S07547 Summary:

BILL NOS07547
 
SAME ASSAME AS A06289
 
SPONSORMCDONALD
 
COSPNSRADDABBO, AVELLA
 
MLTSPNSR
 
Amd Work Comp L, generally; amd S1113, Ins L
 
Provides workers' compensation benefits for injury or sickness, pregnancy or family leave; applies to an employee and to family members taking family leave to care for an employee.
Go to top    

S07547 Actions:

BILL NOS07547
 
06/01/2012REFERRED TO LABOR
Go to top

S07547 Memo:

Memo not available
Go to top

S07547 Text:



 
                STATE OF NEW YORK
        ________________________________________________________________________
 
                                          7547
 
                    IN SENATE
 
                                      June 1, 2012
                                       ___________
 
        Introduced  by Sen. McDONALD -- read twice and ordered printed, and when
          printed to be committed to the Committee on Labor
 
        AN ACT to amend the workers' compensation law and the insurance law,  in
          relation  to  providing  benefits for injury or sickness, pregnancy or
          family leave
 
          The People of the State of New York, represented in Senate and  Assem-

        bly, do enact as follows:
 
     1    Section  1.   Subdivision 2 of section 76 of the workers' compensation
     2  law, as added by chapter 600 of the laws of 1949, is amended to read  as
     3  follows:
     4    2.  The purposes of the state insurance fund herein created are hereby
     5  enlarged to provide [for the] insurance [by the state insurance fund of]
     6  for the payment of the benefits required by section two hundred four  of
     7  this  chapter, including benefits for family care provided either in the
     8  same policy with or in a separate policy from  benefits  for  disability
     9  resulting  from  injury,  sickness  or  pregnancy of an employee, and as
    10  provided pursuant to section two hundred eleven-a of this  chapter.    A
    11  separate  fund  is hereby created within the state insurance fund, which

    12  shall be known as  the  "disability  benefits  fund",  and  which  shall
    13  consist  of  all premiums received and paid into said fund on account of
    14  such insurance, all securities acquired by and through the use of moneys
    15  belonging to said fund and of interest earned upon moneys  belonging  to
    16  said  fund and deposited or invested as herein provided. Said disability
    17  benefits fund shall be applicable to the payment of  benefits,  expenses
    18  and assessments on account of insurance written pursuant to article nine
    19  of this chapter.
    20    §  2.  The  section  heading  and  the first undesignated paragraph of
    21  section 120 of the workers' compensation law, as amended by  chapter  61
    22  of the laws of 1989, are amended to read as follows:
    23    Discrimination  against employees [who bring proceedings]. It shall be
    24  unlawful for any employer  or  his  or  her  duly  authorized  agent  to

    25  discharge  or in any other manner discriminate against an employee as to
    26  his or her employment because such employee has claimed or attempted  to
    27  claim  compensation from such employer, or claimed or attempted to claim
 
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD09329-02-1

        S. 7547                             2
 
     1  any benefits provided under this chapter,  or  because  he  or  she  has
     2  testified  or is about to testify in a proceeding under this chapter and
     3  no other valid reason is shown to exist for such action by the employer.
     4    §  3. Subdivision 9 of section 201 of the workers' compensation law is

     5  amended by adding two new paragraphs C and D to read as follows:
     6    C. "Disability" also includes family care, as defined  in  subdivision
     7  fifteen of this section.
     8    D.  Unless otherwise set forth in this article, all provisions of this
     9  article applicable to "disability" shall apply to (i) disability arising
    10  from injury or sickness; (ii) disability caused by or in connection with
    11  pregnancy; and (iii) disability requiring family care.
    12    § 4. Subdivision 14 of section 201 of the workers'  compensation  law,
    13  as added by chapter 600 of the laws of 1949 and as renumbered by chapter
    14  438 of the laws of 1964, is amended to read as follows:
    15    14.  "A  day  of  disability"  means any day on which the employee was
    16  prevented from performing work because of disability, including any  day

    17  which the employee uses for family care, and for which [he] the employee
    18  has not received his or her regular remuneration.
    19    § 5. Section 201 of the workers' compensation law is amended by adding
    20  ten  new  subdivisions 15, 16, 17, 18, 19, 20, 21, 22, 23 and 24 to read
    21  as follows:
    22    15. "Family care" shall mean any leave taken by an employee from work:
    23    A. to participate in providing care, including physical or  psycholog-
    24  ical care, for a family member of the employee made necessary by a seri-
    25  ous health condition of the family member; or
    26    B.  to  bond  with the employee's child during the first twelve months
    27  after the child's birth, or the first twelve months after the  placement

