N.Y. Workers' Compensation Law § 20: 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.