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  WORKERS COMPENSATION PENALTIES

Workers Compensation Penalty Removed

New York state has passed a particularly onerous law against the small business community.

The law charges business that have employees a $250 file for every day that they do not have Workers Compensation Insurance or the statutory disability insurance.  The Department in charge collecting these penalties is:

State of New York, Workers Compensation Board, Bureau of Compliance, 20 Park Street

Albany, NY 12207 , Attention redetermination Unit

 This is a huge trap for most business starting up.  Many of the payroll companies don't even warn their customers of the law when they sign up for the service.

These fines begin from the first day the company had employees and the fines add up,  These are among the largest fines I have seen levied against small business owners.  I have seen start-ups businesses with 2 and three employees get hit with fines of $30,000 to the one person even got a $110,000 penalty.  Furthermore the officers of these companies are held PERSONALLY LIABLE for these penalties.  The officer have to pay the debt even if they close the company.

Our firm has successfully fought and won many reductions and elimination of penalties.  However the longer the business owner waits to have us fight the penalties the harder it is to have it reduced. So if you received a penalty letter form the Workers Compensation Judgment Unit, then call me immediately at 718 558-5532.   I will help remove these penalties.

- Thomas McGovern, MBA

I get you Workers Compensation Insurance and we remove the penalties imposed by the workers compensation Board

I am expert in Workers Compensation Insurance

If your business has been closed shut down for not having Workers compensation insurance call us immediately!

I will remove, abate, eliminate or reduce your workers compensation penalty.  I guarantee it. 

Call me now if you have any questions about workers Compensation insurance in New York State (929) 290-8609

See workers compensation laws and definition of terms below to learn how to Remove workers Compensation penalties and fines.  Learn How to have your business open again after you have received a cease and desist order from the WCB Workers Compensation board inspectors.

�  220.  Penalties.  1.  Any  employer who fails to make provision for   payment of disability benefits
 as required by section two hundred eleven   of this article within  ten  days  following  the  date  on
 which  such   employer  becomes  a  covered employer as defined in section two hundred   two shall be 
guilty of a misdemeanor and upon conviction  be  punishable   by  a  fine  of  not  less  than  one hundred
 nor more than five hundred   dollars or imprisonment for not more than one year or both, except  that
 where  any  person  has  previously  been convicted of a failure to make   provisions for payment of
disability benefits within the preceding  five   years, upon conviction for a second violation such person 
shall be fined   not  less  than two hundred fifty nor more than one thousand two hundred   fifty dollars 
 in  addition  to  any  other  penalties  including  fines   otherwise provided by law, and upon conviction
 for a third or subsequent   violation  such  person  may  be  fined  up to two thousand five hundred
 dollars in addition to any other  penalties  including  fines  otherwise   provided  by  law. 
 Where  the employer is a corporation, the president,   secretary, treasurer, or officers  exercising  
corresponding  functions,   shall each be liable under this section.     

2.  The  chairman, or any officer of the board designated by him, upon   finding that an employer has
 failed to make provision for the payment of   disability benefits, shall impose upon such employer 
a  penalty  not  in   excess  of  a  sum  equal  to  one-half  of one per centum of his weekly   payroll
 for the period of such failure and a further sum not  in  excess   of  five hundred dollars, which sums 
shall be paid into the fund created   under section two hundred fourteen.     3. If for the purpose of 
obtaining any benefit or  payment  under  the   provisions  of  this  article,  or  for  the  purpose of 
influencing any   determination regarding any benefit payment, either for himself  or  any   other person,
 any person, employee, employer or carrier wilfully makes a   false  statement or representation or fails
 to disclose a material fact,   he shall be guilty of a misdemeanor.     4. Whenever a carrier shall fail
 to make prompt payment of  disability   benefits  payable under this article and after hearing before an 
officer   designated  by  the  chairman  for  that  purpose,  the  chairman  shall   determine  that 
 failure  to  make  such prompt payment was without just   cause, the chairman shall collect from the 
carrier a sum not  in  excess   of  twenty-five per centum of the amount of the benefits as to which the  
 carrier failed to make payment, which  sum  shall  be  credited  to  the   special  fund  for  disability 
 benefits.  In addition, the chairman may   collect and pay over to the employee the sum of ten dollars
 in  respect   to  each  week,  or  fraction  thereof, for which benefits have not been   promptly paid. 
 
 5. In addition to other penalties herein provided, the chairman  shall   remove  from  the  list  of 
physicians authorized to render medical care   under the provisions of  articles  one  to  eight,  
inclusive,  of  this   chapter  and from the list of podiatrists authorized to render podiatric   care 
under section thirteen-k of this chapter,  and  from  the  list  of   chiropractors  authorized  to 
 render  chiropractic  care  under section   thirteen-l of this chapter the name of any physician  or 
 podiatrist  or   chiropractor  whom  he  shall  find, after reasonable investigation, has   submitted 
to the employer or carrier or chairman in connection with  any   claim  for  disability  benefits  under 
 this  article,  a  statement of   disability that is not truthful and complete.     

6. In addition to other penalties herein provided, any person who  for   the  purpose  of  obtaining any
 benefit or payment under this article or   for the purpose of influencing any determination regarding  
any  benefit   payment,  knowingly  makes  a  false statement with regard to a material   fact, shall not 
be entitled to receive  benefits  with  respect  to  the    disability  claimed  or  any  disability  
benefits  during the period of   twelve calendar months thereafter; but this penalty shall not be applied
 more than once with respect to each such offense.     7.  All  fines  imposed  under  subdivisions  one 
and three, except as   herein otherwise provided, shall be paid directly and immediately by the   officer
 collecting the same to the chair, and be  paid  into  the  state   treasury,  provided,  however, that all
 such fines collected by justices   of the peace of towns and police justices of villages shall be  paid 
 to   the  state  comptroller  in  accordance  with  the provisions of section   twenty-seven of the town
 law and section one hundred eighty-five of  the   village law, respectively.     

