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Workers’ Compensation Resources for Claims Administrators

Find information and services for processing workers’ compensation claims in New York.

Payers’ Quick Links

Resources Payers

Special Disability Fund Reimbursements

Insurers may request reimbursement from the Special Disability Fund for claims with dates of accident before 7/1/2007 where the claimant was classified as permanently partially disabled (WCL §15(8)) or where the insurer is liable for paying concurrent employment benefits (WCL §14(6)).

Medical Records

HIPAA Restrictions and Medical Records

Under HIPAA’s Privacy Rule, the Workers’ Compensation Board, workers’ compensation insurers and employers are not covered entities and therefore may continue to use medical information concerning claimants in their customary manner.

Use of the Limited Release (Form C-3.3) in Controverted and Non-Controverted Claims

In adjudicating a workers’ compensation claim, an insurer may need to obtain records of the claimant’s prior relevant medical treatment. A process has been established for obtaining medical records in controverted and non-controverted claims.

Expanded Provider Law: What Payers Need to Know

As part of Governor Cuomo’s 2019-2020 budget, a law was passed expanding the types of providers that can be authorized to treat injured workers in New York State. As of January 1, 2020, licensed clinical social workers, nurse practitioners and acupuncturists, as well as physician assistants, occupational therapists and physical therapists may apply to become Board-authorized providers.

Preferred Provider Arrangements

Learn about reporting requirements for insurers who have contracted with a preferred provider organization (PPO) for the treatment of workers’ compensation injuries and illnesses.