To promote efficient resolution of workers’ compensation
claims, the New York State Workers’ Compensation Board will begin indexing
every complete case on
For information on the announcement, see Subject Number 046-1704.
As a result, the majority of claims assembled that contain a
medical report of treatment and either an Employee
Claim (Form C-3) or First Report of Injury (FROI) will be
indexed by the Board. The only exceptions will be:
- Claims already controverted (by the filing of a FROI-04 or SROI-04)
at the time they became eligible for indexing.
- Claims already accepted without liability (under the provisions of
WCL-§21-a) at the time they became eligible for indexing.
- Claims without any lost time from work, that have been identified
as “Medical Only” claims, where the Agreement to Compensate Code (ATC) has
been left blank. Currently, a payer filing a FROI in a medical-only claim
is required to include an ATC code of L-With Liability unless the claim is
controverted. As part of this initiative, beginning
- Note: If a medical-only claim becomes lost time, it will be
indexed. Payers must update their filings if the worker starts losing time
related to the previously medical-only claim, including making a decision
on accepting liability.
All other standards regarding the provision of notice and
the first payment of benefits by payers remain in place.
Therefore, within 25 days of the date when the Board indexes
a claim, the payer should:
- Accept liability for the claim, or
- Controvert the claim, or
- Provide notice that it is initiating payment of lost wage benefits
or prescribed medicine without accepting liability for the claim under the
provisions of WCL §21-a.
Denials of indexed claims must be filed with the Board
within 25 days of the indexing date or defenses listed in Workers’ Compensation
Law Section 25(2)(b)) may be barred. The Board provided advance notice of this
on Dec. 15, 2023, to allow stakeholders
sufficient time to facilitate compliance.