WORKMANS COMPENSATION

Employers' Responsibilities

· Employers must obtain and keep in effect workers' compensation coverage for their employees; there must be no lapse in coverage even when switching insurance carriers.

The law requires almost all employers operating in New York State to have workers' compensation coverage for their employees. This requirement can be fulfilled by purchasing insurance coverage through an insurance carrier or by obtaining authorization from the Board to be self-insured.

· Employers must post a notice of workers' compensation coverage and employee rights.

This notice is in a form prescribed by the Workers' Compensation Board. Employers obtain the notice from their insurance carrier or, if self-insured, from the Board. The notice includes the name and address of the insurance carrier and the policy number of the employer. It must be posted in a conspicuous place in the employer's place of business. Violations of this requirement can result in a fine of up to $250 per violation.

· An employer may not discriminate against an employee or applicant because he or she has claimed or attempted to claim workers' compensation.

· An employer must report most injuries to the Board and the insurance company, if insured, on Form C-2, Employer's Report of Accident/Occupational Disease(PDF)  [ On-line Version ]  within 10 days after an accident. An employer shall furnish a report of an occupational disease incurred by an employee on the same form.

A C-2 report must be filed with the Board and carrier if the accident results in personal injury which has caused or will cause a loss of time from regular duties of one day beyond the working day or shift on which the accident occurred, or which has required or will require medical treatment beyond ordinary first aid or more than two treatments by a person rendering first aid. Failure to file a C-2 or failure to file it timely may result in a penalty of up to $2,500.

· C-2 forms (Employer's Report of Work-Related Accident/ Occupational Disease) must be maintained by the employer or designated third party for at least 18 years and are subject to review by the Board at any time.

· A record must be made and maintained on Form C-2 of any injury or illness incurred by an employee in the course of employment, even if the extent of the injury does not require that the C-2 be filed with the Board or carrier.

· An employer must report an injured worker's wages or other compensation to the Board. Form C-240, Employer's Statement of Wage Earnings(PDF)  [ On-line Version ].

· An employer must report any changes in an injured worker's pay or work status to the Board. Form C-11, Employer's Report of Injured Employee's Change in Employment Status Resulting from Injury(PDF)  [ On-line Version ].

· Certain employers must undergo safety consultations if directed to do so.

If an employer has an experience modification factor of greater than 1.2 and a payroll in excess of $800,000, they must participate in a mandatory safety and loss prevention program, as outlined by the New York State Department of Labor.

· An employer must provide the Workers' Compensation Board with access to all books, records and payrolls related to employees upon request.

Employers' Rights

· An employer has the right to request that the insurance carrier contest the compensability of a claim.

A claim can be contested for a variety of reasons, including, for example, that the injury was not related to work or that the employee is not injured to the extent he or she is claiming. An employer can request that the insurance carrier contest the claim, but since the carrier has assumed liability for the claim, it is not required to comply with the employer's request. In addition, employers or carriers who engage in dilatory tactics will be penalized.

· An employer has the right to attend any hearings related to a claim filed by one of the employer's workers.

· An employer has the right to electronically access the Board's case file for a claim filed by the employer's worker by visiting one of the Board's customer service centers.

The Board's Electronic Case Folder (eCase) allows parties of interest to view the documents in the claim file electronically. Employers should go to one of the eleven district offices or 30 Customer Service Centers with identification to obtain a password to access the files. Based on the confidentiality of workers' compensation records, please be prepared to offer proof that you are the employer of record in the claim.

· A self-insured employer, or an employer who has failed his or her obligation to secure workers' compensation coverage, has the right to participate in the hearing and present relevant evidence about disputed issues at a hearing.

Employers may request that a hearing be scheduled on a particular issue by writing to the appropriate district office in a timely manner. Corporations must be represented by counsel in proceedings before the Board. Certain defenses will be waived if they are not promptly raised or if the employer or carrier does not timely file a Form C-7, Notice that Right to Compensation is Controverted.

· An employer has the right to report suspected workers' compensation fraud to the Fraud Inspector General.

Fraud Referral Hotline: 1-888-363-6001.

· An employer has the right to appeal or, if insured, to request that the insurance carrier appeal on appropriate grounds a decision of a Workers' Compensation Law Judge regarding a claim filed by an employee.

Any party may appeal a notice of decision within 30 days by writing to the Board requesting Board review; however, a party filing a frivolous appeal will be penalized.

More extensive explanations, rights and down loadable forms are explained at the NYS WORKMANS’ COMPENATION BOARD home page