    28  of the child for adoption or foster care with the employee.
    29    16. "Child" means a biological, adopted or foster child, a step-child,
    30  a  legal ward or a child of a person who stands in parental relationship
    31  to the child who is:
    32    A. less than eighteen years of age; or
    33    B. eighteen years of age or older and incapable of  self-care  because
    34  of a mental or physical disability.
    35    17.  "Domestic  partner"  has the meaning set forth in section four of
    36  this chapter.
    37    18. "Serious health condition" means an illness,  injury,  impairment,
    38  or physical or mental condition that:
    39    A.  requires  inpatient  care  in  a  hospital, hospice or residential
    40  health care facility; or

    41    B. requires continuing treatment by a health care provider.
    42    19. "Parent" means  biological  or  adoptive  parent,  step-parent  or
    43  person  who  stood  in  parental  relationship  to  an employee when the
    44  employee was:
    45    A. less than eighteen years of age; or
    46    B. eighteen years of age or older and incapable of  self-care  because
    47  of a mental or physical disability.
    48    20.  "Family  member" means a child, spouse, domestic partner, parent,
    49  grandchild, grandparent, mother or father of spouse or domestic partner.
    50    21. Persons who stand in parental  relationship  to  a  child  include
    51  those  with  day-to-day  responsibilities  to  care  for and financially

    52  support a child or, in the case of an employee, who had  such  responsi-
    53  bility  for  the employee when the employee was a child. A biological or
    54  legal relationship is not necessary.
    55    22. "Grandchild" means the child of a child.

        S. 7547                             3
 
     1    23. "Health care provider" means a health  care  practitioner  who  is
     2  licensed  under relevant federal or state laws to provide medical, emer-
     3  gency or health services and is treating an employee or a family  member
     4  for a serious health condition.
     5    24. "Family care cost" shall mean:
     6    A.  prior  to  July first, two thousand thirteen, forty-five cents per
     7  week; and

     8    B. during every subsequent year commencing on July first  such  amount
     9  as shall be set by regulation of the superintendent of insurance follow-
    10  ing consultation with the family care advisory council by April first of
    11  the same year based on the superintendent's actuarially sound estimation
    12  of  the  cost  per employee of providing family care benefits, but in no
    13  event more than one hundred fifteen percent of such  estimation  of  the
    14  cost  per  employee  of providing family care benefits through the state
    15  insurance fund.
    16    § 6. The workers' compensation law is amended by adding a new  section
    17  203-a to read as follows:
    18    §  203-a. Retaliatory action prohibited. 1.  The provisions of section

    19  one hundred twenty of this chapter and section two hundred forty-one  of
    20  this article shall be applicable to family care leave as fully as if set
    21  forth in this section.
    22    2.  Nothing  in  this  section shall be deemed to diminish the rights,
    23  privileges, or remedies of any employee under any collective  bargaining
    24  agreement  or  employment  contract;  except  that the institution of an
    25  action in accordance with this section shall be deemed a waiver  of  the
    26  rights  and  remedies  available  under any other contract or collective
    27  bargaining agreement.
    28    § 7. The workers' compensation law is amended by adding a new  section
    29  203-b to read as follows:
    30    § 203-b. Family care leave. Any eligible employee of a covered employ-

    31  er  who,  after  January  first,  two thousand twelve, has in employment
    32  twenty-five or more employees on each of at least  thirty  days  in  any
    33  calendar  year  who takes leave under this section shall be entitled, on
    34  return from such leave, to be restored by the employer to  the  position
    35  of  employment  held  by the employee when the leave commenced, or to be
    36  restored to a comparable position with comparable  employment  benefits,
    37  pay  and  other  terms and conditions of employment. The taking of leave
    38  for the purpose of family care shall not  result  in  the  loss  of  any
    39  employment  benefit  accrued  prior  to  the  date  on  which  the leave
    40  commenced. Nothing in this section shall be  construed  to  entitle  any