8.  (a) The head of a state or municipal department, board, commission   or office authorized or required
 by law to issue any permit  for  or  in   connection  with  any  work  involving  the  employment  of
 employees in   employment as defined in this article, and notwithstanding  any  general   or  special  
statute requiring or authorizing the issue of such permits,   shall not issue such permit unless proof 
duly subscribed by an insurance   carrier is produced in a  form  satisfactory  to  the  chair,  that  
the   payment  of  disability  benefits  for all employees has been secured as   provided by this article.
 Nothing herein, however, shall  be  construed   as  creating  any  liability  on  the  part  of  such 
state or municipal   department, board, commission or office to pay any  disability  benefits   to any 
such employee if so employed.     (b)  The head of a state or municipal department, board, commission or
 office authorized or required by law to enter into any contract  for  or   in  connection  with  any 
 work involving the employment of employees in   employment as defined in this article, and notwithstanding
 any  general   or special statute requiring or authorizing any such contract, shall not   enter  into 
 any  such  contract  unless  proof  duly  subscribed  by an   insurance carrier is produced in a form
 satisfactory to the chair,  that   the payment of disability benefits for all employees has been secured
 as   provided by this article.

Glossary of Workers' Compensation Terms

Abey a Case:
To refile a case, with a notation that an Examiner is to review the case by a specified future date.
Abey an Issue:
To postpone a decision on an issue in a case until a later date, when it is expected than additional pertinent information may or will be available.
Accident (Work-Related):
(WCB) An event, arising out of and in the course of employment, that results in personal injury to a worker.
Accident Date:
(WCB) Refers to either (a) the date the accident is deemed to have occurred or (b) the date of onset assigned to an occupational disease. The accident date is officially established by a Law Judge.
Accident, Notice and Causal Relationship (ANCR):
(WCB) Minimal conditions that must be met before financial responsibility can be assigned to a claim for workers' compensation. Specifically, it must be established that
??? a work-connected accident covered by the Workers' Compensation Law occurred;
??? following the accident, the claimant notified his/her employer within the time limit required by the Workers' Compensation Law; and
??? a causal relationship exists between the accident and a resulting injury or disability.
Adjourn (a Hearing):
(WCB) To put off or suspend until a future time, without making any findings.
Adjudication:
The act or process of adjudicating. A judicial decision or sentence.
Appeal:
(WCB) A legal action taken by one of the parties to the Appellate Division, Third Department, to reverse or amend a decision or direction made by a Board Panel or the Chair of the Workers' Compensation Board.
Apportionment:
(WCB) A proportionate division of all or part of the liability in a case between two or more sources of disability for the same claimant, based on an evaluation of the relative contribution that the sources of disability have made to the claimant's permanent disability.
Arising Out of and in the Course of Employment:
(WCB) Two necessary conditions that must be met to establish a work-connected accidental injury; an injury that "arises out of" is one that results from a hazard of the employment, while an injury "in the course of employment" is one that occurred at a time, place and under circumstances related to the employment.
Attorney Fees:
(WCB) Fees approved by the Board for claimant attorneys in workers' compensation cases. Under WCL .24, no claims for services or supplies are enforceable unless approved by the Board and, if approved, such claims become a lien upon the compensation awarded.
Average Weekly Wage (AWW) for Workers' Compensation Claims:
Wage used to calculate total disability benefit rates for most claimants. Defined at 1/52nd of the injured worker's average annual earnings (200-300 times average daily wage, depending on work schedule), based on the prior year's payroll data. If an injured worker has not worked a substantial portion of the immediately preceding year, the average wage of a comparably employed worker is used in the Board's calculations.
Average Weekly Wage (AWW) for Disability Benefits Claims:
Wage used to calculate disability benefit rates. AWW for disability benefits is based on the disabled employee's earnings during the eight weeks prior to the start of disability.
Board Panel:
(WCB) A panel, usually comprised of three Workers' Compensation Board members (at least one of whom must be a lawyer), that reviews requests to amend decisions made by Workers' Compensation Law Judges, reopens closed cases and considers applications for lump sum non-schedule adjustment awards.
Calendar:
A list of the cases scheduled to be heard on a given date at a specific part at a district office or hearing point.
Cancel (a Case):
(WCB) An action by the Board to nullify indexing when two case numbers are assigned to a single claim.
Case:
(WCB) A reported work injury or illness which has been assembled and assigned a case number (indexed) by an indexing unit of the Workers' Compensation Board.
Case Number:
(WCB) A unique identifier assigned by the Workers' Compensation Board at the time a case is assembled. The case number consists of 8 characters and begins with an alpha character, followed by seven numeric characters. For example, G1234567.
???Volunteer ambulance workers' cases will begin AA, followed by six numbers (e.g. AA123456).
???Volunteer firefighters' cases will begin with FA, followed by six numbers (e.g. FA123456).
Cause of Accident:
(WCB) Object, substance or condition that directly contributed to the occurrence of an accident.
Causation/Causative Factor:
The fact of being the cause of something produced or of happening. The act by which an effect is produced. An important doctrine in fields of negligence and criminal law.
Claim:
(WCB) A request, on a prescribed Form C-3, for workers' compensation for work-connected injury, occupational disease, disablement, or death (Form C-62). A claimant must file a claim within a two-year period from the occurrence of the accidental injury, knowledge of occupational disablement, or death. Failure to file a claim may bar an award for compensation unless the employer has made advance benefit payment or fails to raise the issue, in which event the claim filing requirement is deemed waived.
(NYCIRB, Carriers) A demand for payment or recovery for loss under an insurance contract. Cases are counted as claims only when a payment is made (for indemnity and/or medical benefits) or a reserve is established.
Claims Information Systems (CIS):
(WCB) A data system used by the Board's Claims Unit to record basic case information such as parties of interest, current issues and scheduled hearings. CIS has historically been utilized in calendaring of cases (i.e., establishing hearing schedules) and in case identification.
Classification Code:
(NCCI, NYCIRB) A system of insurance risk classification based on industrial or occupational categories, supported by the National Council on Compensation Insurance and in use in about 40 states where private insurance is available. The system, which includes several thousand 4-digit numeric codes (with more than 700 classifications in use in New York), is extensively used to identify an employer's rate making class(es) and establish basic pricing for workers' compensation insurance.
Close (a Case):
