2006 New York Code - Determination Of Claims For Compensation.

 
    §  20.    Determination  of claims for compensation.   1.  At any time
  after the expiration of the first seven days of disability on  the  part
  of  an  injured  employee,  or at any time after the employee's death, a
  claim for compensation may be presented to the employer or to the chair.
  The board shall have full power and authority to determine all questions
  in relation to the payment of claims presented to  it  for  compensation
  under  the provisions of this chapter.  The chair or board shall make or
  cause to be made such investigation as  it  deems  necessary,  and  upon
  application  of  either  party, shall order a hearing, and within thirty
  days after a claim for compensation is submitted under this section,  or
  such hearing closed, shall make or deny an award, determining such claim
  for  compensation,  and  file  the  same  in  the  office  of the chair.
  Immediately after such filing the chair shall send to the parties a copy
  of the decision.  Upon a hearing pursuant to this section  either  party
  may present evidence and be represented by counsel.  The decision of the
  board  shall  be  final  as  to  all  questions  of fact, and, except as
  provided in section twenty-three of this article, as to all questions of
  law.  Except as provided in section twenty-seven of  this  article,  all
  awards  of  the  board shall draw simple interest from thirty days after
  the making thereof at the rate provided in section five thousand four of
  the civil practice law and rules.  Whenever a hearing or proceeding  for
  the determination of a claim for compensation is begun before a referee,
  pursuant  to  the provisions of this chapter, such hearing or proceeding
  or any adjourned hearing thereon shall continue before the same  referee
  until  a final determination awarding or denying compensation, except in
  the absence, inability or disqualification to act of  such  referee,  or
  for  other  good cause, in which event such hearing or proceeding may be
  continued before another referee by order of the chair or board.
    2. (a) Notwithstanding subdivision one of this section, any claim  for
  compensation by (i) judges, conciliators, and managerial or confidential
  employees  of  the  workers' compensation board and state insurance fund
  who are allocated to a grade M1 or above pursuant to section one hundred
  thirty of the civil service law, (ii) the chair, vice-chair and  members
  of  the  workers'  compensation board, and (iii) the executive director,
  deputy executive directors and members of the board of commissioners  of
  the  state  insurance  fund  shall not be within the jurisdiction of the
  workers' compensation board but instead shall be determined by a neutral
  outside arbitration process as provided by  regulations  promulgated  by
  the  chair.   Such claims shall be filed in the same manner as any other
  claim for compensation under this chapter.
    (b) All issues and questions of law or fact pertaining to such  claims
  shall   be  resolved  by  the  arbitrator  appointed  pursuant  to  this
  paragraph.  Arbitrators shall be appointed by the  chair  to  adjudicate
  claims  under  this  paragraph.    Such  arbitrators shall have the same
  powers and  duties  as  those  accorded  referees  under  this  chapter,
  including powers delegated by the chair.  The provisions of this chapter
  shall  be  applicable to claims under this paragraph insofar as they are
  not inconsistent herewith.
    (c)  An award or decision by an arbitrator pursuant to this  paragraph
  is  deemed  to be a final decision of the board except if review of such
  decision is sought as provided in paragraph (d) of this subdivision.  No
  modification, rescission or review of such  award  or  decision  may  be
  entertained  by the board, notwithstanding any provision of this chapter
  to the contrary.
    (d)  Within thirty days after notice of the  filing  of  an  award  or
  decision  by  an arbitrator, any party in interest may request review of
  the arbitrator's decision by a panel of three arbitrators  in  the  same
  manner  and  to  the  same  extent  as  the decision by a referee may be
  reviewed by the board pursuant to section twenty-three of this  article.
  The  arbitration  panel shall consist of one arbitrator nominated by the
  chair, one arbitrator nominated  by  a  recognized  alternative  dispute
  resolution  organization  and  one  arbitrator  nominated by an employee
  organization certified pursuant to article fourteen of the civil service
  law to represent the collective bargaining unit of the injured  employee
  or,  if  the  injured  employee  is  not  represented  by  a  collective
  bargaining  unit,  by  the  recognized  alternative  dispute  resolution
  organization.    A  party  in  interest may seek review of such award or
  decision of an arbitration panel only by taking appeal therefrom to  the
  appellate  division of the supreme court, third department and the court
  of appeals as provided for decisions of the board  pursuant  to  section
  twenty-three of this chapter.
    (e)   The powers and jurisdiction of the arbitration panel established
  pursuant to this subdivision shall be continuing in the same manner  and
  to the same extent as provided under this chapter to the board.
    (f)  All fees, costs and expenses of arbitration shall be borne by the
  board  and  the state insurance fund as administration expenses pursuant
  to sections eighty-eight and one hundred fifty-one of this chapter.
    (g)  Any claim for compensation by an officer or employee of the board
  or state insurance fund not required  to  be  determined  by  a  neutral
  outside   arbitration   process   pursuant  to  paragraph  (a)  of  this
  subdivision shall be determined initially by a referee  with  review  of
  such  determination  available  pursuant to section twenty-three of this
  chapter.
    (h)  For any claim for compensation by an officer or employee  of  the
  workers'  compensation  board or the state insurance fund whether or not
  such claim is required to be determined by a neutral outside arbitration
  process pursuant to paragraph (a) of this subdivision,  the  referee  or
  arbitrator  making  the  initial  finding of fact concerning any medical
  issue present in the case shall develop the record with opinion evidence
  from an impartial specialist who is an expert in the appropriate medical
  specialty.     Such   impartial   specialist   shall   be   subject   to
  cross-examination at the request of any party in interest.
    (i)    The  state  insurance  fund  shall  administer the claim of any
  officer or employee of the state insurance fund  at  an  office  of  the
  state  insurance  fund  other  than the office which was, at the time of
  injury, disablement or death of such officer or  employee,  his  or  her
  principal workplace.
    (j)    The  chair  shall promulgate regulations necessary to implement
  this subdivision.  Such regulations shall include provisions in relation
  to this subdivision for a single arbitrator to determine a claim in  the
  first  instance and a panel of three arbitrators to review such decision
  upon the application of any party in interest prior to judicial  review.
  Such  regulations  shall also include all special procedures relating to
  the handling  of  claims  of  officers  or  employees  of  the  workers'
  compensation  board  and  the state insurance fund pursuant to paragraph
  (f) of this subdivision.
    3.  Notwithstanding any other provision of  law  to  the  contrary,  a
  member  of  the workers' compensation board, a referee or any arbitrator
  in connection with the adjudication of  any  claim  arising  under  this
  chapter  shall  recuse  himself  or herself on any ground a judge may be
  disqualified pursuant to section fourteen of the judiciary law.