WORKERS’DEPUTY Mindy Roller
COMPENSATION
CHIEF John Sweeney
The Workers’ Compensation Division represents the City and related entities at all hearings, trials, and appeals
before the New York State Workers’ Compensation Board. Additionally, the Division administers all aspects of claims
by covered employees who are injured on the job or incur an occupational disease. The Division strives to provide
employees with all the medical and wage replacement bene?ts to which they are entitled, while objecting to and, if
necessary, litigating unwarranted claims.
Bill Processing
Since medical bill processing is a significant part of the Division’s work, it is now using bill review software to partially automate the
processing of medical bills. The software automatically reduces any bill in excess of the medical fee schedule. This allows Division
employees to concentrate their efforts on determining whether the treatment being billed is related to the case and whether the
treatment is consistent with the Workers’ Compensation Board’s treatment guidelines.
New York enacted its workers’ compensation statute to address the inequities historically existing among employers and employees
with regard to workplace injuries. The New York statute operates on the premise of a tradeoff. Employers assume all liability for
injuries arising out of, and in the course, of employment—regardless of fault. Workers receive limited wage replacement benefits for
lost earning capacity, and are entitled to have all related and necessary medical costs paid. In exchange, employees are prohibited
from suing employers for personal injuries.
New York City is a self-insurer of its workers’ compensation obligations pertaining to the approximately 200,000 covered City
employees. Employees not covered under this statute, but rather by union contracts, include uniformed police officers, firefighters,
and uniformed sanitation workers.
Exposure to Medical Issues
Claims involve nearly every conceivable medical condition, including work-related psychiatric diagnoses, respiratory ailments, heart
conditions, and orthopedic conditions. Division attorneys thus acquire a broad range of medical knowledge and obtain excellent
experience by regularly cross examining medical and lay witnesses.
Diagnostic Testing
In order to reduce costs and provide timely medical attention, the Division recently embarked on a program to provide necessary
diagnostic tests. Through the program, employees who need tests such as X-rays and MRIs are provided with contact information for
a test coordinator designated by the Division. They are given a list of facilities in their area and can schedule their test at the facility
of their choice. Tests can be arranged with a single phone call and take place in the space of a few days. The test results are then
sent to the employee’s treating doctor. This process has resulted in prompt testing and reduced costs through negotiated test fees.
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Practice Spotlight
Signi?cant Matters from 2010 Included:
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Receiving and indexing over 15,000 new claims.
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Paying over $170 million in wage replacement benefits and medical costs to injured employees.
Representing the City at 15,000 hearings, trials, and appeals before the New York State Workers’
Compensation Board.
Processing over 230,000 medical bills.
Obtaining revenue recoveries in excess of $9 million from various sources, including State funds, lien
satisfaction, and insurance arbitration.
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