injured worker’s case.

WORKERS’ COMPENSATION BOARD

Most people in New York don’t realize that the Workers’

Compensation Board even exists. For attorneys like myself,

the Board is where we make our living. It’s where I go almost

every day to represent injured workers. Its headquarters are in

Schenectady but the Board maintains district regional offices

across New York:

• Albany

• Binghamton

• Brooklyn

• Buffalo

• Long Island

• Manhattan

• Queens

• Rochester

• Syracuse

Simply put, the Board is the state agency in charge of workers’

compensation. It makes the official decisions about injured

workers’ cases.

Some facts you should know about the Board include the

following:

1. The Board has the legal power to decide if someone is an

employee or not.

2. The Board officially decides if an injury is or is not job related.

3. The Board is the agency that is in charge of both disability

benefits (off the job benefits) and Workers’ Compensation

benefits (on the job benefits) in the state of New York.

4. The Board has the legal power to penalize and fine employers

if they do not carry Workers’ Compensation insurance.

5. The Board not only decides Workers’ Compensation cases but

also regulates the attorneys who appear before it. Attorneys

for injured workers are never allowed to collect an attorney’s

fee unless the Workers’ Compensation Board approves the

fee. In fact, the Board decides the attorneys’ fees that are

payable; attorneys do not make these decisions.

6. The Board can be contacted through customer service toll

free at (877) 632-4996 Monday through Friday from 8:30

a.m. to 4:30 p.m. or by visiting http://www.wcb.ny.gov/

content/main/Contact.jsp.

WORKERS’COMP:BIG BUSINESS, NASTY POLITICS

 First, let’s clarify that it’s not called Workman’s Comp. It’s Workers’ Comp. Workers’ Comp is big business. Huge political battles continually erupt in the state of New York because employers constantly try to propose and enact changes to curtail worker benefits. All of this goes on behind the scenes. The fight between labor and business is carried on between the governor, the legislature, workers’ groups, labor unions, and the Business Council with little publicity. Most workers have no idea what really goes on, and often what goes on is a push by the Business Council to cut Workers’ Comp benefits statewide. And labor unions trying to push back. Most people couldn’t care less about the Workers’ Compensation system and whether the law is changed to reduce benefits to injured workers, until such changes affect them directly.

W O R K E R S ’ COMPENSATION BOARD

Most people in New York don’t realize that theWorkers’ Compensation Board even exists. For attorneys like myself, the Board is where we make spend our time.  It’s where I go almost every day to represent injured workers. Its headquarters are in Schenectady but the Board maintains district regional offices across New York.  Like the insights I am sharing?  

This post was first posted on Wordpress Blog

ACRONYMS AND TERMINOLOGY (ALPHABET SOUP)

 If you attend a hearing at the Workers’ Compensation Board

and listen to the attorneys speak to each other and to the judge,

you might think they may as well be speaking in Swahili or

Japanese. This is because attorneys who practice Workers’

Compensation use a legal language to talk about cases. They

speak in acronyms, or letters that represent phrases.

Take a look at this common one: “RFA-2 granted; no CCP due

to FTP; NFA.” This means that the carrier requested a hearing

(RFA-2;). At this hearing the judge decided to stop the claimant’s

weekly checks (no CCP) because the claimant didn’t appear at

the hearing (FTP) and there are no further hearings scheduled

at this time (NFA.)

All I can say about this is that if you don’t understand a particular

abbreviation or acronym, you simply need to speak up and ask

what it means.

I have included a short, but not complete, list of common

abbreviations and acronyms and the terms they stand for.

Understanding Workers' Compensation

In my experience, most workers know very little about Workers’ Compensation. Very few understand all of the varied benefits that they are entitled to under the Workers’ Compensation system. Some common myths include the following:

• I have to be out of work to receive Workers’ Comp.

• I probably will be fired if I file for Workers’ Comp.

• I am suing my employer if I file for Workers’ Comp.

• I can’t file if I only work part time.

• I can’t file if I am working off the books.

• I can’t file if I am not a citizen or have immigration issues.

Generally, none of the above statements are true.

“ Very few understand all of the varied benefits that they are entitled to under the Workers’ Compensation system. ” Workers’ Comp in New York is a big, messy, confusing system. It is not, in my opinion, user friendly. My goal is to cut the system down into useable chunks that you can use when you need