Glossary of Workers' Compensation Terms
- Abey a Case:
- To refile a case, with a notation that an Examiner is to review the case
by a specified future date.
- Abey an Issue:
- To postpone a decision on an issue in a case until a later date, when it is
expected than additional pertinent information may or will be available.
- Accident (Work-Related):
- (WCB) An event, arising out of and in the course of
employment, that results in personal injury to a worker.
- Accident Date:
- (WCB) Refers to either (a) the date the accident is deemed to have
occurred or (b) the date of onset assigned to an occupational disease. The accident date is
officially established by a Law Judge.
- Accident, Notice and Causal Relationship (ANCR):
- (WCB) Minimal conditions that must be met before financial responsibility can be
assigned to a claim for workers' compensation. Specifically, it must be established that
• a work-connected accident covered by the Workers' Compensation Law occurred;
• following the accident, the claimant notified his/her employer
within the time limit required by the Workers' Compensation Law; and
• a causal relationship exists between the accident and a resulting injury or disability.
- Adjourn (a Hearing):
- (WCB) To put off or suspend until a future time, without making any findings.
- The act or process of adjudicating. A judicial decision or sentence.
- (WCB) A legal action taken by one of the parties to the Appellate Division,
Third Department, to reverse or amend a decision or direction made by a Board Panel or the
Chair of the Workers' Compensation Board.
- (WCB) A proportionate division of all or part of the liability in a case
between two or more sources of disability for the same claimant, based on an evaluation of the
relative contribution that the sources of disability have made to the claimant's permanent
- Arising Out of and in the Course of Employment:
- (WCB) Two necessary conditions that must be met to establish a work-connected accidental
injury; an injury that "arises out of" is one that results from a hazard of the employment,
while an injury "in the course of employment" is one that occurred at a time, place and under
circumstances related to the employment.
- Attorney Fees:
- (WCB) Fees approved by the Board for claimant attorneys in workers'
compensation cases. Under WCL .24, no claims for services or supplies are enforceable unless
approved by the Board and, if approved, such claims become a lien upon the compensation
- Average Weekly Wage (AWW) for Workers' Compensation Claims:
- Wage used to calculate total disability benefit rates for
most claimants. Defined at 1/52nd of the injured worker's average annual earnings (200-300
times average daily wage, depending on work schedule), based on the prior year's payroll data. If
an injured worker has not worked a substantial portion of the immediately preceding year, the
average wage of a comparably employed worker is used in the Board's calculations.
- Average Weekly Wage (AWW) for Disability Benefits Claims:
- Wage used to calculate disability benefit rates. AWW for disability benefits is based
on the disabled employee's earnings during the eight weeks prior to the start of
- Board Panel:
- (WCB) A panel, usually comprised of three Workers' Compensation
Board members (at least one of whom must be a lawyer), that reviews requests to amend
decisions made by Workers' Compensation Law Judges, reopens closed cases and considers
applications for lump sum non-schedule adjustment awards.
- A list of the cases scheduled to be heard on a given date at a specific part at a
district office or hearing point.
- Cancel (a Case):
- (WCB) An action by the Board to nullify indexing when two case
numbers are assigned to a single claim.
- (WCB) A reported work injury or illness which has been assembled and assigned
a case number (indexed) by an indexing unit of the Workers' Compensation Board.
- Case Number:
- (WCB) A unique identifier assigned by the Workers' Compensation
Board at the time a case is assembled. The case number consists of 8 characters and begins with an alpha character, followed by seven numeric characters. For example, G1234567.
•Volunteer ambulance workers' cases will begin AA, followed by six numbers (e.g. AA123456).
•Volunteer firefighters' cases will begin with FA, followed by six numbers (e.g. FA123456).
- Cause of Accident:
- (WCB) Object, substance or condition that directly contributed to the occurrence of an accident.
- Causation/Causative Factor:
- The fact of being the cause of something produced or of
happening. The act by which an effect is produced. An important doctrine in fields of negligence
and criminal law.
- (WCB) A request, on a prescribed Form C-3, for workers' compensation for
work-connected injury, occupational disease, disablement, or death (Form C-62). A claimant
must file a claim within a two-year period from the occurrence of the accidental injury, knowledge
of occupational disablement, or death. Failure to file a claim may bar an award for compensation
unless the employer has made advance benefit payment or fails to raise the issue, in which event
the claim filing requirement is deemed waived.
