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N.Y. Work. Comp. Law § 221

Determination of contested claims for disability and family leave benefits

Redline — January 1, 2015 → current.View current text →
Current — January 1, 2017
As of January 1, 2015
§ 221. Determination of contested claims for disability benefits.\nWithin twenty-six weeks of written notice of rejection of claim, the\nemployee may file with the chairman a notice that his or her claim for\ndisability benefits has not been paid, and the employee shall submit\nproof of disability and of his or her employment, wages and other facts\nreasonably necessary for determination of the employee's right to such\nbenefits. Failure to file such notice within the time provided, may be\nexcused by the chairman if it can be shown to the satisfaction of the\nchairman not to have been reasonably possible to furnish such notice and\nthat such notice was furnished as soon as possible. On demand of the\nchairman the employer or carrier shall forthwith deliver to the chairman\nthe original or a true copy of the attending physician's or attending\npodiatrist's or accredited practitioner's statement, wage and employment\ndata and all other papers in the possession of the employer or carrier\nwith respect to such claim.\n The board shall have full power and authority to determine all issues\nin relation to every such claim for disability benefits required or\nprovided under this article, and shall file its decision in the office\nof the chairman. Upon such filing, the chairman shall send to the\nparties a copy of the decision. Either party may present evidence and be\nrepresented by counsel at any hearing on such claim. The decision of\nthe board shall be final as to all questions of fact and, except as\nprovided in section twenty-three of this chapter, as to all questions of\nlaw. Every decision of the board shall be complied with in accordance\nwith its terms within ten days thereafter except in case of appeal, and\nany payments due under such decision shall draw simple interest from\nthirty days after the making thereof at the rate provided in section\nfive thousand four of the civil practice law and rules.\n
§ 221. Determination of contested claims for disability and family\nleave benefits. In accordance with regulations adopted by the chair,\nwithin twenty-six weeks of written notice of rejection of claim, the\nemployee may file with the chair a notice that his or her claim for\ndisability or family leave benefits has not been paid, and the employee\nshall submit proof of disability or entitlement to family leave and of\nhis or her employment, wages and other facts reasonably necessary for\ndetermination of the employee's right to such benefits. Failure to file\nsuch notice within the time provided, may be excused if it can be shown\nnot to have been reasonably possible to furnish such notice and that\nsuch notice was furnished as soon as possible. On demand the employer or\ncarrier shall forthwith deliver to the board the original or a true copy\nof the health care provider's report, wage and employment data and all\nother documentation in the possession of the employer or carrier with\nrespect to such claim.\n The chair or designee, shall have full power and authority to\ndetermine all issues in relation to every such claim for disability\nbenefits required or provided under this article, and shall file its\ndecision in the office of the chairman. Upon such filing, the chairman\nshall send to the parties a copy of the decision. Either party may\npresent evidence and be represented by counsel at any hearing on such\nclaim. The decision of the board shall be final as to all questions of\nfact and, except as provided in section twenty-three of this chapter, as\nto all questions of law. Every decision shall be complied with in\naccordance with its terms within ten days thereafter except as permitted\nby law upon the filing of a request for review, and any payments due\nunder such decision shall draw simple interest from thirty days after\nthe making thereof at the rate provided in section five thousand four of\nthe civil practice law and rules. The chair shall adopt rules and\nregulations to carry out the provisions of this article including but\nnot limited to resolution of contested claims and requests for review\nthereof, and payment of costs for resolution of disputed claims by\ncarriers. Any designated process shall afford the parties the\nopportunity to present evidence and to be represented by counsel in any\nsuch proceeding. The chair shall have the authority to provide for\nalternative dispute resolution procedures for claims arising under\nfamily leave, including but not limited to referral and submission of\ndisputed claims to a neutral arbitrator under the auspices of an\nalternative dispute resolution association pursuant to article\nseventy-five of the civil practice law and rules. Neutral arbitrator\nshall mean an arbitrator who does not have a material interest in the\noutcome of the arbitration proceeding or an existing and substantial\nrelationship, including but not limited to pecuniary interests, with a\nparty, counsel or representative of a party. Any determination made by\nalternative dispute resolution shall not be reviewable by the board and\nthe venue for any appeal shall be to a court of competent jurisdiction.\n

Official source: NYS Open Legislation (New York State Senate). Reproduced from public-domain New York statutes; confirm against the official source for the current text. Not legal advice.