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March 20, 2023

Workers' Compensation Board required to address the issues raised by a Claimant for workers' compensation benefits in an administrative appeal to the Board

The Workers' Compensation Board, [Board] found that where, as here, a claim for workers' compensation benefits "was never indexed," the provisions of Workers' Compensation Law §25(2)(b) are inapplicable and ruled that the employer did not file an untimely notice of controversy. Claimant's subsequent application for reconsideration was denied. Claimant appealed the Board's decision.

The Appellate Division held that although the Board concluded that Workers' Compensation Law §25(2)(b) is inapplicable given that the claim was never indexed, the Board did not address the related issue raised upon administrative appeal that the employer's initial FROI-00 form was a binding acceptance of the claim.* Further, said the court, the Board provided "no reasoning or basis for its determination that the notice of controversy was timely filed." 

This, said the Appellate Division , precluded "a meaningful appellate review by this Court".

Citing  Matter of Sequino v Sears Holdings, 206 AD3d 1408 and Matter of Ippolito v NYC Tr. Auth., 203 AD3d 1360, the Appellate Division reversed the Board's decision, concluding that the matter must be remitted to the Board for it "to satisfy its obligation to address the issues raised by claimant on administrative appeal and provide a detailed explanation for its determination."

* Claimant contended that the employer's initial FROI-00 form indicated "L — With Liability" and should be deemed a binding acceptance of the claim with liability. The Appellate Division's decision notes that 12 NYCRR 300.37(c) "dispenses with the need for indexing where a claim is accepted".

Click HERE to access the Appellate Division's decision posted on the Internet.

 

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