N.Y. Workers' Compensation Law § 221: Determination of contested claims for disability and family leave benefits

§ 221. Determination of contested claims for disability and family

leave benefits. In accordance with regulations adopted by the chair,

within twenty-six weeks of written notice of rejection of claim, the

employee may file with the chair a notice that his or her claim for

disability or family leave benefits has not been paid, and the employee

shall submit proof of disability or entitlement to family leave and of

his or her employment, wages and other facts reasonably necessary for

determination of the employee's right to such benefits. Failure to file

such notice within the time provided, may be excused if it can be shown

not to have been reasonably possible to furnish such notice and that

such notice was furnished as soon as possible. On demand the employer or

carrier shall forthwith deliver to the board the original or a true copy

of the health care provider's report, wage and employment data and all

other documentation in the possession of the employer or carrier with

respect to such claim.

The chair or designee, shall have full power and authority to

determine all issues in relation to every such claim for disability

benefits required or provided under this article, and shall file its

decision in the office of the chairman. Upon such filing, the chairman

shall send to the parties a copy of the decision. Either party may

present evidence and be represented by counsel at any hearing on such

claim. The decision of the board shall be final as to all questions of

fact and, except as provided in section twenty-three of this chapter, as

to all questions of law. Every decision shall be complied with in

accordance with its terms within ten days thereafter except as permitted

by law upon the filing of a request for review, and any payments due

under such decision 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. The chair shall adopt rules and

regulations to carry out the provisions of this article including but

not limited to resolution of contested claims and requests for review

thereof, and payment of costs for resolution of disputed claims by

carriers. Any designated process shall afford the parties the

opportunity to present evidence and to be represented by counsel in any

such proceeding. The chair shall have the authority to provide for

alternative dispute resolution procedures for claims arising under

family leave, including but not limited to referral and submission of

disputed claims to a neutral arbitrator under the auspices of an

alternative dispute resolution association pursuant to article

seventy-five of the civil practice law and rules. Neutral arbitrator

shall mean an arbitrator who does not have a material interest in the

outcome of the arbitration proceeding or an existing and substantial

relationship, including but not limited to pecuniary interests, with a

party, counsel or representative of a party. Any determination made by

alternative dispute resolution shall not be reviewable by the board and

the venue for any appeal shall be to a court of competent jurisdiction.