(WCB) To remove a case from further consideration; a decision to close a case is based on a judge's determination that no further rulings by the Board will be necessary in the case. A case closing is effected by a statement on a WCB decision (e.g., "Case is closed."). The closing date is the date of the hearing or the effective date of the decision. A Board Panel may also close a case.
Compensated Cases Closed (CCC):
(WCB) A data system used to summarize cases that have been closed with an award of indemnity benefits during a particular calendar year. The annual files generally contain 120,000-140,000 case records and include information about case/claimant background, employment, injury/accident characteristics, extent of disability, indemnity benefits and selected decision characteristics.
Conciliation:
(WCB) A Workers' Compensation Board process established to resolve, in an expeditious and informal manner (e.g. through meetings or telephone conferences), issues involving non-controverted claims in which the expected duration of benefits is fifty-two weeks or less. Failure to reach an agreement through the conciliation process results in the case being scheduled for a hearing.
Contested:
To bring an action at law. To make the subject of dispute, contention, or litigation.
Continue (a Case):
(WCB) To complete a hearing on a case without closing the case, leaving additional matters to be resolved at a future hearing.
Controverted Claim:
(WCB) A claim challenged by the insurer on stated grounds. The Board sets a pre-hearing for the determination of the grounds and directs the parties to appear and present their case.
C-2:
A Board form titled "Employer's Report of Work-Related Accident or Occupational Disease" filed by employers within ten days after an accident occurs, as required by WCL .110. The form includes a section identifying the case and principal parties and additional sections labeled "Accident," "Injured Person," "Nature of Injury," "Cause of Accident," and "Fatal Cases." Failure to make timely C-2 filings subjects employers to potential administrative and criminal penalties.
C-3:
A Board form titled "Employee's Claim for Compensation," that should be completed by the injured worker and submitted to the Board within two years of the accident or onset date. The C-3 form contains much of the same information as the C-3 (sections describing the Injured Person, Employer, Place and Time of accident, Injury, Nature and Extent of Injury, Medical Benefits received, Compensation Benefits received/claimed, etc.).
C-4:
A Board form titled "Attending Doctor's Report," that requests information about claimant/claim identification, claim parties of interest, injury history, diagnosis, treatment, disability, causal relation of accident to disability, and degree of impairment. The form is to be filed by the doctor within two days of initial treatment, with additional reports during continued treatment, including a final report.
C-7:
A Board form titled "Notice that Right to Compensation is Controverted," that a carrier (as appropriate) must file within (1) 18 days of the date disability begins or (2) ten days of the date the employer first had knowledge of the alleged injury, whichever is later. Within 25 days from the Board's mailing of a notice of indexing in volunteer firefighter or volunteer ambulance worker cases.) The form contains
??? information identifying the claim, person (allegedly) injured, employer and carrier,
??? a description of the alleged injury and town/county/state where alleged injury occurred,
??? reasons why right to compensation is controverted,
??? dates for start of alleged disability, employer/carrier first knowledge of injury, receipt of a C-2 from the employer and
??? statement concerning whether notification has been given to the disability benefits insurance carrier, and date of notification.
C-8/8.6:
A Board form titled "Notice that Payment of Compensation for Disability has been Stopped or Modified," that carriers are required to file within 16 days of the date on which benefit payments are stopped or modified. The form includes
??? information identifying the claim, injured person, employer and carrier,
??? a summary of total disability benefits, partial disability benefits and disfigurement awards paid,
??? a summary of the claimant's return-to-work and earnings status and
??? if appropriate, an explanation of why indemnity benefits have not been paid in full. Depending on circumstances cited by the carrier and the claimant's response, the filing of a C-8/8.6 may or may not trigger an immediate hearing.
Debarment:
The 2007 Workers' Compensation Reform Legislation included provisions that would prevent employers that had various types of workers' compensation noncompliance infractions from bidding on Public Work Projects. NYS governmental entities including State, county and municipal agencies may not contract with businesses that are listed on a Debarment List.
Decision:
A determination arrived at after consideration. A report of a conclusion.
Decision and Award Data System (D&A):
A recently added component of the Board's Claims Information System designed to facilitate production of trial calendar decision notices and other materials prepared by Claims unit keyboard specialists. The system is also being developed as a source of information about case/decision characteristics and indemnity benefits.
Dependent
A person eligible to receive death benefits in a fatal injury case; the regular receipt of contributions by the alleged dependent upon which he/she relies and needs to sustain his/her customary mode of living constitutes dependency. Surviving widows and children under age 18 years are eligible for benefits without proving dependency, and other eligible recipients (if dependency is established) may include dependent handicapped children over age 18 years of age, grandchildren, brothers and sisters under age 18, dependent parents and grandparents.
Disablement:
To deprive of legal right, qualification, or capacity. To make incapable or ineffective; esp: to deprive of physical, moral, or intellectual strength.
District:
(WCB) One of the Board's ten regions of New York state. The regions are Albany, Binghamton, Brooklyn, Buffalo, Long Island, Manhattan, Peekskill, Queens, Rochester and Syracuse.
Examiner:
(WCB) Incumbent in the Workers' Compensation Examiner job title series who performs examining work, applying knowledge of law and of Board rules, regulations, policies and procedures to compensation and disability benefit case information. Among the actions regarding workers' compensation cases that Examiners may perform:
??? determining whether a case should be indexed;
??? evaluating claim forms and developing information required by judges for case decisions;
??? requesting information (by phone, letter, etc.) needed for case development;
??? evaluating whether a compensation case may be processed on an informal calendar;
??? referring appropriate cases to the conciliation process; and
??? preparing formal notices of decision based on judge's directions.
Exclusive Remedy:
The premise on which the Workers' Compensation system is based: workers gave up the right to sue the employer in exchange for medical care for payment for their injuries.
Experience Rating:
A method for determining an employer's workers' compensation premiums that reflects a) a comparison of the employers recent loss experience with the amount the employer would have been expected to pay if it had been an average employer in the same industry with the same payroll and b) the credibility or confidence assigned to the employer's loss experience. In practice, insurers assign no credibility to employers with average class premiums below a certain amount (e.g., $5,000/yr).
