New York Workers Compensation News

New York Workers Compensation John Sweeney, Division Chief

Under the New York Workers' Compensation Law, employees who suffer workplace injuries or an occupational malady receive compensation through an arrangement quite different from the common-law tort system. Under workers' compensation, employers are responsible for compensating workers for all injuries resulting from employment. Unlike in the tort system, the worker does not need to prove that his or her employer was negligent in some respect. The compensation that workers receive consists of defined wage replacement benefits and payment for all necessary medical treatment, but not damages for pain and suffering. Most employers have insurance coverage for their workers' compensation exposure.

The City of New York is a self-insurer of the workers' compensation benefits for its covered employees (excluding police officers, firefighters and uniformed sanitation workers). The Workers' Compensation Division processes the claims of City employees who have been injured on the job or afflicted with an occupational disease. The Division's mission is to provide all claimants with the benefits to which they are legally entitled and also to object to unwarranted claims. The Division represents the City in all claims and proceedings before the State Workers' Compensation Board.

In FY 2003, the Division received approximately 16,000 new claims, authorizing payment of over $93 million in wage replacement benefits to injured employees, and responded to nearly 180,000 medical bills. The Division also obtained revenue recoveries in excess of $13.6 million from various sources, including State funds, lien satisfaction and insurance arbitration. Because the workers' compensation statute contains presumptions in favor of compensability, contesting a claim that's deemed questionable can present a formidable test. The statute does not permit pre-trial discovery, depositions or interrogatories without permission of an administrative law judge - something rarely granted. Without such discovery, the cross-examination of witnesses and medical experts represents an extraordinary challenge. In addition, evidence rules are only applicable at the discretion of the law judge, so an attorney cannot predict what testimony or other evidence will be deemed admissible.

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