Change in Process when Form C-7, Notice that Right to Compensation is Controverted, is Filed

Date: June 5, 2007

Workers' Compensation Reform was passed by the New York State Legislature and signed into law by the Governor on March 13, 2007. As part of this reform legislation, Workers' Compensation Law Section 25(2-a) governing the scheduling of pre-hearing conferences in controverted claims was amended. The changes to Section 25(2-a) went into effect immediately.

The New Rules for Controverted Cases: Section 25(2-a) now requires that the pre-hearing conference for a controverted claim be held no more than 45 days after the receipt of Notice that Right to Compensation is Controverted, Form C-7, and receipt of a medical report referencing the injury. This change:

• reduces the time for scheduling a pre-hearing conference from 60 to 45 days, but
• adds a requirement that the Board receive a medical report referencing the injury before the pre-hearing conference may be scheduled. The medical report may be filed by the claimant, his or her treating medical provider, the employer or the employer's insurance carrier.

Procedures to Streamline the Process: In order to streamline the process and allow the shortest possible time between receipt of the necessary documents and the pre-hearing conference, the Board has created an electronic "C-7 workgroup" in each District Office. Claims examiners within each C-7 workgroup continuously monitor controverted claims. As part of these streamlining efforts, the C-7 workgroups will inform the claimant, his or her representative, and the insurance carrier when a hearing may not be scheduled because the file does not contain a medical report referencing an injury. In addition, when the Board file contains information as to the treating medical provider's identity and contact information, the C-7 workgroup will contact the medical provider directly.

To ensure that a pre-hearing conference is not delayed, every claimant and his or her representative should make every effort to obtain and file with the Board any existing medical reports referencing the injury. While the Worker's Compensation Board is committed to the timely scheduling of pre-hearing conferences in controverted cases, a conference cannot be scheduled until a medical report referencing an injury is received.

Death Claims: When it is claimed that the work related accident or illness caused the death of an employee, the C-7 workgroup will schedule a pre-hearing conference whenever the claimant has filed a C-62 "Claim for Compensation in a Death Case" accompanied by a death certificate.

Thank you for your cooperation.

Donna Ferrara
Chair