Extent of Disability:
(WCB) A single-digit numeric code used by the WCB's Research and Statistics unit to characterize the disability classification assigned to a case closed with indemnity benefits. The codes are:
0 = Death case
1 = Permanent total disability
2 = Permanent partial disability (PPD) - Schedule award only
3 = Facial disfigurement award only
4 = Schedule PPD and facial disfigurement award
5 = Temporary disability only
6 = Temporary disability and facial disfigurement award
7 = Non-schedule PPD - Lump sum settlement
8 = Non-schedule PPD - No present loss of earnings
9 = Non-schedule PPD - Carrier to continue payments
Final Adjustment Hearing:
(WCB) A hearing held in cases involving the loss or loss-of-use of a member or organ of the body in which the principal issue is the extent of loss or loss-of-use (e.g., claims normally involving schedule awards).
Hearing:
(WCB) The WCL provides that no case may be closed without notice to all interested parties, with all such parties having an opportunity to be heard. Board hearings are held before Workers' Compensation Law Judges who hear and determine claims for compensation, for the purpose of ascertaining the rights of the parties. The Board, upon receipt of an application for review of a judge's decision, may also hold hearings.
Hearing Point:
Facilities, other than the seven District Offices, for which calendars are prepared and at which hearings are held.
Indemnity Benefits:
Compensation paid to the workers' compensation claimants for non-medical loss resulting from an injury or illness. Six types of award are permitted by the WCL:
??? temporary total disability benefits (for periods of total wage loss);
??? temporary partial disability benefits (for periods of partial wage loss);
??? facial disfigurement awards (at judge's discretion but subject to a maximum, for cosmetic facial disfigurement resulting from the accident or exposure);
??? permanent partial disability benefits (for loss if physical function or for periods of partial wage loss after a claimant has been classified as having a permanent partial disability);
??? permanent total disability benefits (for loss of wage earning capacity after a claimant has been classified as having a permanent total disability); and
??? death benefits (compensation benefits awarded to spouse, children or under certain circumstances, other family members following a work-related death).
Indexed Claim:
(WCB) A claim case folder which has been assembled and assigned a case number by the Board's Claims Unit.
Judge:
See Workers' Compensation Law Judge.
Jurisdiction:
(WCB) The right to hear and determine a workers' compensation case. The Board has jurisdiction over cases with employment in NYS. Notable exclusions from the Board' jurisdiction in New York State include: federal government workers and certain employees of local government, many NYC government occupations (civil service police, firefighters, sanitation workers), most NYC teachers, and casual employments (yard work by minors, baby-sitters, etc.). Workers covered by separate compensation systems under federal laws (maritime employments, merchant seafarers, interstate railroad employees, etc.) may elect to submit to NYS jurisdiction by waiving their federal rights and remedies. Coverage for some worker classes in NYS is elective (e.g., part-time household workers, sole proprietors, corporate officers, certain musicians, and farm workers earning less than $1,200 per year).
Licensed Representative:
(WCB) (a) Any person other than an attorney who is authorized by the Board to represent claimants or insurance carriers before the Board and, in some instances, to receive a fee, fixed by the Board, for such services. (b) Any person other than an attorney who is authorized by the Board to represent self-insurers before it.
Licensed Claimant Representative:
(WCB) (a) Any person other than an attorney who is authorized by the Board to represent claimants or insurance carriers before the Board and, in some instances, to receive a fee, fixed by the Board, for such services. (b) Any person other than an attorney who is authorized by the Board to represent self-insurers before it.
Lost Time:
(WCB) A period of total wage loss and loss of earning capacity, beyond the statutory waiting period, caused by the claimant's work-connected disability. In workers' compensation cases only, if the disability period exceeds 14 days, compensation will be paid from the first day of disability. There is no waiting period for volunteer ambulance worker or volunteer firefighter cases.
Lump Sum Settlement:
(WCB) A negotiated and Board-approved agreement, termed a "non-schedule adjustment," between a claimant with a non-schedule permanent partial disability and the insurer(s). As a result of the agreement the claimant receives a sum of money representing all future compensation for his/her disability, and the case is considered closed. Under WCL .15(5-b), granting of a settlement by the Board requires that (a) the right to compensation has been established and compensation has been paid for at least three months, (b) the continuance of disability and of future earning capacity cannot be ascertained with reasonable certainty, (c) there has been a physical examination of the claimant prior to approval, and (d) the Board considers the settlement "fair and in the best interest of the claimant." In practice, lump sum settlements are usually final, but the law provides for reopening's if the Board finds that there has been a change in condition or degree of disability not contemplated at the time of the settlement.
Manual Rates:
The listed premium, stated as dollars per $100 of weekly earnings for each employee, in a state's current schedule; in New York the manual rates are linked to the Classification Code system (i.e., rates are stated for each work classification code used in the state).
Maximum Medical Improvement (MMI):
(WCB) An assessed condition of a claimant based on medical judgment that (a) the claimant has recovered from the work injury to the greatest extent that is expected and (b) no further change in his/her condition is expected. A finding of maximum medical improvement is a normal precondition for determining the permanent disability level of a claimant.
Medical Benefits:
Medical treatment provided, under the Workers' Compensation Law, to injured workers as a result of injuries arising out of and in the course of employment.
Medical Fee Schedule:
A schedule, established by the Chair of the Workers' Compensation Board, of charges and fees for medical treatment and care furnished to workers' compensation claimants.
Medical Treatment:
(WCL) Care (other than first aid) administered by a physician, chiropractor or podiatrist or on a physician's referral, by a psychologist, or physical or occupational therapist.
Misclassification:
(An action by an employer to intentionally attempt to reduce required workers' compensation insurance premiums by misclassifying employees as "independent contractors", and/or misclassifying the work that of a business to a classification that is less hazardous. An employer must keep accurate records of the number of employees, classification, wages and accidents for their business for four years. Failure to keep adequate and/or accurate records may result in a fine of $1,000 per every 10-day period of noncompliance or two times the cost of compensation. Additionally, the fine for criminal conviction is from $1,000 to $50,000.
Misrepresentation:
An action by an employer to intentionally attempt to reduce required workers' compensation insurance premiums by not keeping accurate/adequate payroll records, paying workers "off the books", misclassifying employees as "independent contractors" and/or misclassifying the work that of a business to a classification that is less hazardous. An employer must keep accurate records of the number of employees, classification, wages and accidents for their business for four years. Failure to keep adequate and/or accurate records may result in a fine of $1,000 per every 10-day period of noncompliance or two times the cost of compensation. Additionally, the fine for criminal conviction is from $1,000 to $50,000.
Modify a Decision:
A decision that partially changes a previous decision -- e.g., a Board Panel memorandum of decision which amends a Workers' Compensation Law Judge decision.
Motion Calendar Hearing:
(WCB) In a case in which no controversy or outstanding issue exists, a proposed decision is prepared and the parties are notified. A hearing is held only if one of the parties objects to the proposed decision.
National Council on Compensation Insurance (NCCI):
An association of workers' compensation insurers which serves as the workers' compensation rating organization in about two-thirds of the states. The group establishes standards for use in rate making, develops policy forms, collects statistics, and provides statistical support and services.
National Institute for Occupational Safety and Health (NIOSH):
An agency within the U.S. Department of Health and Human Services established in 1970. It is part of the Center for Disease Control and Prevention and is generally responsible for conducting research and making recommendations for the prevention of work-related illnesses and injuries. NIOSH's responsibilities include: investigating potentially hazardous working conditions (as requested by employer or employees), evaluating workplace hazards, creating and disseminating methods for preventing disease/injury/disability, conducting scientifically valid research on safety issues, and providing education and training in the field of occupational safety and health.
New York Compensation Insurance Rating Board:
A private, non-profit association of licensed insurance companies that provide workers' compensation insurance in New York; the organization is responsible (among other things) for collecting and reviewing compensation loss experience from carriers, developing policy forms and rating plans, conducting actuarial analyses and preparing rate filings with the New York State Insurance Department.
Non-Compensated Case:
A closed case which has never awarded indemnity benefits.
Non-schedule Permanent Partial Disability:
Non-fatal injuries that do not involve schedule permanent partial disabilities or cosmetic facial disfigurement and in which the claimant retains some earning capacity are assigned permanent disability benefits based on the claimant's actual or presumed wage loss, with benefits to continue for the duration of the wage loss disability.
Notice:
Written notification from an employee to his/her employer, indicating that a work-connected injury or injury has occurred. For accidental injuries, notice must be given no later than 30 days after the accident; the Board must excuse a failure to give notice on the grounds that a) for some reason, notice could not have been given; b) the employer had knowledge of the accident; or c) the employer's case has not been prejudiced. In cases involving occupational diseases, the time period for notice is 2 years from the date of disablement or from the date when the employee knew, or should have known, that the disease was due to the nature of employment.
Occupation:
(Census Bureau) A numeric coding structure widely adopted by federal, state and private occupation analysts, for identifying the occupation of an injured worker.
Occupational Disease (OD):
A disease arising from employment conditions for a class of workers, with the disease occurring as a natural incident for particular occupations, distinct from and exceeding the ordinary hazards and risks of employment. To be considered an occupational disease, there must be some recognizable link between the disease and some distinctive feature of the workers' job.
Occupational Disease, Notice and Causal Relationship (ODNCR):
(WCB) Minimal conditions that must be met before financial responsibility can be assigned to a claim for workers' compensation based on occupational disease. Specifically, it must be established that (a) the claimant has an occupational disease recognized by the WCL, (b) the claimant has, after the onset of the disease, notified his/her employer within the statutory time limit (two years from date of disablement or from date when claimant knew or should have known that the disease was due to the nature of the employment, whichever is greater), and (c) a causal relationship exists between work-related activities and exposure, the development of the occupational disease, and a subsequent disability.
Occupational Illness:
Any abnormal condition or disorder, other than one resulting from an occupational injury, caused by exposure to environmental factors associated with employment; it includes acute and chronic illnesses or diseases which may be caused by inhalation, absorption, ingestion or direct contact.
Occupational Injury:
Any injury, such as a fracture, sprain, amputation, etc. - which results from a work accident or other exposure involving a single accident in the work environment.
Party of Interest:
The claimant, employer, carrier and any statutory fund that may be liable in the particular case.
Planned Coverage:
An employer may provide benefits under a Board approved Plan for Disability Benefits (or one negotiated by agreement and accepted by the Chair of the Board as meeting the requirements of the NYS Disability Benefits Law (DBL)) ONLY when such a Plan is insured through one of the carriers licensed by New York State to write statutory disability benefits insurance policies or by an employer who has been authorized by the NYS Workers' Compensation Board to self-insure for disability benefits. All Plans accepted by the NYS Workers' Compensation Board shall cover only those employees that are eligible for benefits under the NYS DBL. Such accepted Plans must meet ALL statutory requirements as set forth by the NYS DBL.
Premium:
The total amount paid for an insurance policy. For workers' compensation insurance, premiums are normally calculated using a rate per $100 of the payroll for covered employees.
Reduced Earnings:
(WCB) A compensation rate based on the claimant's partial wage loss or partial loss of earning capacity due to a condition related to a compensable work-connected injury.
Reimbursement, Request for:
A request by an employer for reimbursement for wages paid to an employee for a period during which the employee was eligible to receive workers' compensation or disability benefits. A request by a compensation carrier for reimbursement out of the Special Disability Fund. A request by a disability benefits carrier for reimbursement of benefits paid to a claimant while the workers' compensation case was being litigated.
Reopened Case:
A workers' compensation case which has been closed by a Workers' Compensation Law Judge or a Board Panel that is subsequently made active again to determine the claimant's eligibility for benefits.
Reopened Cases Fund:
(WCB) A fund established to assume liability for additional awards in cases in which the application to reopen the case occurs more than seven years from the date of injury and more than three years from the payment of the last payment of compensation. The Fund is financed through payments in non-dependency death cases and through assessments made periodically against all carriers.
Request for Further Action:
When a Party-of-Interest in a case requests Board intervention.
Rescind (a Decision):
