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Conciliation Processing

PART 312

Section 312.1. Statement of purpose

To address claims [where the duration of benefits is eight weeks or less] in a more expeditious and informal [basis] manner, and to provide a mechanism for such claims to be processed without undue controversy.

Section 312.2. Referral to conciliation [bureau--lost time eight weeks or less] processing

Within 30 days of carrier's response to notice of index, [All] all cases [with lost time of eight] where the expected duration of benefits is fifty-two weeks or less shall be referred [to the] for conciliation [bureau] processing, except [as follows:

(a) If] if a case is suitable for motion calendar or administrative determination processing. [, such processing shall take place even if lost time is eight weeks or less.
(b) Where lost time is eight weeks or less and the only issue present (which prevents motion calendar processing) is a possible final adjustment, the case shall be scheduled for a final adjustment hearing.
(c)] If a case is initially controverted (C-7 filed), the case will be processed for a pre-hearing conference under subdivision 2-a of section 25 of the Workers' Compensation Law.

Section 312.3. [Proposed conciliation agreement] Conciliation Processing

(a) The [Workers' Compensation Board assigned counsel] Conciliator shall completely review each case folder and, where necessary, contact the various parties for additional information, documents, reports and fee requests, if any.
(b) Based on the evidence in the file and on information obtained from the parties, if any, the [counsel] Conciliator shall, whenever possible, prepare a proposed conciliation [agreement] decision. Where disputes on any issues exist, the [counsel] Conciliator shall attempt to reconcile them through a meeting with the parties. The presumptions contained in section 21 of the Workers' Compensation Law shall be applied whenever appropriate. The proposed [agreement] conciliation decision shall be served [by mail] upon all parties. [Any] Within 30 days thereafter, any party in interest may submit to the board its written comments regarding the proposed [agreement] conciliation decision or request a meeting of all the parties, [within 30 days of its mailing] and shall simultaneously serve copies of such comments or request on all other parties in interest. A meeting, if requested, [may] shall be scheduled in accordance with section 312.4 of this Part.
(c) The proposed [agreement] conciliation decision shall contain an appropriate proposed fee for the claimant's attorney or licensed representative, if any.

Section 312.4. Conciliation Meetings

(a) Meetings of all necessary parties will be arranged by the [Workers' Compensation Board assigned counsel] Conciliator, [whenever needed] when necessary, or within 30 days after receipt of a request for a conciliation meeting.
(b) No later than five days before the conciliation meeting, any party may review the workers' compensation case folder at the office where the conciliation meeting will be held, and may make photocopies (at its own expense) of any documents and reports.
(c) If the claimant is not represented at the conciliation meeting, the Conciliator shall advise the claimant of their right to have representation present, their right to reasonable adjournment to procure representation, and their right to withdraw from any agreement in accordance with paragraph (g) of subdivision 2-b of section 25 of the Workers' Compensation Law.
(d) After advising the unrepresented claimant at the conciliation meeting in accordance with paragraph (e) of subdivision 2-b of section 25 of the Workers' Compensation Law, the Conciliator shall request the claimant's written consent to participate in the conciliation process on a form prescribed by the Chair. If the claimant declines conciliation processing, the Conciliator shall transfer the case to a pre-hearing conference commencing the regular hearing calendar process.

Section 312.5. Conciliation [agreements] decisions.

(a) If the claimant is represented by an attorney or licensed representative, the [agreement] proposed conciliation decision will become final if no request for a meeting or no objection [to the proposed agreement] is received by the board within 30 days of the board's mailing of the proposed [agreement] conciliation decision to all parties, or when signed in the presence of the [Workers' Compensation Board assigned counsel] Conciliator, and shall constitute an award of the board for all purposes, except as provided in subdivisions [(f), (h) and (I)] (g), (i) and (j) of this section.
(b) If the claimant is not represented by an attorney or licensed representative, the [agreement] proposed conciliation decision will not become final if a request for a meeting or an objection to the decision is received by the Board within 30 days of the Board's mailing of the proposed conciliation decision to all parties. In addition, it will not become final until it is reviewed and approved by a Workers' Compensation Law [judge] Judge designated by the Chair. The Workers' Compensation Law [judge] Judge shall conduct such review and render his or her [decision] approval or disapproval within 15 days of receipt of the proposed conciliation decision from the conciliation bureau.
(c) A notice of approval or disapproval shall be sent to all parties in interest following the Workers' Compensation Law [judge] Judge review detailed in subdivision (b) of this section.
(d) If the Workers' Compensation Law [judge] Judge approves the [agreement] proposed conciliation decision, an unrepresented claimant shall have 10 days from receipt of the notice required in subdivision (c) of this section to withdraw from the [agreement] proposed conciliation decision.
(e) An employer [,] or carrier [or special fund shall not be permitted] also has a right to [withdraw from] object to the [agreement] proposed conciliation decision. Such objection must be received by the Board within 30 days of mailing of the proposed decision pursuant to subdivision (b) of this section.
[(e)] (f) Where the parties do not agree, or, if the claimant is unrepresented, where a Workers' Compensation Law [judge] Judge disapproves [the proposed agreement] or where the claimant withdraws from the [agreement] proposed conciliation decision, the case shall be [returned to the appropriate claims unit for processing on the regular trial] referred for hearing calendar processing, which may include a pre-hearing conference.
[(f) Conciliation agreements] (g) Final conciliation decisions are not reviewable under section 22 and section 23 of the Workers' Compensation Law. The continuing jurisdiction of the board under section 123 of the Workers' Compensation Law applies to conciliation cases.
[(g)] (h) The carrier is to file form [C-8] C-8/8.6 showing payments made. Form [C-8] C-8/8.6 in conciliation cases is to be filed within the time frame enumerated in section 25 of the Workers' Compensation Law.
[(h)] (i) Where the carrier has failed to make timely payments (within 10 days) of any award as required in the conciliation [agreement] decision, a fine of $500 shall be imposed by the chair, or an employee of the board designated by the chair, in accordance with paragraph [(g)] (h) of subdivision 2-b of section 25 of the Workers' Compensation Law. Such fine shall not be reviewable under section 22 and section 23 of the Workers' Compensation Law, but shall be reviewable by an employee of the board designated by the chair to review such fine in accordance with procedures established by the chair. The time for payment of an award to an unrepresented claimant runs from the expiration of the claimant's time to withdraw from the [agreement] proposed conciliation decision, pursuant to subdivision [(e)] (d) of this section.
[(I)] (j) The penalties and assessments contained in paragraph (f) of subdivision 3 of section 25 of the Workers' Compensation Law, for late payment of awards, shall not be applicable to conciliation cases.