WHAT PAYERS NEED TO KNOW - ARCHIVED UPDATES
April 9, 2026
RFA-2 eForm now mandatory
Use of the new Request for Further Action by Insurer/Employer (RFA-2) eForm is now mandatory for all payers. The Board will not accept or act on paper RFA-2 forms postmarked after April 7, 2026.
Read more in a notification dated April 8, 2026.
Changes to Workers' Compensation Law Section 21-a
As part of her 2025 State of the State proposals, and in response to feedback from the payer community, Governor Kathy Hochul signed an amendment to Workers' Compensation Law Section 21-a (WCL § 21-a). This amendment will allow payers to provisionally pay for medical care under this section without admitting liability. Currently, WCL § 21-a only allows payers to pay for indemnity and prescribed medicine for up to one year without admitting liability.
Read more in Subject Number 046-1801.
Penalties for failure to file timely Disability and Paid Family Leave Proof of Coverage (POC) transactions
In 2008, the New York State Legislature amended New York State Workers Compensation Law (WCL) §54 and §226 to authorize the New York State Workers' Compensation Board (Board) to penalize workers' compensation carriers, disability benefits carriers, and the New York State Insurance Fund for failure to timely file proof of coverage (POC) transactions. Timely filing of these transactions is a critical component in the Board's compliance efforts. For disability benefits carriers, the Board will issue penalties through the Insurance Compliance Inquiry Application (IC Inquiry). Carriers will receive a penalty letter and statement in the mail, but the summary and detailed reports will be available on the web.
Read more in Subject Number 046-1802.
FROI filings: when to use Notification Only and Medical Only
The Board has seen payers incorrectly submit the First Report of Injury — Notification Only (FROI-00) filings instead of FROI-00 — Medical Only filings. Payers should carefully consider the circumstances of the claim when determining whether to file a FROI-00 Notification Only or a FROI-00 Medical Only.
Read more in a notification dated March 31, 2026.
Important new guidance for disallowed cases
To further streamline processes for disallowed cases, the Board has issued new guidance for payers. The guidance says that payers should file an Explanation of Benefits/Explanation of Review (EOB/EOR) to the health care provider in disallowed cases, not A Notice of Objection to a Payment of a Bill for Treatment (From C-8.1B).
Read more in a notification dated March 25, 2026.
Entertaining requests for deposition extensions
When the Board issues a decision directing medical testimony by deposition, a party of interest may request an extension of time to complete the deposition and file the required transcript.
Read more in a notification dated March 25, 2026.
New inbox added to process for claimant information updates
On December 13, 2024, the Board announced a new process to update claimant information. When a payer receives the Claimant Name and Address Form (Form OC-966) , a First Report of Injury (FROI 02) must be submitted to the Board to update a claimant's address in the case file. The FROI 02 will automatically update the claimant's address field in the case file, overwriting the claimant address information currently in the file.
Read more in a notification dated March 17, 2026.
Faxed claim-related form submissions (including IME reports) no longer accepted as of April 1, 2026
As of April 1, 2026, faxed submissions of claim-related documents are no longer accepted. This includes independent medical examination (IME) reports.
Under New York State Workers' Compensation Law (NYS WCL) Section 137(1)(a), IME reports must be submitted on the same day and in the same manner to all required parties, including the injured worker (claimant).
Read more in a notification dated March 12, 2026.
Reminders
The What Payers Need to Know section of the Board's website walks payers through getting started in the workers' compensation system, becoming a trading partner, administering claims, and more.
Electronic submission of the CMS-1500 form is mandatory. Visit CMS-1500 initiative for more details and send your questions to CMS1500@wcb.ny.gov.
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The latest versions of several Paid Family Leave presentations are available, including family care, foster care/adoption, military leave, and bonding. Visit the Paid Family Leave website for more information.
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