November 3, 2005
Governor Pataki proposes cost-saving workers' compensation reform
Governor Pataki today proposed comprehensive workers' compensation reform that lowers costs for businesses while increasing benefits for injured workers.
“We welcome this new initiative by Governor Pataki to craft a comprehensive workers' compensation package which recognizes the many inequities in the current comp system," said Daniel B. Walsh, president of The Business Council of New York State. "Taken as a whole, this initiative will help employers of all sizes and types, particularly those in New York's manufacturing community. We look forward to working with the Governor and the Legislature in a good faith effort to bring the comp system more in line with that of our competitor states.”
A release from the Governor's office said the plan would decrease business costs by 15 percent and increase benefits for injured workers by 25 percent.
“We know that lowering the cost of doing business is a proven way to create new jobs,” Governor Pataki said. “Workers’ Compensation is one of the biggest costs for businesses and if left unchecked can be an impediment to creating new jobs.”
"I urge the Legislature to work with me to enact these important reforms so that we can help New York businesses better compete, protect tens of thousands of jobs across the State and ensure benefits for injured workers,” the Governor said.
The proposal would reduce the Second Injury Fund assessment, a move The Business Council had urged lawmakers to take. The plan would reduce employers costs by more than $190 million by adjusting the calculation used to determine the assessments from 150 percent of the previous year's disbursements to 115 percent.
The proposal would create a system of tiered benefit levels for injuries that are not scheduled, authorize comprehensive fee schedules for medical goods and pharmaceuticals and would "better" coordinate anti-fraud efforts, the release said.
The proposal would also reduce frivolous claims against the Second Injury Fund and expand the Alternate Dispute Resolution program to include the unionized manufacturing sector.
"It would also increase benefit levels for workers injured on and off the job, increasing the maximum weekly indemnity benefits paid to injured workers by 25 percent from $400 to $500 per week," the release said.
The maximum disability benefit awarded to workers injured off the job would increase 100 percent, from $170 to $340, the release said.
The proposal would also:
- Establish objective medical guidelines to evaluate injuries
and illnesses in workers' comp cases.
- Prevent all workers who are incarcerated and convicted of a
crime from receiving benefits.
- Allow carriers or self-insured employers to contract with providers
to perform "diagnostic tests, x-ray examinations, MRI’s
or radiological exams and require claimants to use facilities
within that network (except in emergency cases), giving employers
greater control over
- Allow supplemental benefits for injured workers to equal up
to two-thirds of their average weekly wages.
- Authorize injured workers to receive non-emergency medical procedures
costing less than $1,000 without prior authorization.
- Require employers to file an injury report with their carrier
within 3 business days of notification of the injury. The Board
would have to be notified within five days. The proposal would
also require that carriers or self-insured employers provide the
injured workers the option of a settlement agreement.
- Move all claims that are unresolved after one year to the expedited
- Mandate that requests for discretionary full board review be
filed within 30 days and would impose a fine on employers, carriers
or clamant representatives for filing frivolous appeals.
- Require the Board to schedule a pre-hearing conference no more
than 45 days after learning a claim is disputed.
- Expand the payment-without-prejudice provision to include prescription
- Accelerate benefit delivery to injured workers by accelerating the conciliation process.
The Governor's office said the proposal would establish a pilot program to encourage the "voluntary delivery of compensation and medical benefits to injured workers without intervention by the Board, but subject to the Board's supervision."
More details on the Governor's proposal area available at www.state.ny.us/governor/press/05/1103051.htm.