(NYCIRB, Carriers) A demand for payment or recovery for loss under an insurance contract.
Cases are counted as claims only when a payment is made (for indemnity and/or medical benefits)
or a reserve is established.
- Claims Information Systems (CIS):
- (WCB) A data system used by the Board's Claims Unit to record basic case information such
as parties of interest, current issues and scheduled hearings. CIS has historically been
utilized in calendaring of cases (i.e., establishing hearing schedules) and in case identification.
- Classification Code:
- (NCCI, NYCIRB) A system of insurance risk classification based
on industrial or occupational categories, supported by the National Council on Compensation
Insurance and in use in about 40 states where private insurance is available. The system, which
includes several thousand 4-digit numeric codes (with more than 700 classifications in use in New
York), is extensively used to identify an employer's rate making class(es) and establish basic
pricing for workers' compensation insurance.
- Close (a Case):
- (WCB) To remove a case from further consideration; a decision to
close a case is based on a judge's determination that no further rulings by the Board will be
necessary in the case. A case closing is effected by a statement on a WCB decision (e.g., "Case is
closed."). The closing date is the date of the hearing or the effective date of the decision. A
Board Panel may also close a case.
- Compensated Cases Closed (CCC):
- (WCB) A data system used to summarize cases
that have been closed with an award of indemnity benefits during a particular calendar year. The
annual files generally contain 120,000-140,000 case records and include information about
case/claimant background, employment, injury/accident characteristics, extent of disability,
indemnity benefits and selected decision characteristics.
- (WCB) A Workers' Compensation Board process established to resolve,
in an expeditious and informal manner (e.g. through meetings or telephone conferences), issues
involving non-controverted claims in which the expected duration of benefits is fifty-two weeks or
less. Failure to reach an agreement through the conciliation process results in the case being
scheduled for a hearing.
- To bring an action at law. To make the subject of dispute, contention, or litigation.
- Continue (a Case):
- (WCB) To complete a hearing on a case without closing the case,
leaving additional matters to be resolved at a future hearing.
- Controverted Claim:
- (WCB) A claim challenged by the insurer on stated grounds. The
Board sets a pre-hearing for the determination of the grounds and directs the parties to appear
and present their case.
- A Board form titled "Employer's Report of Work-Related Accident or
Occupational Disease" filed by employers within ten days after an accident occurs, as required by
WCL .110. The form includes a section identifying the case and principal parties and additional
sections labeled "Accident," "Injured Person," "Nature of Injury," "Cause of Accident," and
"Fatal Cases." Failure to make timely C-2 filings subjects employers to potential administrative
and criminal penalties.
- A Board form titled "Employee's Claim for Compensation," that should be
completed by the injured worker and submitted to the Board within two years of the accident or
onset date. The C-3 form contains much of the same information as the C-3 (sections describing
the Injured Person, Employer, Place and Time of accident, Injury, Nature and Extent of Injury,
Medical Benefits received, Compensation Benefits received/claimed, etc.).
- A Board form titled "Attending Doctor's Report," that requests information about
claimant/claim identification, claim parties of interest, injury history, diagnosis, treatment,
disability, causal relation of accident to disability, and degree of impairment. The form is to be
filed by the doctor within two days of initial treatment, with additional reports during continued
treatment, including a final report.
- A Board form titled "Notice that Right to Compensation is Controverted," that a
carrier (as appropriate) must file within (1) 18 days of the date disability begins or (2) ten days of
the date the employer first had knowledge of the alleged injury, whichever is later. Within 25
days from the Board's mailing of a notice of indexing in volunteer firefighter or volunteer
ambulance worker cases.) The form contains
• information identifying the claim, person (allegedly) injured, employer and carrier,
• a description of the alleged injury and town/county/state where alleged injury occurred,
• reasons why right to compensation is controverted,
• dates for start of alleged disability, employer/carrier first knowledge of injury,
receipt of a C-2 from the employer and
• statement concerning whether notification has been given to the disability benefits
insurance carrier, and date of notification.
- A Board form titled "Notice that Payment of Compensation for Disability has been
Stopped or Modified," that carriers are required to file within 16 days of the date on which benefit
payments are stopped or modified. The form includes
• information identifying the claim, injured person, employer and carrier,
• a summary of total disability benefits, partial disability benefits and disfigurement awards paid,
• a summary of the claimant's return-to-work and earnings status and
• if appropriate, an explanation of why indemnity benefits have not been paid in full.
Depending on circumstances cited by the carrier and the claimant's response, the filing of a
C-8/8.6 may or may not trigger an immediate hearing.
- The 2007 Workers' Compensation Reform Legislation included provisions that would prevent
employers that had various types of workers' compensation noncompliance infractions
from bidding on Public Work Projects. NYS governmental entities including State,
county and municipal agencies may not contract with businesses that are listed on a
- A determination arrived at after consideration. A report of a conclusion.
- Decision and Award Data System (D&A):
- A recently added component of the Board's
Claims Information System designed to facilitate production of trial calendar decision notices and
other materials prepared by Claims unit keyboard specialists. The system is also being developed
as a source of information about case/decision characteristics and indemnity benefits.
- A person eligible to receive death benefits in a fatal injury case; the
regular receipt of contributions by the alleged dependent upon which he/she relies and needs to
sustain his/her customary mode of living constitutes dependency. Surviving widows and children
under age 18 years are eligible for benefits without proving dependency, and other eligible
recipients (if dependency is established) may include dependent handicapped children over age 18
years of age, grandchildren, brothers and sisters under age 18, dependent parents and
- To deprive of legal right, qualification, or capacity. To make incapable or
ineffective; esp: to deprive of physical, moral, or intellectual strength.
- (WCB) One of the Board's ten regions of New York state. The regions are Albany, Binghamton, Brooklyn, Buffalo, Long Island, Manhattan, Peekskill, Queens, Rochester and Syracuse.
- (WCB) Incumbent in the Workers' Compensation Examiner job title series
who performs examining work, applying knowledge of law and of Board rules, regulations,
policies and procedures to compensation and disability benefit case information. Among the
actions regarding workers' compensation cases that Examiners may perform:
• determining whether a case should be indexed;
• evaluating claim forms and developing information required by judges for case decisions;
• requesting information (by phone, letter, etc.) needed for case development;
• evaluating whether a compensation case may be processed on an informal calendar;
• referring appropriate cases to the conciliation process; and
• preparing formal notices of decision based on judge's directions.
- Exclusive Remedy:
- The premise on which the Workers' Compensation system is based: workers gave up the right to sue the
employer in exchange for medical care for payment for their injuries.
- Experience Rating:
- A method for determining an employer's workers' compensation
premiums that reflects a) a comparison of the employers recent loss experience with the amount
the employer would have been expected to pay if it had been an average employer in the same
industry with the same payroll and b) the credibility or confidence assigned to the employer's loss
experience. In practice, insurers assign no credibility to employers with average class premiums
below a certain amount (e.g., $5,000/yr).
- Extent of Disability:
- (WCB) A single-digit numeric code used by the WCB's Research
and Statistics unit to characterize the disability classification assigned to a case closed with
indemnity benefits. The codes are:
- 0 = Death case
- 1 = Permanent total disability
- 2 = Permanent partial disability (PPD) - Schedule award only
- 3 = Facial disfigurement award only
- 4 = Schedule PPD and facial disfigurement award
- 5 = Temporary disability only
- 6 = Temporary disability and facial disfigurement award
- 7 = Non-schedule PPD - Lump sum settlement
- 8 = Non-schedule PPD - No present loss of earnings
- 9 = Non-schedule PPD - Carrier to continue payments
- Final Adjustment Hearing:
- (WCB) A hearing held in cases involving the loss or
loss-of-use of a member or organ of the body in which the principal issue is the extent of loss or
loss-of-use (e.g., claims normally involving schedule awards).
- (WCB) The WCL provides that no case may be closed without notice to all
interested parties, with all such parties having an opportunity to be heard. Board hearings are
held before Workers' Compensation Law Judges who hear and determine claims for
compensation, for the purpose of ascertaining the rights of the parties. The Board, upon receipt
of an application for review of a judge's decision, may also hold hearings.
- Hearing Point:
- Facilities, other than the seven District Offices, for which calendars are
prepared and at which hearings are held.
- Indemnity Benefits:
- Compensation paid to the workers' compensation claimants for
non-medical loss resulting from an injury or illness. Six types of award are permitted by the
• temporary total disability benefits (for periods of total wage loss);
• temporary partial disability benefits (for periods of partial wage loss);
• facial disfigurement awards (at judge's discretion but subject to a maximum, for cosmetic
facial disfigurement resulting from the accident or exposure);
• permanent partial disability benefits (for loss if physical function or for periods of partial
wage loss after a claimant has been classified as having a permanent partial disability);
• permanent total disability benefits (for loss of wage earning capacity after a claimant has
been classified as having a permanent total disability); and
• death benefits (compensation benefits awarded to spouse, children or under certain
circumstances, other family members following a work-related death).
- Indexed Claim:
- (WCB) A claim case folder which has been assembled and assigned a
case number by the Board's Claims Unit.
- See Workers' Compensation Law Judge.
- (WCB) The right to hear and determine a workers' compensation case.
The Board has jurisdiction over cases with employment in NYS. Notable exclusions from the
Board' jurisdiction in New York State include: federal government workers and certain
employees of local government, many NYC government occupations (civil service police,
firefighters, sanitation workers), most NYC teachers, and casual employments (yard work by
minors, baby-sitters, etc.). Workers covered by separate compensation systems under federal
laws (maritime employments, merchant seafarers, interstate railroad employees, etc.) may elect to
submit to NYS jurisdiction by waiving their federal rights and remedies. Coverage for some
worker classes in NYS is elective (e.g., part-time household workers, sole proprietors, corporate
officers, certain musicians, and farm workers earning less than $1,200 per year).
- Licensed Representative:
- (WCB) (a) Any person other than an attorney who is
authorized by the Board to represent claimants or insurance carriers before the Board and, in
some instances, to receive a fee, fixed by the Board, for such services. (b) Any person other than
an attorney who is authorized by the Board to represent self-insurers before it.
- Licensed Claimant Representative:
- (WCB) (a) Any person other than an attorney who
is authorized by the Board to represent claimants or insurance carriers before the Board and, in
some instances, to receive a fee, fixed by the Board, for such services. (b) Any person other than
an attorney who is authorized by the Board to represent self-insurers before it.
- Lost Time:
- (WCB) A period of total wage loss and loss of earning capacity, beyond the
statutory waiting period, caused by the claimant's work-connected disability. In workers'
compensation cases only, if the disability period exceeds 14 days, compensation will be paid from
the first day of disability. There is no waiting period for volunteer ambulance worker or volunteer
- Lump Sum Settlement:
- (WCB) A negotiated and Board-approved agreement, termed a
"non-schedule adjustment," between a claimant with a non-schedule permanent partial disability
and the insurer(s). As a result of the agreement the claimant receives a sum of money
representing all future compensation for his/her disability, and the case is considered closed.
Under WCL .15(5-b), granting of a settlement by the Board requires that (a) the right to
compensation has been established and compensation has been paid for at least three months, (b)
the continuance of disability and of future earning capacity cannot be ascertained with reasonable
certainty, (c) there has been a physical examination of the claimant prior to approval, and (d) the
Board considers the settlement "fair and in the best interest of the claimant." In practice, lump
sum settlements are usually final, but the law provides for reopening's if the Board finds that there
has been a change in condition or degree of disability not contemplated at the time of the
- Manual Rates:
- The listed premium, stated as dollars per $100 of weekly earnings for
each employee, in a state's current schedule; in New York the manual rates are linked to the
Classification Code system (i.e., rates are stated for each work classification code used in the
- Maximum Medical Improvement (MMI):
- (WCB) An assessed condition of a claimant
based on medical judgment that (a) the claimant has recovered from the work injury to the
greatest extent that is expected and (b) no further change in his/her condition is expected. A
finding of maximum medical improvement is a normal precondition for determining the permanent
disability level of a claimant.
- Medical Benefits:
- Medical treatment provided, under the Workers' Compensation Law,
to injured workers as a result of injuries arising out of and in the course of employment.
- Medical Fee Schedule:
- A schedule, established by the Chair of the Workers'
Compensation Board, of charges and fees for medical treatment and care furnished to workers'
- Medical Treatment:
- (WCL) Care (other than first aid) administered by a physician,
chiropractor or podiatrist or on a physician's referral, by a psychologist, or physical or
- (An action by an employer to intentionally attempt to reduce required workers'
compensation insurance premiums by misclassifying employees as "independent
contractors", and/or misclassifying the work that of a business to a classification
that is less hazardous. An employer must keep accurate records of the number of
employees, classification, wages and accidents for their business for four years.
Failure to keep adequate and/or accurate records may result in a fine of $1,000 per
every 10-day period of noncompliance or two times the cost of compensation.
Additionally, the fine for criminal conviction is from $1,000 to $50,000.
- An action by an employer to intentionally attempt to reduce required workers'
compensation insurance premiums by not keeping accurate/adequate payroll records,
paying workers "off the books", misclassifying employees as "independent contractors"
and/or misclassifying the work that of a business to a classification that is less
hazardous. An employer must keep accurate records of the number of employees,
classification, wages and accidents for their business for four years. Failure to
keep adequate and/or accurate records may result in a fine of $1,000 per every
10-day period of noncompliance or two times the cost of compensation. Additionally,
the fine for criminal conviction is from $1,000 to $50,000.
- Modify a Decision:
- A decision that partially changes a previous decision -- e.g., a Board
Panel memorandum of decision which amends a Workers' Compensation Law Judge
- Motion Calendar Hearing:
- (WCB) In a case in which no controversy or outstanding
issue exists, a proposed decision is prepared and the parties are notified. A hearing is held only if
one of the parties objects to the proposed decision.
- National Council on Compensation Insurance (NCCI):
- An association of workers' compensation insurers which serves as the workers'
compensation rating organization in about two-thirds of the states. The group
establishes standards for use in rate making, develops policy
forms, collects statistics, and provides statistical support and services.
- National Institute for Occupational Safety and Health (NIOSH):
- An agency within the
U.S. Department of Health and Human Services established in 1970. It is part of the Center for
Disease Control and Prevention and is generally responsible for conducting research and making
recommendations for the prevention of work-related illnesses and injuries. NIOSH's
responsibilities include: investigating potentially hazardous working conditions (as requested by
employer or employees), evaluating workplace hazards, creating and disseminating methods for
preventing disease/injury/disability, conducting scientifically valid research on safety issues, and
providing education and training in the field of occupational safety and health.
- New York Compensation Insurance Rating Board:
- A private, non-profit association of
licensed insurance companies that provide workers' compensation insurance in New York; the
organization is responsible (among other things) for collecting and reviewing compensation loss
experience from carriers, developing policy forms and rating plans, conducting actuarial analyses
and preparing rate filings with the New York State Insurance Department.
- Non-Compensated Case:
- A closed case which has never awarded indemnity benefits.
- Non-schedule Permanent Partial Disability:
- Non-fatal injuries that do not involve
schedule permanent partial disabilities or cosmetic facial disfigurement and in which the claimant
retains some earning capacity are assigned permanent disability benefits based on the claimant's
actual or presumed wage loss, with benefits to continue for the duration of the wage loss
- Written notification from an employee to his/her employer, indicating that a
work-connected injury or injury has occurred. For accidental injuries, notice must be given no
later than 30 days after the accident; the Board must excuse a failure to give notice on the
grounds that a) for some reason, notice could not have been given; b) the employer had
knowledge of the accident; or c) the employer's case has not been prejudiced. In cases involving
occupational diseases, the time period for notice is 2 years from the date of disablement or from
the date when the employee knew, or should have known, that the disease was due to the nature
- (Census Bureau) A numeric coding structure widely adopted by federal,
state and private occupation analysts, for identifying the occupation of an injured worker.
- Occupational Disease (OD):
- A disease arising from employment conditions for a class
of workers, with the disease occurring as a natural incident for particular occupations, distinct
from and exceeding the ordinary hazards and risks of employment. To be considered an
occupational disease, there must be some recognizable link between the disease and some
distinctive feature of the workers' job.
- Occupational Disease, Notice and Causal Relationship (ODNCR):
- (WCB) Minimal conditions that must be met before financial responsibility can be assigned to a claim for workers'
compensation based on occupational disease. Specifically, it must be established that (a) the
claimant has an occupational disease recognized by the WCL, (b) the claimant has, after the onset
of the disease, notified his/her employer within the statutory time limit (two years from date of
disablement or from date when claimant knew or should have known that the disease was due to
the nature of the employment, whichever is greater), and (c) a causal relationship exists between
work-related activities and exposure, the development of the occupational disease, and a
- Occupational Illness:
- Any abnormal condition or disorder, other than one resulting from
an occupational injury, caused by exposure to environmental factors associated with employment;
it includes acute and chronic illnesses or diseases which may be caused by inhalation, absorption,
ingestion or direct contact.
- Occupational Injury:
- Any injury, such as a fracture, sprain, amputation, etc. - which
results from a work accident or other exposure involving a single accident in the work
- Party of Interest:
- The claimant, employer, carrier and any statutory fund that may be
liable in the particular case.
- Planned Coverage:
- An employer may provide benefits under a Board approved Plan for Disability
Benefits (or one negotiated by agreement and accepted by the Chair of the Board as
meeting the requirements of the NYS Disability Benefits Law (DBL)) ONLY when such a
Plan is insured through one of the carriers licensed by New York State to write
statutory disability benefits insurance policies or by an employer who has been
authorized by the NYS Workers' Compensation Board to self-insure for disability
benefits. All Plans accepted by the NYS Workers' Compensation Board shall cover
only those employees that are eligible for benefits under the NYS DBL. Such
accepted Plans must meet ALL statutory requirements as set forth by the NYS DBL.
- The total amount paid for an insurance policy. For workers' compensation
insurance, premiums are normally calculated using a rate per $100 of the payroll for covered
- Reduced Earnings:
- (WCB) A compensation rate based on the claimant's partial wage
loss or partial loss of earning capacity due to a condition related to a compensable
- Reimbursement, Request for:
- A request by an employer for reimbursement for wages
paid to an employee for a period during which the employee was eligible to receive workers'
compensation or disability benefits. A request by a compensation carrier for reimbursement out
of the Special Disability Fund. A request by a disability benefits carrier for reimbursement of
benefits paid to a claimant while the workers' compensation case was being litigated.
- Reopened Case:
- A workers' compensation case which has been closed by a Workers'
Compensation Law Judge or a Board Panel that is subsequently made active again to determine
the claimant's eligibility for benefits.
- Reopened Cases Fund:
- (WCB) A fund established to assume liability for additional
awards in cases in which the application to reopen the case occurs more than seven years from the
date of injury and more than three years from the payment of the last payment of compensation.
The Fund is financed through payments in non-dependency death cases and through assessments
made periodically against all carriers.
- Request for Further Action:
- When a Party-of-Interest in a case requests Board intervention.
- Rescind (a Decision):
- (WCB) A Board Panel memorandum of decision which voids or
annuls a Workers' Compensation Law Judge decision. Decisions to rescind are usually issued
without prejudice in order to allow the parties to present evidence or testimony not previously
presented to a Workers' Compensation Law Judge.
- Rescind (a Penalty):
- (WCB): In certain instances the NYS Workers' Compensation Board issues a penalty for noncompliance
with the mandatory coverage provisions of the NYS Workers' Compensation Law for
workers' compensation and/or disability benefits to a legal entity that is not
required to carry such insurance policy(ies). The Workers' Compensation Board will
review documentation submitted by the legal entity that shows that such coverage is
not required and the Workers' Compensation Board will "rescind" (withdraw or cancel)
the penalty action. The legal entity is not required to pay the penalty amount
related to the rescinded penalty.
- Review Bureau:
- (WCB) A department of the Workers' Compensation Board which
processes requests for reopening's of closed cases and objections to Workers' Compensation Law
Judge decisions. In addition, the unit previously processed requests to close compensation cases
with lump sum non-schedule adjustments, but since 1995 such requests have been handled by the
- Review, Request for:
- (WCB) A written request for a Board Panel review of a Workers'
Compensation Law Judge decision.
- Schedule Permanent Partial Disability:
- (WCB) Maximum benefit week schedules in the
WCL are generally used in determining lifetime benefits for injuries to major body parts. Injuries
amounting to less than a 100 percent functional loss are awarded a percentage of the scheduled
weeks, and there are also provisions for additional weeks required for a protracted healing
- Second Injury Fund:
- A special fund, technically known in New York as the Special
Disability Fund, which assumes, in certain cases, part of the permanent disability liability resulting
from injuries to previously handicapped workers. The fund, which is funded by assessments
against carriers and self-insureds, was created to assure handicapped workers receive full
workers' compensation benefits, while encouraging employers to hire physically handicapped
persons by protecting them against disproportionate liability in the event of subsequent
- (WCB) In lieu of purchasing insurance from an insurance carrier, an
employer or group of employers may assume the liability for the payment of workers'
compensation benefits to employees by depositing securities or a surety bond in an amount
required by the Board.
- Special Funds:
- Funds established under the WCL to assure payments of benefits
associated with claims, usually by transferring all or part of the liability to the Fund.
- State Insurance Fund:
- A quasi-public agency whose activities include a) providing
workers' compensation insurance coverage to private and public employers; b) providing other
lines of insurance coverage; and c) acting as an agent in NYS in workers' compensation cases
involving NYS employees. The State Insurance Fund must offer workers' compensation
insurance to any employer requesting it, making the Fund an "insurer of last resort" for employers
otherwise unable to obtain coverage.
- Statutory Disability Benefits Insurance Policy:
- New York is one of a handful of states that require employers to provide disability benefits coverage to
employees for an off-the-job injury or illness. Cash benefits are 50 percent of a
claimant's average weekly wage, but no more than the maximum benefit allowed,
currently $170 per week. Benefits are paid for a maximum of 26 weeks of disability
during 52 consecutive weeks. Coverage for statutory disability benefits can be
obtained through a disability benefits insurance carrier who is authorized by the
NYS Workers' Compensation Board to write such policies. Another option is for large
employers to become authorized by the Board to self-insure.
- Stop Work Orders:
- A stop work order means that a business MUST cease all operations – no work at all
may take place until the Stop Work Order is officially removed. Section 141-b of
the WCL states that a business may be issued a stop work order if workers'
compensation coverage is not in place. Receipt of a stop work order may lead to
disbarment from any State, municipal or public body Public Works contract or
subcontract for 1 year (5 years for felony conviction).
- Symptomatic Treatment:
- Medical treatments aimed at providing relief from the
symptoms of a disease or injury, rather than providing a permanent remedy to the underlying
- Tentative Rate:
- A weekly rate assigned by the Workers' Compensation Board for
carrier indemnity payments, pending final adjudication of outstanding issues relating to benefit
- Third Party Action:
- (WCB) This term refers to lawsuits against equipment
manufacturers, facility owners and other non-employer parties whose products or services
contributed to the occurrence of an accident. Under WCL, a compensation claim is a workers'
sole remedy against the employer, but lawsuits may be initiated against third parties for
contributory negligence, product defects, etc.
- Total Disability:
- With meaning of workers' compensation acts, means lack of ability to
follow continuously some substantially gainful occupation without serious discomfort or pain and
without material injury to health or danger to life.
- Trial Calendar Hearing:
- (WCB) A regularly scheduled hearing on a case conducted by a
WCLJ that is designed to permit the introduction of evidence and/or witnesses and the
presentation of arguments by the parties.
- Uninsured Employers' Fund:
- A special fund which provides for the payment of workers'
compensation cases where the employer was not insured nor self-insured and has defaulted in the
payment of workers' compensation.
- See Average Weekly Wage.
- Wage Expectancy:
- (WCB) A decision element assigning an artificial wage rate to a
young claimant, based on the authority of WCL .14(5).
- Wage Replacement:
- (WCB) The proportion of pre-injury wages replaced by workers'
- Waiting Period:
- (WCB) Period covering the first seven days of disability resulting from
a work-connected injury or illness. Workers' compensation indemnity benefits are not allowable
for the first seven days of disability, except that (a) in cases where the disability period exceeds 14
days, indemnity awards are allowed from the date of disability, and (b) there is no waiting period
for VAWBL/VFBL cases.
- Workers' Compensation Board, New York State (WCB):
- (a) The agency charged with
administering the Workers' Compensation Law, the Volunteer Ambulance Workers' Benefit Law
and the Volunteer Firefighters' Benefit Law and the Disability Benefits Law. (b) The thirteen
member Board responsible (directly or through review of delegated authority) for determining all
issues involving claims under the WCL. Members are appointed to seven-year terms by the
Governor, by and with the advice and consent of the Senate. The Governor designates the Chair
- Workers' Compensation Law (WCL):
- Chapter 67 of the Consolidated Laws, governing
the workers' compensation system; separate laws cover compensation benefits for volunteer
firefighters and volunteer ambulance workers.
- Workers' Compensation Law Judge (WCLJ; Compensation Claims Referee):
- (WCB) An officer appointed by the Chair of the Workers' Compensation Board from a Civil Service
competitive process to hear and determine claims and to conduct such hearings and investigations
and make such orders, decisions and determinations as may be required in the adjudication of the
claims. A Judge's decision is deemed the decision of the Board unless the Board modifies or
rescinds such decision.