The Court of Appeals has issued a potentially ground-breaking new ruling, highlighting that for employers and insurance carriers who wish to controvert a workers’ compensation claim, it is now more important than ever to make certain that the form C-7 is filed in a timely basis.  

In the matter of Cappellino v. Baumann and Sons Bus Company, 2012 N.Y. Lexis 172; 2012 NY Slip Op. 852, February 9, 2012, the claimant, while supervising a van and bus wash, suffered a fatal heart attack and the decedent’s wife brought a claim for death benefits.  The law judge found that the employer failed to file the Notice of Controversy, a form C-7, within 25 days of the indexing of the case, pursuant to WCL Section 25(2)(b).   Traditionally, the remedy for this has been to bar the employer from asserting the defense that the claim arose out of or in the course of his/her employment and the defense of the employer/employee relationship.  However, the other defenses have traditionally been available.

A hearing was held in which a physician retained by the employer was permitted to testify that, in his opinion, the decedent’s work activity was not a precipitating cause of death.  This traditionally has been germane to the issue of causal relationship, not accident arising in or out of the course of employment.  The Workers’ Compensation Board and the Appellate Division later ruled that the decedent’s death was not causally related to his employment.  The Court of Appeals, however, reversed, stating “there is an undisputed finding that the employer untimely filed the notice of controversy and there was no showing of good cause or other reason to excuse the failure.  Thus, the employer should have been precluded from offering its physician’s testimony to dispute claimant’s evidence on the issue of causation.”

The Court of Appeals finding has the potential to dramatically limit, if not eliminate entirely, the instances where an employer and carrier can file a C-7 form untimely and still prevail in their controversy.  Traditionally causal relationship has remained a viable issue in these cases, but the Court of Appeals ruling may mean that is coming to an end. 

For more information on how this ruling may impact your business, please contact S. Philip Unwin (585.295.8340; punwin@goldbergsegalla.com), Damon M. Gruber (716.566.5491; dgruber@goldbergsegalla.com), Sean P. Beiter (716.566.5409; sbeiter@goldbergsegalla.com), or another member of the Goldberg Segalla Labor and Employment Practice Group.