(WCB) A Board Panel memorandum of decision which voids or annuls a Workers' Compensation Law Judge decision. Decisions to rescind are usually issued without prejudice in order to allow the parties to present evidence or testimony not previously presented to a Workers' Compensation Law Judge.
Rescind (a Penalty):
(WCB): In certain instances the NYS Workers' Compensation Board issues a penalty for noncompliance with the mandatory coverage provisions of the NYS Workers' Compensation Law for workers' compensation and/or disability benefits to a legal entity that is not required to carry such insurance policy(ies). The Workers' Compensation Board will review documentation submitted by the legal entity that shows that such coverage is not required and the Workers' Compensation Board will "rescind" (withdraw or cancel) the penalty action. The legal entity is not required to pay the penalty amount related to the rescinded penalty.
Review Bureau:
(WCB) A department of the Workers' Compensation Board which processes requests for reopening's of closed cases and objections to Workers' Compensation Law Judge decisions. In addition, the unit previously processed requests to close compensation cases with lump sum non-schedule adjustments, but since 1995 such requests have been handled by the district offices.
Review, Request for:
(WCB) A written request for a Board Panel review of a Workers' Compensation Law Judge decision.
Schedule Permanent Partial Disability:
(WCB) Maximum benefit week schedules in the WCL are generally used in determining lifetime benefits for injuries to major body parts. Injuries amounting to less than a 100 percent functional loss are awarded a percentage of the scheduled weeks, and there are also provisions for additional weeks required for a protracted healing period.
Second Injury Fund:
A special fund, technically known in New York as the Special Disability Fund, which assumes, in certain cases, part of the permanent disability liability resulting from injuries to previously handicapped workers. The fund, which is funded by assessments against carriers and self-insureds, was created to assure handicapped workers receive full workers' compensation benefits, while encouraging employers to hire physically handicapped persons by protecting them against disproportionate liability in the event of subsequent employment injury.
Self-Insurance:
(WCB) In lieu of purchasing insurance from an insurance carrier, an employer or group of employers may assume the liability for the payment of workers' compensation benefits to employees by depositing securities or a surety bond in an amount required by the Board.
Special Funds:
Funds established under the WCL to assure payments of benefits associated with claims, usually by transferring all or part of the liability to the Fund.
State Insurance Fund:
A quasi-public agency whose activities include a) providing workers' compensation insurance coverage to private and public employers; b) providing other lines of insurance coverage; and c) acting as an agent in NYS in workers' compensation cases involving NYS employees. The State Insurance Fund must offer workers' compensation insurance to any employer requesting it, making the Fund an "insurer of last resort" for employers otherwise unable to obtain coverage.
Statutory Disability Benefits Insurance Policy:
New York is one of a handful of states that require employers to provide disability benefits coverage to employees for an off-the-job injury or illness. Cash benefits are 50 percent of a claimant's average weekly wage, but no more than the maximum benefit allowed, currently $170 per week. Benefits are paid for a maximum of 26 weeks of disability during 52 consecutive weeks. Coverage for statutory disability benefits can be obtained through a disability benefits insurance carrier who is authorized by the NYS Workers' Compensation Board to write such policies. Another option is for large employers to become authorized by the Board to self-insure.
Stop Work Orders:
A stop work order means that a business MUST cease all operations ??" no work at all may take place until the Stop Work Order is officially removed. Section 141-b of the WCL states that a business may be issued a stop work order if workers' compensation coverage is not in place. Receipt of a stop work order may lead to disbarment from any State, municipal or public body Public Works contract or subcontract for 1 year (5 years for felony conviction).
Symptomatic Treatment:
Medical treatments aimed at providing relief from the symptoms of a disease or injury, rather than providing a permanent remedy to the underlying condition.
Tentative Rate:
A weekly rate assigned by the Workers' Compensation Board for carrier indemnity payments, pending final adjudication of outstanding issues relating to benefit rates.
Third Party Action:
(WCB) This term refers to lawsuits against equipment manufacturers, facility owners and other non-employer parties whose products or services contributed to the occurrence of an accident. Under WCL, a compensation claim is a workers' sole remedy against the employer, but lawsuits may be initiated against third parties for contributory negligence, product defects, etc.
Total Disability:
With meaning of workers' compensation acts, means lack of ability to follow continuously some substantially gainful occupation without serious discomfort or pain and without material injury to health or danger to life.
Trial Calendar Hearing:
(WCB) A regularly scheduled hearing on a case conducted by a WCLJ that is designed to permit the introduction of evidence and/or witnesses and the presentation of arguments by the parties.
Uninsured Employers' Fund:
A special fund which provides for the payment of workers' compensation cases where the employer was not insured nor self-insured and has defaulted in the payment of workers' compensation.
Wage:
See Average Weekly Wage.
Wage Expectancy:
(WCB) A decision element assigning an artificial wage rate to a young claimant, based on the authority of WCL .14(5).
Wage Replacement:
(WCB) The proportion of pre-injury wages replaced by workers' compensation benefits.
Waiting Period:
(WCB) Period covering the first seven days of disability resulting from a work-connected injury or illness. Workers' compensation indemnity benefits are not allowable for the first seven days of disability, except that (a) in cases where the disability period exceeds 14 days, indemnity awards are allowed from the date of disability, and (b) there is no waiting period for VAWBL/VFBL cases.
Workers' Compensation Board, New York State (WCB):
(a) The agency charged with administering the Workers' Compensation Law, the Volunteer Ambulance Workers' Benefit Law and the Volunteer Firefighters' Benefit Law and the Disability Benefits Law. (b) The thirteen member Board responsible (directly or through review of delegated authority) for determining all issues involving claims under the WCL. Members are appointed to seven-year terms by the Governor, by and with the advice and consent of the Senate. The Governor designates the Chair and Vice-Chair.
Workers' Compensation Law (WCL):
Chapter 67 of the Consolidated Laws, governing the workers' compensation system; separate laws cover compensation benefits for volunteer firefighters and volunteer ambulance workers.
Workers' Compensation Law Judge (WCLJ; Compensation Claims Referee):
(WCB) An officer appointed by the Chair of the Workers' Compensation Board from a Civil Service competitive process to hear and determine claims and to conduct such hearings and investigations and make such orders, decisions and determinations as may be required in the adjudication of the claims. A Judge's decision is deemed the decision of the Board unless the Board modifies or rescinds such decision.


