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Certification Statement on Checks/Drafts
Issued to Claimants and Health Providers

Chapter 635 of the Laws of 1996 amended Section 132 of the Workers' Compensation Law by adding a subsection 2, as follows:

Every check or draft issued directly to a benefit recipient or provider of health services in payment of a claim made pursuant to this chapter shall contain a printed statement on the reverse side immediately above the signature line for the first endorsement indicating that in endorsing the check or draft for payment the benefit recipient or provider of health services is certifying that such person is entitled to such payment and that circumstances which would effect entitlement to receive the payment have not changed. The statement shall be in a form prescribed by the workers' compensation board after consultation with the superintendent of insurance.

Accordingly, the following statement is to appear on the reverse of all checks or drafts in accordance with Federal Reserve Board guidelines:

By endorsement of this check, the payee, under penalty of fine and/or imprisonment, certifies entitlement to this payment for benefits or services, circumstances affecting such entitlement have not changed and no false statements or representations have been made in support of the claim for payment. False representations could result in civil and criminal penalties.

Amended Section 132 is effective November 9, 1996.

Thank you for your cooperation.


Robert R. Snashall