Header graphic for print
The New York Disability Law Blog Information and Help for Disabled Individuals with Workers' Compensation, Social Security Disability and Construction Accident Claims

Appeals

Posted in Long Term Disability / ERISA, NY Workers Compensation Claims

To appeal a decision essentially means bringing a case to a higher court system after a Judge’s ruling.

During a hearing before a Worker’s Compensation Law Judge, medical records, personal testimony and other evidence is reviewed and a decision is made as to whether or not the claimant is entitled to compensation or benefits. The Judge also decides what these include and for how long they may be received.

However, this ruling need not be the final word on the matter if either the employer or the employee deems it unfair. Either party may appeal the decision within 30 days of the Judge’s decision. Such applications to the Worker’s Compensation Board must be submitted in writing. Three Worker’s Compensation Board Members will review the case should the application be granted.

There are four possible outcomes of this review. The Judge’s decisions will either be affirmed, canceled modified or sent back for further development of the record. Should the panel disagree on some aspect of the case, any interested party may submit an application for a full board review.

Appeals of the boards decision may be taken to the Appellate Division, Third Department, Supreme Court of the State of New York within 30 days.

While a case is being reviewed by the Board Panel, the insurance company does not have to pay weekly benefits. However, compensation and doctor bills must be paid if upheld by the Board, even if an appeal is being made to the Appellate Division. Any uncontroversial aspect of the Judge’s award may be received even if an application for review is filed.

The claimant always has the right to an attorney or licensed representative who may not ask for or accept payment from their client. The Law Judge or Board Panel may determine legal fees and deduct this from the claimant’s overall compensation.