Thomas McGovern, MBA, CVA
Sanjay Agrawal, President
Kedar Gupta, Director
Augustine Sampa, Director
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We service the following areas: Queens, Brooklyn, Manahattan, Bronx, Staten Island, Kings County, Richmond County, Nassua County, Suffolk county,Astoria, Ditmars, Steinway, Bayside, Bay Terrace, Oakland Gardens, Belle Harbor, Bellerose. Breezy Point. Broad Channel. Cambria Heights. College Point. Corona. Douglaston, Douglas Manor, East Elmhurst, Elmhurst, Far Rockaway, Arverne, Bayswater, Edgemere, Flushing, Auburndale, Kew Gardens Hills, Floral Park, Forest Hills, Forest Hills Gardens, Fresh Meadows, Glendale, Glen Oaks, Hollis, Hollis Hills, Holliswood, Howard Beach, Lindenwood, Jackson Heights, Jamaica, Briarwood, Jamaica Estates, Jamaica Hills, South Jamaica, Kew Gardens, Laurelton, Little Neck, Long Island City, Hunters Point, Ravenswood, Queensbridge, Maspeth, Middle Village, New Hyde Park, Ozone Park, Queens Village, Rego Park, LeFrak City, Richmond Hill, Ridgewood, Rockaway Beach, Rosedale, Saint Albans, Springfield Gardens, South Ozone Park, Sunnyside, Whitestone, Beechhurst, Malba, Woodhaven, Woodside--- All of New York State


