N.Y. Looks to Speed Comp Benefits to Ill 9/11 Rescue Workers

August 15, 2006

New York State has adopted a trio of laws designed to speed workers’ compensation benefits for workers and their families with claims related to 9/11 rescue efforts.

The first new law enables many workers who became ill after the expiration of the statutory two-year workers’ compensation filing deadline to resubmit their claim for further consideration. The legislation was developed as the result of negotiations by the Workers’ Compensation Board, the State Insurance Fund, the AFL-CIO and the Legislature.

The second new law permits application for accidental death benefits to families of police officers, firefighters, and other uniformed personnel who participated in the rescue, recovery and clean-up operations at the World Trade Center site.

The third new law eliminates the statute of limitations to allow rescue and recovery workers who retired from public service to later have their retirement status reclassified as accidental disability if illnesses related to their work on the rescue, recovery and clean-up operations service on 9/11 later surface.

The state has also adopted a plan to improve 9/11 rescue workers’ access to the benefits available through the workers compensation system. The plan creates additional flexibility to provide coverage for health care while claims are being litigated by the insurer, ensures access to medical procedures that require pre-approval in a more time-sensitive manner, and calls upon insurers to exercise options available to them under current law to provide workers compensation benefits to claimants before their cases have been fully resolved.

“New York will never forget the heroes of September 11th, the men and women who tirelessly worked at the site of the world’s most horrific terror attacks, to help save lives, recover the remains of loved ones and begin the rebuilding process in Lower Manhattan,” Governor George Pataki said. “The brave men and women suffering from hidden health issues stemming from September 11th should not be denied benefits because of a statutory time limit that they had no hope of meeting.”

The workers’ compensation plan addresses five areas:

· Legislation (S.8348) that alters the two-year deadline for certain claims by directing the Workers’ Compensation Board to apply the standards of “Occupational Diseases” for claimants who have developed illnesses over time as a result of their services during rescue, recovery and clean-up operations following the September 11th attacks. There is no statute of limitations for claims submitted by individuals who volunteered at the World Trade Center site or the Staten Island Landfill as those benefits are paid through the federal grants.

Under the current Workers’ Compensation Law, a worker who is injured on the job as the result of a specific, identifiable workplace incident must file a workers’ compensation claim within two years of the date of the accident. Workers’ who develop illnesses as a result of exposure to harmful elements directly related to their employment are classified as having sustained an occupational illness. The deadline for “Occupational Disease” cases extends to 2 years from the time in which the claimant knew or should have known that the condition is related to his or her employment. Often occupational illnesses do not manifest themselves for a long period of time.

The creation of a new law eases the two-year statue of limitations for those individuals who became ill after the deadline had passed by designating these claims as “occupational illnesses.” It further enables claimants whose illnesses developed over time, and whose claims were previously rejected due to the statutory deadline, to seek reconsideration by reopening his or her claim.

· Legislation (A.11255-A) permits the families of eligible public employees who participated in the rescue, recovery and cleanup efforts and who die of a disease to apply for accidental death benefits. In the case of uniformed employees of the police and fore departments such benefits would equate to 100 percent of salary benefits.

(On June 14, 2005, the Pataki signed into law legislation that permitted New York City firefighters, police officers and other public employees to more easily qualify for disability pensions by creating a legal presumption that individuals who in the line of duty were involved in September 11th related operations, and incurred certain physical injuries or diseases that resulted in a disability are entitled to a 75 percent disability pension.)

· Additional legislation (A.10731-A) eliminates the statute of limitations to permit those involved in the World Trade Center rescue, recovery and clean-up operations who retired and later became disabled from illnesses related to their service, to have their retirement status re-categorized as accidental disability. This re-classification would provide more generous benefits provided they file a sworn affidavit of their participation in the WTC operations by June 14, 2007.

· The new measures also call on workers’ compensation insurers and self insured employers to exercise an option enacted as part of Pataki’s 1996 Workers’ Compensation reforms, which enabled insurers to expeditiously pay for medical treatment without prejudicing their right to further litigate a claim or admitting liability to the claim.

· Directs the Workers’ Compensation Board to expand the use of the MD-1 program created in 2002. The program utilizes Orders of the Chair to address insurers’ failure to act in a timely fashion as required by law. The measure will ensure swifter access to medical care for claimants who have not received authorization for non-emergency health care procedures, such as MRI’s and surgery.

Insurers are expected to provide authorizations or denials within 30 days of a request for medical treatment. This provision will direct the Chair to authorize procedures when a claimant is left to languish for more than 30 days without a response from the insurer.

· Provides immediate relief for workers injured at Ground Zero or related activities by using a portion of the $50 million grant from the federal government to provide benefits to volunteers to pay for medical treatment during the period in which a claimant’s workers’ compensation case is being controverted by the insurer.
In New York State, businesses that have employees are required to provide insurance coverage or self-insure to pay for workers’ compensation benefits.

To date, the Workers’ Compensation Board has indexed 10,779 claims related to the World Trade Center attacks. Of those claims, 94 percent are classified as fully resolved, which means all issues that can be resolved at this time are resolved. The Workers’ Compensation Board maintains eternal jurisdiction over workers’ compensation claims and will reopen claims when circumstances dictate.

Source: Office of N.Y. Governor

Topics Carriers Legislation Claims Workers' Compensation New York

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