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Workers' Compensation Coverage


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Administrative Review of a WCLJ Decision

Either side may seek administrative review of the decision within 30 days of the filing of the Judge's decision. This is done by applying in writing for Board review. A panel of three Board Members will review the case. This panel may affirm, modify or rescind the Judge's decision, or restore the case to the calendar for further development of the record. In the event the panel is not unanimous, any interested party may make application in writing for mandatory review of the full Board. The full Board must review and either affirm, modify or rescind such decision. In addition, following a unanimous decision of the Board panel, a party may file an application for discretionary full Board review. The application for discretionary full Board review will either be denied by the Board or, when warranted, the Board panel decision may be rescinded by resolution of the full Board. When the original Board panel decision is rescinded a new panel decision will be issued.

Appeals of Board Panel decisions may be taken to the Appellate Division, Third Department, Supreme Court of the State of New York, within 30 days (WCL §23). The decision of the Appellate Division may be appealed to the Court of Appeals.

Note: When seeking administrative review, the carrier does not pay for any contested weekly benefits while the claim is being reviewed by a Board Panel (WCL §23). The carrier must pay any portion of the award that is not the subject of dispute. For example if the carrier concedes that the employee has a mild disability and the WCLJ found the disability was total, the carrier must pay the employee at the mild rate while it seeks administrative review of the finding of total disability. When the carrier does not concede any liability, then the entire WCLJ award is stayed pending administrative review by the Board panel.

Following administrative review, the carrier must make any payment of compensation and physician's bills directed by the Board Panel, even if an application for discretionary full Board review and/or an appeal is made to the Appellate Division. (Lehsten v. NACM, 93 NY2d 368 [1999]).