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Workers' Compensation Board

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BPR Program Update


Spring 2016 Update

The Workers' Compensation Board Business Process Re-engineering (BPR) website continues to be updated with current information regarding the status of a variety of BPR initiatives.

Medical Portal

Release 1 of the portal is scheduled to go live later this year. This first release enables health care providers to submit medical authorization and variance requests (C-4Auth, MG-1 and MG-2) electronically directly to the payer for review. Medical Portal functionality includes a user dashboard and work queue, search capabilities, user preferences, and document management features.

The Board held 20 WebEx sessions this winter to demonstrate the portal's functionality. A total of 1,028 people participated in the sessions, and the feedback was very positive. A PowerPoint presentation, Medical Portal Treatment Authorization Requests (TARs), is available for anyone who was unable participate. Additional sessions have been scheduled and are posted at Medical Portal Webinars. If you have any comments or feedback on the Medical Portal, please email medauth@wcb.ny.gov.

Issues Resolution

Elimination of Administrative Determinations (AD) for cases with no lost time and no issues or disputes requiring a decision went into effect on January 15, 2016. These cases will now be able to be resolved more quickly. Please see Subject Number 046-777, Reduction of Administrative Determinations for Claims with No Lost Time for more information. Modified Application for Board Review (Form RB-89) and Rebuttal of Application for Board Review (Form RB-89.1) are now available on the Board's website under Forms. The modifications make the forms easier to complete. Additional changes are in progress to enable the forms to be submitted using the Board's Web Upload Link. Document submission via Web Upload is a more secure transaction than email or fax and is often faster. Web Upload transmissions are usually available in eCase in a shorter amount of time than documents submitted by email or fax.

Changes to the Section 32 Waiver Agreement process went into effect on March 1, 2016, which utilize a desk review process in cases where the injured worker (other than a minor dependent) is represented by an attorney and only indemnity is settled, or when all parties to the agreement request a desk review. The use of desk review will reduce the time it takes to approve a Section 32 Waiver Agreement and allow calendar time to be prioritized for cases with more pressing issues. The Board will continue to review other Section 32 Waiver Agreements through the hearing process.

The new Voluntary Binding Review (VBR) went into effect on March 28, 2016. VBR is a more expeditious alternative to the normal appeals process on decisions involving determinations of compensation on indemnity benefits. Participation in VBR is voluntary and requires the agreement of both sides to the dispute as well as the Board.

Education

The Issues Resolution team has prepared a Continuing Legal Education (CLE) presentation on the new Voluntary Binding Review process. The presentations began in February and will continue through April 27, 2016. See Continuing Legal Education – Voluntary Binding Review for a complete schedule.

The Board has also developed an educational video, Settling Your Claim, for injured workers who are considering entering into a Section 32 Agreement. The video explains the purpose of the Section 32 Agreement, what it means to enter into one, and what is being attested to if the injured worker does not attend a formal hearing. Injured workers will to be required to attest to having watched the video to ensure that they fully understand the agreement.

Monitoring Performance Program

The Monitoring Performance Program went live on October 1, 2015. In January 2016, penalties began for late First Reports of Injury (FROI). To give payers more time to improve their performance, penalties for the following performance indicators will be postponed from the original time frames:

  • Timely Subsequent Reports of Injury (SROIs) showing initial payment
  • Timely Initial Payment
  • Timely Controversy

Adjusting the schedule provides more time for payers to educate employers on the importance of timely notification of workplace injuries. Payers will be notified when new dates have been set.

Subject Number 046-808 on the Monitoring Performance Program, providing information on the proper use of certain filings, including Subsequent Report Of Injury - Partial Denial (SROI-PDs) and Subsequent Report Of Injury - Initial Payment (SROI-IPs), was published last fall. PowerPoint presentations of the webinars are available on the Monitoring and Compliance section of the Board's website. If you have any additional questions about the performance program, please email the Monitoring unit at monitoring@wcb.ny.gov.

Virtual Hearings

The virtual hearings initiative is an important part of the BPR's focus on improving the injured worker's experience. Virtual hearings will enable injured workers to attend hearings remotely, e.g., from home, or their attorney's office, using state of the art video conferencing or in some cases audio only. The project has been making progress towards its user acceptance testing stage. Once the technology has been thoroughly tested, a virtual hearings pilot program will begin in selected locations, with eventual expansion to all hearing sites.

Comments/Ideas/Feedback

Please send any comments, ideas, or other feedback to the BPR mailbox at BPR@wcb.ny.gov. Additionally, you can receive notifications about BPR webinars, various events, published documents and other Board activities, by subscribing to the Board's WCB Notifications service.