NY Work Comp L § 20 (2021)
2021 New York Laws WKC - Workers' Compensation Article 2 - Compensation 20 - Determination of Claims for Compensation.

§  20.    Determination  of claims for compensation.   1.  At any time after the expiration of the first seven days of disability on  the  part of  an  injured  employee,  or at any time after the employee's death, a claim for compensation may be presented to the employer or to the chair. The board shall have full power and authority to determine all questions in relation to the payment of claims presented to  it  for  compensation under  the provisions of this chapter.  The chair or board shall make or cause to be made such investigation as  it  deems  necessary,  and  upon application  of  either  party, shall order a hearing, and within thirty days after a claim for compensation is submitted under this section,  or such hearing closed, shall make or deny an award, determining such claim for  compensation,  and  file  the  same  in  the  office  of the chair. Immediately after such filing the chair shall send to the parties a copy of the decision.  Upon a hearing pursuant to this section  either  party may present evidence and be represented by counsel.  The decision of the board  shall  be  final  as  to  all  questions  of fact, and, except as provided in section twenty-three of this article, as to all questions of law.  Except as provided in section twenty-seven of  this  article,  all awards  of  the  board shall draw simple interest from thirty days after the making thereof at the rate provided in section five thousand four of the civil practice law and rules.  Whenever a hearing or proceeding  for the determination of a claim for compensation is begun before a referee, pursuant  to  the provisions of this chapter, such hearing or proceeding or any adjourned hearing thereon shall continue before the same  referee until  a final determination awarding or denying compensation, except in the absence, inability or disqualification to act of  such  referee,  or for  other  good cause, in which event such hearing or proceeding may be continued before another referee by order of the chair or board.   2. (a) Notwithstanding subdivision one of this section, any claim  for compensation by (i) judges, conciliators, and managerial or confidential employees  of  the  workers' compensation board and state insurance fund who are allocated to a grade M1 or above pursuant to section one hundred thirty of the civil service law, (ii) the chair, vice-chair and  members of  the  workers'  compensation board, and (iii) the executive director, deputy executive directors and members of the board of commissioners  of the  state  insurance  fund  shall not be within the jurisdiction of the workers' compensation board but instead shall be determined by a neutral outside arbitration process as provided by  regulations  promulgated  by the  chair.   Such claims shall be filed in the same manner as any other claim for compensation under this chapter.  (b) All issues and questions of law or fact pertaining to such  claims shall   be  resolved  by  the  arbitrator  appointed  pursuant  to  this paragraph.  Arbitrators shall be appointed by the  chair  to  adjudicate claims  under  this  paragraph.    Such  arbitrators shall have the same powers and  duties  as  those  accorded  referees  under  this  chapter, including powers delegated by the chair.  The provisions of this chapter shall  be  applicable to claims under this paragraph insofar as they are not inconsistent herewith.  (c)  An award or decision by an arbitrator pursuant to this  paragraph is  deemed  to be a final decision of the board except if review of such decision is sought as provided in paragraph (d) of this subdivision.  No modification, rescission or review of such  award  or  decision  may  be entertained  by the board, notwithstanding any provision of this chapter to the contrary.  (d)  Within thirty days after notice of the  filing  of  an  award  or decision  by  an arbitrator, any party in interest may request review of the arbitrator's decision by a panel of three arbitrators  in  the  same manner  and  to  the  same  extent  as  the decision by a referee may be  reviewed by the board pursuant to section twenty-three of this  article. The  arbitration  panel shall consist of one arbitrator nominated by the chair, one arbitrator nominated  by  a  recognized  alternative  dispute resolution  organization  and  one  arbitrator  nominated by an employee organization certified pursuant to article fourteen of the civil service law to represent the collective bargaining unit of the injured  employee or,  if  the  injured  employee  is  not  represented  by  a  collective bargaining  unit,  by  the  recognized  alternative  dispute  resolution organization.    A  party  in  interest may seek review of such award or decision of an arbitration panel only by taking appeal therefrom to  the appellate  division of the supreme court, third department and the court of appeals as provided for decisions of the board  pursuant  to  section twenty-three of this chapter.  (e)   The powers and jurisdiction of the arbitration panel established pursuant to this subdivision shall be continuing in the same manner  and to the same extent as provided under this chapter to the board.  (f)  All fees, costs and expenses of arbitration shall be borne by the board  and  the state insurance fund as administration expenses pursuant to sections eighty-eight and one hundred fifty-one of this chapter.  (g)  Any claim for compensation by an officer or employee of the board or state insurance fund not required  to  be  determined  by  a  neutral outside   arbitration   process   pursuant  to  paragraph  (a)  of  this subdivision shall be determined initially by a referee  with  review  of such  determination  available  pursuant to section twenty-three of this chapter.  (h)  For any claim for compensation by an officer or employee  of  the workers'  compensation  board or the state insurance fund whether or not such claim is required to be determined by a neutral outside arbitration process pursuant to paragraph (a) of this subdivision,  the  referee  or arbitrator  making  the  initial  finding of fact concerning any medical issue present in the case shall develop the record with opinion evidence from an impartial specialist who is an expert in the appropriate medical specialty.     Such   impartial   specialist   shall   be   subject   to cross-examination at the request of any party in interest.  (i)    The  state  insurance  fund  shall  administer the claim of any officer or employee of the state insurance fund  at  an  office  of  the state  insurance  fund  other  than the office which was, at the time of injury, disablement or death of such officer or  employee,  his  or  her principal workplace.  (j)    The  chair  shall promulgate regulations necessary to implement this subdivision.  Such regulations shall include provisions in relation to this subdivision for a single arbitrator to determine a claim in  the first  instance and a panel of three arbitrators to review such decision upon the application of any party in interest prior to judicial  review. Such  regulations  shall also include all special procedures relating to the handling  of  claims  of  officers  or  employees  of  the  workers' compensation  board  and  the state insurance fund pursuant to paragraph (f) of this subdivision.   3.  Notwithstanding any other provision of  law  to  the  contrary,  a member  of  the workers' compensation board, a referee or any arbitrator in connection with the adjudication of  any  claim  arising  under  this chapter  shall  recuse  himself  or herself on any ground a judge may be disqualified pursuant to section fourteen of the judiciary law.