The New York Workers Compensation Board (WCB) has posted on its Web site for public comment proposed regulations designed to limit the time it takes to resolve workers' compensation claims that insurers contest to 90 days or less.

The contested cases are called “controverted” claims, and eight years ago they took an average of 353 days to resolve, said Joe Cavalcante, a WCB spokesman.

In 2005, controverted claim resolution averaged 200 days, and though that number had dropped below 200 in 2006. Workers' compensation reform legislation in 2007 set a goal of resolving these claims in 90 days or less.

This initiative, called the Indexing and Controverted Claims Process (ICCP), is also known as the “rocket docket.” The goal, according to Mr. Cavalcante, is to require more information earlier in the process. With more information, Mr. Cavalcante said, the reasons to controvert a claim diminish, and cases can proceed expeditiously.

Currently, Mr. Cavalcante explained, carriers are able to controvert claims with, for example, an employer statement but without a medical report. The new rules would require a medical report with either an employer statement or an employee statement in order to controvert a claim.

A problem with the current system, Mr. Cavalcante said, is that carriers are bringing cases to the hearing process without doctor reports, and judges are telling the carriers to come back after obtaining the medical reports.

By the time carriers get the necessary information together for the case to proceed, the process has already gone through two hearings. This, Mr. Cavalcante said, increases costs to the system.

In order to draft the regulations, Mr. Cavalcante said the WCB reviewed recommendations from the Insurance Department. He also said the medical, employer and employee forms were all revamped with significant input from all interested parties.

The public comment period will begin on July 30 and will last for 45 days. To view the proposed regulation, and other information associated with the New York workers' compensation reforms, visit http://www.wcb.state.ny.us/content/main/Reform/Updates.jsp.

Special Reports /

NY WCB Posts Proposed Rule To Speed Claims Process

Related Stories

Recommended For You