Compliance Corner: N.Y. Hearings, Section 32 Waivers

Albany, NY (WorkersCompensation.com) -- Insurers will often accept a claim and promptly begin paying benefits. However, an insurer can dispute a claim for various reasons. It may not agree that the employee was injured, it may not believe the injury occurred while it provided insurance, or any number of other situations.

In New York, Board claims examiners and conciliators first attempt to resolve issues. If they can't, the Board will hold hearings in front of a workers' compensation law judge. The judge takes testimony and reviews your medical records and wages. The judge then decides the issue and sets the amount of any award.

Get compliance summaries from New York and around the U.S. with Simply Research

Virtual hearings allow injured workers, attorneys or representatives, witnesses, and others to attend workers’ compensation hearings online. Participants no longer have to travel to a hearing site to attend but can do so remotely. Virtual hearings are available for all workers’ compensation claim hearings statewide.

Section 32 Waivers

In a bulletin released last week, the NYS Workers' Compensation Board announced that it would begin utilizing a desk review process, as opposed to a formal hearing, to review Section 32 waiver agreements involving claimants who are represented by counsel so long as the gross settlement amount is $10,000 or less.

In New York, a Section 32 waver agreement results from a settlement agreement between a carrier and an injured worker to settle a workers' compensation claim.

Back in 2016, New York established criteria for desk review resolution of Section 32 agreements. At that time, the Board indicated that the desk review process was to be used for settlements in which an injured worker has legal representation and:

+ The agreement settles only indemnity benefits and leaves open medical benefits,
OR
+ All parties to the agreement request desk review.

Due to staffing levels and the allocation of administrative resources, many Section 32 waiver agreements settling only indemnity benefits continued to be considered at a hearing before a Workers' Compensation Law Judge and not via the desk review process.

To improve efficiency for the benefit of all parties, the Board announced that it would resume the desk review process for a substantial majority of agreements that settle only indemnity benefits. Effective July 1, most such agreements will be reviewed administratively, via desk review, without a hearing.

Share This Article: