Volunteer Firefighter's and Volunteer Ambulance Worker's Guide to Workers' Compensation Benefits
Frequently Asked Questions
- Q. If an activity is authorized by the proper authority, is it covered?
- A. Not necessarily. The ambulance or fire officer may authorize an activity, but if it is
not provided for in the law, it may not be compensable.
- Q. Must the volunteer ambulance worker or firefighter lose time in regular
employment in order for the disability to be covered?
- A. Not necessarily. The disability is compensable if there is loss of earning capacity, or
loss of use or partial use of a bodily member, eye or hearing.
- Q. If a volunteer ambulance worker or firefighter receives remuneration or a
gratuity in the performance of a duty or activity which is covered under the law, can he/she still
sustain a compensable injury in the line of duty?
- A. No. However, reimbursement of expenses for meals, lodging, necessary travel or receipt of
a mileage allowance and the acceptance of transportation, food, drink, shelter, clothing and
similar items while on duty are not deemed to be remuneration or a gratuity.
- Q. May a volunteer firefighter or ambulance worker render emergency service
with another district or company?
- A. Yes. Whenever a volunteer member offers individual service to another company in New York
State, but outside the area regularly served by the member's company or district, and after
such services are accepted by the officer in command at the scene, the responsibility for
benefits resulting from an injury in the line of duty will be that of the fire or ambulance
company (and its political subdivision) which has accepted such voluntary service.
- Q. Does the notice of injury have to be in writing?
- A. The volunteer member, or a representative, must sign the notice. However, the Board
may excuse the failure to give written notice on any of the following grounds: for some
sufficient reason notice could not have been given; a member of a body in charge of, or any
officer of, the ambulance or fire company/district had knowledge within a 90 days of the
injuries or death; the political subdivision, ambulance company or insurance carrier was
not prejudiced by a delay in giving such notice; the cause of disablement or death was
not known to be the result of service performed in the line of duty as a volunteer member
in sufficient time to comply with the notice requirement.
- Q. If the injury is compensable, how much medical care is provided?
- A. Necessary medical care is provided for as long as the injury and process of recovery require.
- Q. Is medical care provided even when there is no lost time from work?
- A. Yes.
- Q. When does medical care require advance authorization?
- A. Advance authorization by the political subdivision or fire or ambulance
company liable for the payment of benefits or its insurance carrier is necessary for
certain types of care, such as nursing, and for other services that significantly increase costs.
- Q. Is the volunteer member reimbursed for the purchase of necessary medicines
or prescribed drugs?
- A. Yes. The claimant must obtain receipts and submit them to the political subdivision,
company or insurance carrier involved.
- Q. What happens when a claim is contested by the insurance carrier?
- A. The insurance carrier contesting a claim must file a notice of controversy with
the Board within eighteen days after the disability begins or within ten days of learning
of the accident, whichever is greater. The carrier must give the reasons why the claim is
not being paid. The issue is resolved by a W.C. Law Judge at a pre-hearing conference or a hearing.
- Q. May a closed case be reopened?
- A. Yes. The Board may reopen a closed case, subject to time limitations set forth in the
statute, upon application of any party. The application must set forth the basis for the requested
reopening. However, a claim that has been totally settled by a waiver agreement cannot be reopened
by the Board.
- Q. What is the penalty for making a false claim to obtain benefits?
- A. Such a person is guilty of workers' compensation fraud; an E-Felony.