The workers'' compensation claims process can be long, drawn out and frustrating for both employees and employers. But in New York, the wait is over for thousands of employees and employers.
New York''s injured workers and employers are benefiting from an informal case resolution process. The process helped the New York State Workers'' Compensation Board resolve 42,000 more claims in 2001 than in the previous year, while holding 68,000 fewer hearings. Board Chairman Robert R. Snashall called the statistics a "clear example of the value of the informal case resolution process."
Governor George Pataki directed the board to continuously increase efficiency and fairness for injured workers and employers. Snashall said that "by emphasizing the use of informal resolution methods, we have enabled claimants to explore more options, resolve cases faster, and receive benefits sooner, with fewer inconveniences."
Board data reveal that greater than 92 percent of cases processed informally are resolved within 18 months compared to 78 percent of the cases that are sent to the formal hearing process. Furthermore, 85 percent of claims processed informally are resolved within a year compared to 68 percent of claims administered through hearings. Last year, 57 percent of claims were processed through hearings and 43 percent used an informal resolution method. A record 322,814 cases were resolved in 2001.
"Clearly the hearing process continues to hold a significant place in the workers'' compensation system," Snashall admitted. "The data is showing, however, that informal mechanisms should be considered whenever possible because they enable the Board to deliver benefits faster and resolve cases faster."
Some frequently used informal case resolution techniques include:
- Section 32 Agreement - Created by the New York Employment Safety and Security Act of 1996, the Section 32 Agreement offers injured workers and employers/insurance carriers the option of settling out of court. Prior to the institution of Section 32 Agreements, most cases were subjected to the potentially lengthy hearing process.
- Conciliation - The law directs cases that involve benefits of duration less than 52 weeks to the more efficient conciliation process where board attorneys attempt to reach agreements between the parties. Conciliation allows parties to arbitrate agreements quickly, rather than rely on the more lengthy and litigious nature of the hearing process.
- Administrative Determination - Administrative determination empowers board staff to reach decisions settling non-contested cases.
- Walk-in Stipulation Kalendar - The WISK program enables parties to bypass the traditional hearing process by requesting a walk-in hearing to immediately resolve the claim once they have reached an agreement.
Under the New York State Workers'' Compensation Law, any claimant who prefers a traditional hearing may request one at any time prior to the resolution of the claim.
"For claimants whose time is extremely valuable, attending a hearing at the workers'' compensation office is a tremendous inconvenience," said Snashall. "Informal resolutions have relieved claimants who have had the misfortune of being injured on the job, from the burden of sacrificing a day at work or a day of healing to attend what could be an unnecessary hearing."
by Sandy Smith ([email protected])