Queens Neighborhood with zip codes

Arverne , 11692, Astoria Heights , 11370 , Astoria , 11102, 11103 , 11105 , Auburndale , 11358, Bay Terrace , 11360 Bayside , 11359, 11360, 11361 Bayswater , 11691 Beechhurst , 11357 Bellaire , 11427, 11428, 11429
Belle Harbor , 11694 Bellerose , 11426 Blissville , 11101 Breezy Point , 11697 Briarwood , 11435 Broad Channel , 11693 Cambria Heights , 11411 College Point , 11356 Corona , 11368 Ditmars , 11005, 11370 Douglaston , 11362, 11363 , Dutch Kills , 11101 , East Elmhurst , 11369, 11370, 11371 , Edgemere , 11690 , Elmhurst , 11373 , Far Rockaway , 11096, 11690, 11691, 11692, 11693, 11694, 11695, 11697 ,  Floral Park , 11001, 11002, 11003, 11004, 11005 , Flushing , 11351, 11352, 11354, 11355, 11356, 11357, 11358, 11359, 11360, 11361, 11362, 11363, 11364, 11365, 11366, 11367, 11368, 11369, 11370, 11371, 11372, 11373, 11374, 11375, 11377, 11378, 11379, 11380, 11381, 11385, 11386, 11390 , Forest Hills Gardens , 11375 , Forest Hills , 11375
Fresh Meadows , 11365, 11366 , Fresh Pond , 11385 , Glen Oaks , 11004 , Glendale , 11385 , Hammels , 11693
Hillcrest , 11365, 11366 , Hollis Hills , 11427 , Hollis , 11423 ,  Holliswood , 11423 , Howard Beach , 11414
Hunters Point , 11101 , Jackson Heights , 11372, 11370 , Jamaica , 11405, 11411, 11412, 11413, 11414, 11415, 11416, 11417, 11418, 11419, 11420, 11421, 11422, 11423, 11424, 11425, 11426, 11427, 11428, 11429, 11430, 11431, 11432, 11433, 11434, 11435, 11436, 11439, 11451, 11499 , Jamaica Estates , 11423, 11432
Jamaica Hills , 11432 , Kew Gardens Hills , 11367 , Kew Gardens , 11415, 11418, 11424 , Laurelton , 11413
LeFrak City , 11368 , Linden Hill , 11354 , Lindenwood , 11414 , Long Island City , 11101, 11102, 11103, 11104, 11105, 11106, 11109 , Little Neck , 11362, 11363 , Malba , 11357 , Maspeth , 11378 , Meadowmere , 11422
Middle Village , 11379 , Murray Hill , 11358 , Neponsit , 11694 , New Hyde Park , 11040, 11042 , North Shore Towers , 11005 , Oakland Gardens , 11364 , Ozone Park , 11416, 11417 , Pomonok , 11365 , Queens Village , 11427, 11428, 11429 , Queensboro Hill  , 11355 , Queensbridge , 11101 , Ravenswood , 11106 , Rego Park , 11374 , Richmond Hill , 11418 , Ridgewood , 11385, 11386 , Rochdale Village , 11434 , Rockaway Beach , 11693
Rockaway Park , 11694 , Rosedale , 11422 , Roxbury , 11697 , Saint Albans , 11412 , South Jamaica , 11435, 11433, 11436, 11434  , South Ozone Park , 11420, 11436 , Springfield Gardens , 11413 , Sunnyside Gardens , 11104 , Sunnyside , 11104 , Tudor Village , 11417 , Whitestone , 11357 , Willets Point , 11368 , Woodhaven , 11421 , Woodside , 11377 , 

 

Brooklyn Neighborhood with zip codes

Albemarle-Kenmore Terrace, 11226, Bath Beach 11214, Bay Ridge, 11209,  Bedford Stuyvesant, 11216, Bensonhurst, 11214, Bergen Beach, 11234, Beverley Square East, 11226, Beverley Square West, 11226, Boerum Hill, 11201,11217, Borough Park, 11219, Brighton Beach, 11235, Broadway Junction, 11233, Brooklyn Heights, 11201, Brownsville, 11212, Bushwick, 11221, Canarsie, 11236,  Carroll Gardens, 11231, Caton Park,   11218, City Line, 11207, Clinton Hill, 11205, Cobble Hill, 11201, Coney Island, 11224, Crown Heights, 11225,11213, Crown Heights North, 11213, Cypress Hills, 11208, Ditmas Park, 11226, Ditmas Park West, 11226, Downtown,11201, DUMBO, 11201, Dyker Heights, 11228, East Flatbush, 11203, East New York, 11207, 11208, East Williamsburg, 11206, Farragut, 11210, Fiske Terrace, 11230, Flatbush, 11226, Flatlands, 11236, Fort Greene, 11205, Fort Hamilton, 11209, Fulton Ferry, 11201, Georgetown, 11230, Gerritsen Beach, 11229, Gowanus, 11231, Gravesend, 11223, Greenpoint, 11222, Greenwood Heights, 11232, Highland Park, 11207, Homecrest, 11239, Kensington, 11218, Mapleton, 11204, Madison, 11229, Manhattan Beach, 11234, Manhattan Terrace,  11230, Marine Park, 11234, Midwood, 11230, Midwood Park, 11210, Mill Basin, 11234, Mill Island, 11234, Navy Yard, 11205, New Lots, 11236, North Side, 11211, Northeast Flatbush, 11212, Ocean Hill, 11233, Ocean Parkway, 11230, Paerdegat Basin, 11236, Park Slope, 11215, 11217, Plum Beach, 11235, Prospect Lefferts Gardens, 11225, Prospect Heights, 11217, 11238, Prospect Park South, 11217, Red Hook, 11231, Remsen Village, 11236, Rugby, 11203, Sea Gate, 11224, Sheepshead Bay, 11235, South Midwood, 11210, South Side, 11210, South Park Slope, 11215, Spring Creek,        

11239, Stable Brooklyn, 11218, Starrett City, 11239, Stuyvesant Heights, 11216, Sunset Park, 11220, Vinegar Hill, 11201, Weeksville, 11233, West Midwood, 11230, Williamsburg, 11206,11211, Windsor Terrace, 11218, Wingate, 11203, 

 

 

 

 

 

 

 

 


 


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Advantage Brokerage, Inc

NYC Business Insurance
164-03 89th Ave Ste. 1-C

Jamaica, New York 11432

New York City Business Insurance

8845 164th St, Jamaica NY 11432 

Queens County, New York City, N.Y.C.
Phone: (929) 290-8609

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