2013 New York Consolidated Laws
WKC - Workers' Compensation
Article 9 - (200 - 242) DISABILITY BENEFITS
217 - Notice and proof of claim.


NY Work Comp L § 217 (2012) What's This?
 
    §  217.  Notice  and  proof of claim.   1. Written notice and proof of
  disability shall be furnished to the employer by or  on  behalf  of  the
  employee  claiming  benefits or, in the case of a claimant under section
  two hundred seven of this article, to  the  chair,  within  thirty  days
  after  commencement  of the period of disability. Additional proof shall
  be furnished thereafter from time to time as the employer or carrier  or
  chair  may  require  but  not more often than once each week. Such proof
  shall include a statement of  disability  by  the  employee's  attending
  physician or attending podiatrist or attending chiropractor or attending
  dentist  or attending psychologist or attending certified nurse midwife,
  or in the case of an employee who adheres to the faith or  teachings  of
  any church or denomination, and who in accordance with its creed, tenets
  or  principles  depends  for healing upon prayer through spiritual means
  alone in the  practice  of  religion,  by  an  accredited  practitioner,
  containing  facts  and opinions as to such disability in compliance with
  regulations of the chair. Failure to furnish notice or proof within  the
  time and in the manner above provided shall not invalidate the claim but
  no  benefits  shall  be required to be paid for any period more than two
  weeks prior to the date on which the required proof is furnished  unless
  it  shall  be  shown  to  the satisfaction of the chair not to have been
  reasonably possible to furnish such notice or proof and that such notice
  or proof was furnished as soon as possible; provided, however,  that  no
  benefits  shall  be  paid  unless  the  required  proof of disability is
  furnished within twenty-six weeks after commencement of  the  period  of
  disability.  No limitation of time provided in this section shall run as
  against  any person who is mentally incompetent, or physically incapable
  of providing such notice as a result of a serious medical condition,  or
  a  minor  so  long  as  such person has no guardian of the person and/or
  property.
    2. An employee claiming benefits shall, as requested by  the  employer
  or  carrier,  submit  himself or herself at intervals, but not more than
  once  a  week,  for  examination  by  a  physician  or   podiatrist   or
  chiropractor  or  dentist  or  psychologist  or  certified nurse midwife
  designated by the employer or carrier. All such  examinations  shall  be
  without  cost to the employee and shall be held at a reasonable time and
  place.
    3. The chair may direct the claimant to submit  to  examination  by  a
  physician  or  podiatrist  or  chiropractor  or  dentist or psychologist
  designated by him or her in any case in which the  claim  to  disability
  benefits  is  contested  and in claims arising under section two hundred
  seven, and in other cases as the chair or board may require.
    4. Refusal of the claimant without good cause to submit  to  any  such
  examination  shall  disqualify  him  from all benefits hereunder for the
  period of such refusal, except as to benefits already paid.
    5. If benefits required to be paid by this article have been  paid  to
  an  employee,  further  payments  for  the  same disability shall not be
  barred solely because of failure to give notice  or  to  file  proof  of
  disability  for  the period or periods for which such benefits have been
  paid.
    6. In the event that a claim for benefits is rejected, the carrier  or
  employer  shall  send by first class mail written notice of rejection to
  the claimant within forty-five days of receipt of proof  of  disability.
  Failure  to  mail  such  written  notice  of  rejection  within the time
  provided, shall bar the employer or carrier from contesting  entitlement
  to  benefits  for any period of disability prior to such notice but such
  failure may be excused by the  chairman  if  it  can  be  shown  to  the
  satisfaction  of  the  chairman  not to have been reasonably possible to
  mail such notice and that such notice was mailed as  soon  as  possible.

  Such  notice  shall  include  a  statement,  in a form prescribed by the
  chairman, to the effect that the claimant may, for the purpose of review
  by the board, file with the chairman notice that his or  her  claim  has
  not been paid.

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