New York Codes, Rules and Regulations › Title 12 - DEPARTMENT OF LABOR › Chapter V - Workers' Compensation › Subchapter A - General Provisions › Part 300 - Procedure before the Board › Section 300.37 - Case file creation and indexing of claims that may be controverted

Current through Register Vol. 46, No. 28, July 10, 2024
(a)
Case
				  file.
Upon receiving any document or notice regarding a claim or
					 potential claim for workers' compensation benefits for which a case number has
					 not been assigned and a case file has not been created, the board shall assign
					 a unique case number and create a case file. The assignment of a case number
					 and creation of a case file is not the indexing of a claim for purposes of
					 filing a notice of controversy in accordance with paragraph (b) of subdivision
					 (2) of section 25  of the Workers' Compensation Law. The board shall assign the
					 case number and create the case file within five business days of receipt of
					 said document for which a case file does not exist. Nothing in this section
					 changes existing law with respect to the filing of a claim for purposes of the
					 limitations period set forth in Workers' Compensation Law, section 28.
(b)
Indexing.
(1) The board will index a claim for
				  compensation only upon the receipt of these notices or forms:
(i) a notice or form prescribed by the chair
				  for an employee, dependent or beneficiary, volunteer firefighter, volunteer
				  ambulance worker, or a volunteer who meets the definition set forth in
				  subdivision (1) of section 161  of the Workers' Compensation Law for a
				  participant in World Trade Center rescue, recovery or cleanup operations to
				  make a claim for compensation, death benefits or volunteer benefits
				  (hereinafter referred to as employee claim form) pursuant to the Workers'
				  Compensation Law, Volunteer Firefighters' Benefit Law or Volunteer Ambulance
				  Workers' Benefit Law, or a notice or form prescribed by the chair for an
				  employer or political subdivision to report an injury or illness of an
				  employee, volunteer firefighter or volunteer ambulance worker as required by
				  Workers' Compensation Law, section 110 and/or Volunteer Firefighters' Benefit
				  Law section 42 and section 57 or Volunteer Ambulance Workers' Benefit Law
				  section 42 and section 57 (hereinafter referred to as employer's
				  report);
(ii) a completed report or
				  form as prescribed by the chair for a medical provider treating an injured
				  employee to report on medical treatment which references an injury (hereinafter
				  referred to as medical report), except that the medical report need not be in
				  the prescribed format where:
(a) the treating
				  medical provider is based out of state;
(b) the claimant was treated in an emergency
				  room; or
(c) the claimant is
				  deceased; and
(iii) a
				  completed and executed limited authorization to obtain relevant medical records
				  regarding the prior medical history of the body part or illness at issue
				  (hereinafter referred to as limited release). The limited release is only
				  required if the claimant files a completed employee claim form and indicates on
				  the form that he or she had a prior injury to the same body part or similar
				  illness to the one(s) listed on the form. It shall be part of the employee
				  claim form and compliant with the Health Insurance Portability and
				  Accessibility Act.