Overview
Waiver Agreement Management Office (WAMO) negotiates and seeks Board approval for Section 32 waiver agreements on behalf of the Special Disability Fund (Fund) for WCL §§ 14(6) and 15(8) claims. When more individual claims are settled, fewer claims require reimbursement from the Fund which results in a lower annual assessment against self-insured employers, insurers and the State Insurance Fund.
WAMO encourages insurers and claimants and their representatives to contact WAMO if they are interested in a Section 32 waiver agreement.
WAMO Individual Waiver Agreement
WAMO has created an Excel WAMO Worksheet (which should be used for all settlements effective October 31, 2022) that calculates the maximum indemnity amount, maximum medical amount and total Special Fund reimbursement offer. This helps all parties of interest know approximately how much money a claimant will receive by settling a Special Funds claim through a Section 32 Waiver Agreement. The calculation is approximate and assumes that all information entered is accurate. If all parties agree, the WAMO Worksheet should be emailed to WAMO@wcb.ny.gov.
WAMO also requires the terms of the settlement agreement so that WAMO can draft, sign and send the Section 32 Waiver Agreement. Please use the WAMO Individual Settlement Agreement Terms (SAT) Form to provide the terms of the waiver agreement including the name of the law firm, settlement amounts and percentages, the attorney fee requested, and other information that must be included in the Section 32 Waiver Agreement.
Procedure
Step 1
The insurer or claimant submits the WAMO Worksheet and SAT Form to WAMO@wcb.ny.gov.
Note: Insurers should only submit these forms if the following answers are yes:
- Is the claimant interested in settling all claims?
- Does the insurer have an Medicare Set Aside (MSA) if one is required by Center for Medicare & Medicaid Services (CMS)?
Step 2
WAMO reviews the WAMO Worksheet and SAT Form for accuracy and completeness. WAMO will either:
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Authorize the settlement, sign a Section 32 Waiver Agreement and distribute it to the parties for their signature.
OR
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Reject the settlement with specific reason(s). Parties may have an opportunity to resubmit the request.
Step 3
The insurer or claimant submits the signed Section 32 Waiver Agreement to wcbclaims@wcb.ny.gov and all parties attend the scheduled hearing where the Workers' Compensation Law Judge (WCLJ) will approve or disallow the agreement.
Step 4
If the WCLJ approves the agreement, the insurer will pay the claimant and seek reimbursement from SFG.
Note: Any party has ten days from the date of approval to withdraw from a waiver agreement.
- The first step to settle a claim is to make sure all parties are interested in a settlement.
- If all parties want to settle, email a completed Excel WAMO Worksheet (which should be used for all settlements effective October 31, 2022) to WAMO@wcb.ny.gov. Remember to answer all the questions as completely as possible to avoid delay.
- Once the WAMO Worksheet is received, it will be reviewed and returned with an authorized settlement amount or a rejection reason. If any information is missing or incomplete, WAMO will contact the sender and ask for additional information.
- If the agreement includes the settlement of both indemnity payments and medical care, then a Medicare Set-Aside (MSA) may be required.
- If all parties agree to the settlement amount and all paperwork is completed, Special Funds Group (SFG) will draft the Section 32 Waiver Agreement and distribute to the other parties for signature.
- Once the agreement is fully executed by all parties, it is submitted to the Board for approval by a Workers' Compensation Law Judge (WCLJ).
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If the WCLJ approves the agreement, the insurer will pay the claimant and seek reimbursement from SFG.
Note: Any party has ten days from the date of approval to withdraw from a waiver agreement.
Section 32 Templates
- SFG Settlement Agreement - Section 32 WCL Indemnity Only (sample with data)
- SFG Settlement Agreement - Section 32 WCL Indemnity and Medical (sample with data)
Resources
- WAMO Individual Settlement Agreement Terms (SAT) Form (MS Word)
- Section 32 Waiver Agreements
- WAMO Worksheet (MS Excel). (which should be used for all settlements effective October 31, 2022)
- Special Disability Fund Reimbursements
Contact Us
Email: wamo@wcb.ny.gov
Phone: (855) 430-3602