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.
Last modified: February 3, 2019