Speeding up the resolution process for COVID-19 claims

Dear Claims Administrator –

Your prompt action is needed to ensure that COVID-19 claims are resolved in a timely manner, to ensure individuals with a workplace illness receive prompt and proper medical care and indemnity benefits.

The NYS Workers’ Compensation Board (Board) is requesting your immediate assistance to speed up the resolution process for COVID-19 claims when a notice of controversy has been filed. As you may know, the Board promptly schedules pre-hearing conferences for controverted cases. When a claim has medical documentation on file, the pre-hearing conference is typically held within 30 days of receipt of the notice. Scheduling a pre-hearing conference may be delayed if the Board does not have medical documentation on file. 

For COVID-19 claims, the Board is not receiving the timely medical documentation required in order to establish a claim, and we need your help in doing so. For all open COVID-19 claims, please complete your review of your claims systems and send the requested documentation to the Board no later than September 25, 2020.

• For COVID-19 claims where you have filed a notice of controversy (FROI-04 or SROI-04 transaction in eClaims), but do not have medical documentation in your case files, please contact the injured worker and request that they send you and the Board copies of COVID-19 related medical documents. Documents may be emailed to wcbclaimsfiling@wcb.ny.gov (preferred) or mailed to:

NYS Workers' Compensation Board
Centralized Mailing Address
PO Box 5205
Binghamton, NY 13902-520

• For COVID-19 claims where you have filed a notice of controversy (FROI-04 or SROI-04 transaction in eClaims), have medical documentation on file but medical documents have not been uploaded to eCase, please send such documentation to the Board at: wcbclaimsfiling@wcb.ny.gov. You can request a listing of all controverted COVID-19 claim case numbers for which the Board currently has no medical documentation by emailing datarequests@wcb.ny.gov. Please provide your W-number and contact information including your name, title, email address and phone number, and we will promptly respond.

If you are not the correct individual to respond to this request, please forward to the appropriate individual. 

Questions? Contact datarequests@wcb.ny.gov. 

Thank you for your continuing efforts to resolve these cases expeditiously. 

Sincerely,

Clarissa Rodriguez
Chair, New York State Workers' Compensation Board

This letter is available on the Board's website, including a PDF version.