Workers’ Compensation Law § 25-a Is Closing — Are You Prepared?
Employers, take note: Workers’ Compensation Law § 25-a, which sets the eligibility for transferring cases to Special Funds Conservation Committee, closes on January 1, 2014.
Cases are ruled eligible if seven years from the date of accident has lapsed; if it is three years from the last payment of compensation (to the claimant); if it constitutes a true closing; if it is being reopened after seven- and three-year time periods; and if liability has shifted (the latter is not an absolute requirement).
What course of action should you take before the deadline? Here are some of the most common scenarios, and the appropriate action.
Scenario #1: The case meets the seven- and three-year time periods and the carrier paid everything on the file outside of the seven- and three-year time period (including medical/prescription/batteries/cane).
- Action: File an RFA-2 for § 25-a. There is no requirement that the medical in the file be current within the past year. If you have paid for a single medical bill outside the seven/three time periods, you may be eligible for § 25-a.
Scenario #2: The case meets the seven- and three-year time periods, but there is no medical after and the claimant has a history of treating regularly every year.
- Action: Protectively file an RFA-2 for § 25-a and refer the case to your legal counsel. Under Rebeor v. Moose Lodge, you may obtain WCL § 25-a on the premise of “potential liability” by demonstrating the claimant’s regular pattern of treatment.
Scenario #3: The case meets the seven- and three-year time periods, but there is no treatment.
- Action: Protectively file an RFA-2 for § 25-a with the following language to avoid any potential penalty for frivolous hearing: “In accordance with WCL § 25-a(1-a), the carrier maintains that this case falls under the provisions of § 25-a as we anticipate the claimant to treat in the near future. We do not request a hearing at this time to address § 25-a.”
Scenario #4: The case meets the seven- and three-year time periods, but it looks like a “mess” — what about true closure?
- Action: Immediately refer to your legal counsel for review to identify any possible issues to prevent § 25-a. There is still time to fix any true closure issues prior to the deadline.
For more information on how this may impact your business, please contact: