This is based on two-thirds of the worker’s average weekly wage not to exceed the maximum rate established at the time of the accident. It is paid for the duration of the disability.

This is paid when the injured worker returns to work at a lower wage. It is paid at 2/3 of the difference between the worker’s wages before and after their injury.

The weekly rate for 100 percent disability is calculated at 2/3 of the worker’s average weekly wage not to exceed the maximum rate established at the time of the accident. It is paid for the duration of the disability.

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  Disfigurement: NY pays WC benefits for serious facial, head, neck, or chest disfigurements. The maximum payable is $20,000.

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  Scheduled Loss of Use (SLU): These payments are made for a fixed period at a fixed amount, for the loss of the use of a body part (hand, leg, etc.). They are shown as "SLU" on the SROI previously C-8/8.6 paper form. They cause offset and are not the same as Section 15.3.v payments (see below).

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  Section 15.3.v Payments: Payments under New York State Workers' Compensation Law Section 15.3.v compensate a worker for loss of a limb. These payments are rare, and are NOT OFFSETTABLE, since the law includes a reverse-offset provision.

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  Section 32 Settlement: This represents a lump sum award. Settlements of this kind usually are a final disposition of the claim for the injury in question.

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  Third-Party Settlement (or Third-Party Action): In these cases, the carrier stops paying WC because another (third) party is liable. The SROI previously C-8 or EC-23 form shows when payment stopped. The form should also show when payment starts again, but it does not always do so. In addition, the carrier ordinarily places a lien on the settlement, requiring that the third party repay some or all of the WC (see DI 52105.010 on Third-Party Settlements). The carrier may also use the form to show the amount of the third-party payment being subtracted from the WC payment. When this happens, the WC payment is not being made for the period shown. Don’t assume that the WC payments resumed at the end of the period. Instead, look for documentation that says specifically when the WC payment resumed.

When a WC claimant has settled a third-party action, the WC carrier may be required to pay a portion of any third-party litigation expenses. If the value of the future benefits cannot be determined at the time of the settlement, the carrier may be required to periodically pay its equitable share of attorney fees and costs incurred by the claimant in securing the third-party settlement. These payments are referred to as Burns Payments. Burns payments made by the carrier during the carrier's "holiday" period are viewed as equitable reimbursement for the carrier's proportionate share of the claimant's third-party litigation expenses, which the carrier is required to make pursuant to WCL § 29(1). The carrier may continue to make these Burns payments to the claimant until the gross amount of the compensation awarded equals the claimant's net recovery. At that time, WC payments may resume.

Burns payments are often confused with periodic WC payments. These payments are not WC payments, nor are they paid in lieu of WC. Therefore, they are not subject to the offset provisions of the Social Security Act.

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  Contact the worker or the worker's attorney and request a copy of the settlement.

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  Do not accept the attorney's allegation that the court case of Burns v. Varriale is cited.

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  If the actual settlement is not available, contact the WC carrier or insurance carrier to obtain the proof.

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  Documentation of a telephone call to the carrier is sufficient proof of Burns involvement.

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  Read the settlement to determine if the court case of Burns v. Varriale is cited.

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  Post a Special Message to the MBR citing this procedure and identifying the continuing payments as Burns payments.

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  If it is determined that the case is not a Burns payment, be sure to develop for reimbursement of WC payments made and account for the reimbursement in accordance with established procedure.

Payments made under the VFBL of New York are WC. The VFBL benefits correspond to the maximum benefit paid under the WC law. Since these VFBL benefits are not under the State WC statute, knowledge of such benefits would probably not be elicited from the WC question on the disability application. Also, since these people are volunteer firefighters, the last employer shown would not provide a lead to this benefit. Be alert to the possibility of VFBL benefits when asking the worker about the nature and history of the disability.

The World Trade Center Volunteer Fund (WTCVF or Volunteer Fund) is money appropriated by the Federal government to the New York State Workers’ Compensation Uninsured Employers’ Fund for the claims of volunteers who lost wages because they were injured or disabled during the World Trade Center rescue, recovery, or clean-up between 09/11/2001 and 09/12/2002. Article 8-A of the New York State Worker’s Compensation Law provides that volunteers who became disabled as a result of their efforts are eligible to file a claim for WC benefits EVEN THOUGH THE STATUTORY TIME TO FILE HAS PASSED. Although volunteers are usually not “employees” for the purposes of WC benefits, the Uninsured Employers’ Fund is deemed the employer for purposes of administering and paying claims to these volunteers, and the benefits are made by the N.Y.S. Workers’ Compensation Board. Benefits paid through the WTCVF are workers’ compensation benefits and ARE subject to offset.

Section 207 of New York's General Municipal Law provides for the payment of full salary to certain salaried firefighters and police officers injured in the line of duty. Because the salary payments are not made under the WC law and because the WC is not paid directly to the injured worker, Section 207 payments are NOT OFFSETTABLE. For information on WC payments made to employers see DI 52110.010.

Verify the exact period for which the worker received Section 207 (see DI 52145.001 for acceptable evidence). If the verification in file is over 2 years old, re-verify to determine whether Section 207 payments continue and, if not, the dates the worker actually received this WC.

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  Remove offset only for the period Section 207 payments were received.

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  Advise the affected worker that offset is not being imposed because the payments are under Section 207.

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  Instruct the worker to notify us if they begin to receive regular WC.

Supplemental benefits are payable to workers receiving total permanent disability based on injury dates before 01/01/1979. They are not available to workers with injury dates of 01/01/1979 or later. The worker must have filed for supplemental WC benefits to receive them. The State of New York reduced its supplemental WC benefits by 50 percent of any Federal disability benefits received. Since the supplemental payment is considered an integral part of the basic WC benefit, no part of the whole WC benefit was cause for offset of DIB before 07/01/1990.

The effective date of supplemental WC benefits was determined by the WC injury date, as shown in the chart below:

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  Verify that the worker is entitled to the supplemental benefit.

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  Remove offset effective with the date of imposition (but no earlier than the above effective dates) through 06/30/1990.

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  Code the case as reverse jurisdiction (RJ) for that period.

New York cases are assigned 8-digit WCB case numbers. The case number format:

DYYSSSSS: ‘D’ is the code for WC district office, ‘YY’ is the year the case was indexed, and ‘SSSSS’ is a 5-digit sequence number beginning with 00001 on January 1^. However, for volunteer firefighters, the case number would start with F and have only a 4-digit sequence number (FDYYSSSS); and for volunteer ambulance workers, it would start with ‘A’ (ADYYSSSS).

There are cases where we need to see material that’s been ‘archived’ in NY’s online records. In this case, you can write to the State to request that they restore the file.

Write to them at:

New York State Workers' Compensation Board

PO Box 5205

Binghamton NY 13902-5205

Be sure to include the injured worker's name, address, SSN, and WC case number (the name of the employer and the carrier also help) and ask them to “restore” the workers’ compensation information (be sure to use the term "restore").

The WCB generally responds in about 3 weeks. The documents are either mailed to us, or restored electronically to the WCB website. If your diary has matured, first check the WCB website to see if the documents were loaded; if they weren't, check to see if they were mailed as paper and/or scanned into the Paperless Processing System, the CEF, or NDRED.

SIF is a WC insurance carrier, administered by the State. SIF serves the same function as the private insurance carriers; it is NOT the same as the NY Workers' Compensation Board.

Often, claimants submit correspondence from SIF that shows only the SIF claim number. The SIF claim number (not the WCB case number) can be found in the "Carrier Case Number" box on the SROI previously C-8, C-23, or similar forms, and is often the only claim number shown on correspondence or check stubs from SIF. The SIF claim number consists of eleven digits, but the last three digits only identify the SIF office code. Even when the SIF claim number is shown with only 8 digits, it will be a different number than the NY WCB claim number for the same case.

Using the link in ‘Exhibits’ below, you will reach the NY SIF web site. If you input the NY SIF claim number, the website provides the name, phone number, fax number, and email address of the Case Manager assigned to the case. To use the website, input the first 8 digits of the carrier claim number. The Case Manager can assist in clarifying the SIF payments, and frequently can supply the WCB claim number if we don't already have it.

A few carriers are self-insured, and do not report workers’ compensation benefits to the NY WC Board. An example would be the Electrical Workers Union. For self-insured carriers, technicians will need to contact the carriers directly for proof of workers’ compensation.