    41  restored employee to the accrual of any seniority or employment benefits
    42  during  any  period of leave, or any right, benefit or position to which
    43  the employee would have been entitled had the  employee  not  taken  the
    44  leave.   A violation of this section shall be a violation of section one
    45  hundred twenty of this chapter and all remedies and penalties  available
    46  under  section one hundred twenty of this chapter shall be available for
    47  violations of this section as fully as if set forth in this section.
    48    § 8. Subdivision 1 of section 204 of the workers' compensation law, as
    49  added by chapter 600 of the laws of 1949, is amended and a new  subdivi-
    50  sion 3 is added to read as follows:
    51    1.  Disability  benefits  shall be payable to an eligible employee for

    52  disabilities commencing after June thirtieth,  nineteen  hundred  fifty,
    53  beginning  with  the eighth consecutive day of disability and thereafter
    54  during the continuance of disability, subject to the limitations  as  to
    55  maximum  and minimum amounts and duration and other conditions and limi-
    56  tations in this section and in sections two hundred five and two hundred

        S. 7547                             4
 
     1  six of this article.   Successive periods of disability  caused  by  the
     2  same  or  related  injury or sickness or reason for family care shall be
     3  deemed a single period of disability only  if  separated  by  less  than
     4  three months.
     5    3.  The  weekly  benefit  which  the  disabled employee is entitled to
     6  receive for disability commencing on or after January first,  two  thou-

     7  sand  twelve  shall  be  fifty  percent of the employee's average weekly
     8  wage, but in no case shall such benefit exceed  thirty-five  percent  of
     9  the  statewide average weekly wage as determined by the state department
    10  of labor pursuant to subdivision sixteen of section two of this chapter.
    11  The weekly benefit which the disabled employee is  entitled  to  receive
    12  for disability commencing on or after April first, two thousand thirteen
    13  shall  be fifty percent of the employee's average weekly wage, but in no
    14  case shall such benefit exceed forty percent of  the  statewide  average
    15  weekly  wage  as determined by the state department of labor pursuant to
    16  subdivision sixteen of section two of this chapter. The  weekly  benefit

    17  which  the  disabled  employee  is  entitled  to  receive for disability
    18  commencing on or after April first, two thousand fourteen shall be fifty
    19  percent of the employee's average weekly wage but in no case shall  such
    20  benefit  exceed  forty-five percent of the statewide average weekly wage
    21  as determined by the state department of labor pursuant  to  subdivision
    22  sixteen  of  section  two  of this chapter. The weekly benefit which the
    23  disabled employee is entitled to receive for disability commencing on or
    24  after April first, two thousand fifteen and subsequently shall be  fifty
    25  percent  of the employee's average weekly wage but in no case shall such
    26  benefit exceed fifty percent of the statewide  average  weekly  wage  as

    27  determined  by  the  state  department  of labor pursuant to subdivision
    28  sixteen of section two of this chapter.
    29    § 9. Subdivisions 1, 2, 3, 4, 7 and 8 of section 205 of  the  workers'
    30  compensation law, subdivision 1 as amended by chapter 651 of the laws of
    31  1958,  subdivision  2  as amended by chapter 270 of the laws of 1990 and
    32  subdivisions 3, 4, 7 and 8 as added by chapter 600 of the laws  of  1949
    33  and  as renumbered by chapter 352 of the laws of 1981, are amended and a
    34  new subdivision 9 is added to read as follows:
    35    1. (a) For disability resulting from injury, sickness or pregnancy  of
    36  an employee, for more than twenty-six weeks during a period of fifty-two
    37  consecutive calendar weeks or during any one period of disability; or

    38    (b)  For  family  care,  for more than twelve weeks during a period of
    39  fifty-two consecutive calendar weeks or during any one period of  family
    40  care;
    41    2. for any period of disability resulting from the injury, sickness or
    42  pregnancy  of an employee during which an employee is not under the care
    43  of a duly licensed physician or with  respect  to  disability  resulting
    44  from  a  condition  of  the foot which may lawfully be treated by a duly
    45  registered and licensed podiatrist of the state  of  New  York  or  with
    46  respect to a disability resulting from a condition which may lawfully be
    47  treated  by  a duly registered and licensed chiropractor of the state of
    48  New York or with respect to a  disability  resulting  from  a  condition
    49  which may lawfully be treated by a duly licensed dentist of the state of

    50  New  York  or  with  respect  to a disability resulting from a condition
    51  which may lawfully be treated by a duly registered and licensed psychol-
    52  ogist of the state of New York or with respect to a disability resulting
    53  from a condition which may lawfully be treated by a duly certified nurse
    54  midwife, for any period of such disability during which an  employee  is
    55  neither under the care of a physician nor a podiatrist, nor a chiroprac-
    56  tor,  nor  a dentist, nor a psychologist, nor a certified nurse midwife;

        S. 7547                             5
 
     1  and for any period of disability during which an employee who adheres to
     2  the faith or teachings of any church or denomination and who in  accord-
     3  ance with its creed, tenets or principles depends for healing upon pray-
     4  er  through  spiritual  means  alone in the practice of religion, is not

     5  under the care of a practitioner duly accredited by the church or denom-
     6  ination, and provided such employee shall submit to all  physical  exam-
     7  inations as required by this chapter[.];
     8    3. for any disability resulting from injury or sickness of an employee
     9  occasioned by the wilful intention of the employee to bring about injury
    10  to  or  the sickness of himself or another, or resulting from any injury
    11  or sickness sustained in the perpetration by the employee of an  illegal
    12  act;
    13    4.  for any day of disability during which the employee performed work
    14  for remuneration or profit; but not including any remuneration  received
    15  for caring for a foster or adopted child or other individual residing in
    16  the employee's place of residence;
    17    7.  for  any disability due to any act of war, declared or undeclared,

    18  if such act shall occur after June thirtieth,  nineteen  hundred  fifty,
    19  except  that  nothing  in  this  subdivision  shall bar an employee from
    20  receiving benefits under this article for care of a family member  disa-
    21  bled due to an act of war;
    22    8.  for any disability resulting from an injury, sickness or pregnancy
    23  of the employee commencing before the employee becomes eligible to bene-
    24  fits hereunder [or commencing prior  to  July  first,  nineteen  hundred
    25  fifty,  but  this  shall not preclude benefits for recurrence after July
    26  first, nineteen hundred fifty, of a disability commencing  prior  there-
    27  to.];
    28    9. for any day of absence from work required pursuant to any discipli-

    29  nary  process; or, in regard to family care benefits, any day of absence
    30  from work resulting from injury, sickness or pregnancy of the  employee,
    31  including  any leave taken under section seventy-one or seventy-three of
    32  the civil service law.
    33    § 10. The workers' compensation law is amended by adding a new section
    34  205-a to read as follows:
    35    § 205-a. Relationship between disability benefits for family care  and
    36  for  the  employee's  own injury, sickness or pregnancy.  The receipt of
    37  benefits for disability resulting from injury, sickness or pregnancy  of
    38  the  employee, shall not count toward any time limitation under subdivi-
    39  sion one of section two hundred five of this article on the  receipt  of

    40  benefits  for  family  care, and the receipt of benefits for family care
    41  shall not count toward any time  limitation  under  subdivision  one  of
    42  section  two hundred five of this article on the receipt of benefits for
    43  disability resulting from injury, sickness or pregnancy to the employee,
    44  except that an employee may receive  disability  benefits  on  only  one
    45  claim at any time.
    46    §  11.  Subdivision 3 of section 209 of the workers' compensation law,
    47  as amended by chapter 415 of the laws of 1983, is  amended  to  read  as
    48  follows:
    49    3.  The  contribution  of each such employee to the cost of disability
    50  benefits provided by this article shall be one-half of one per centum of
    51  the employee's wages paid to him  on  and  after  July  first,  nineteen

    52  hundred fifty, but not in excess of sixty cents per week for the cost of
    53  disability  benefits  for  injury, sickness or pregnancy of the employee
    54  plus the family care cost, as  defined  in  subdivision  twenty-four  of
    55  section two hundred one of this article.

        S. 7547                             6
 
     1    §  12.  Section  211  of  the  workers' compensation law is amended by
     2  adding two new subdivisions 7 and 8 to read as follows:
     3    7. such family care benefits as are provided for in this article shall
     4  be  in addition to, and shall not amend, repeal or replace, the terms of
     5  any agreement that is collectively  negotiated between an  employer  and
     6  an  employee  organization,  including agreement or interest arbitration

     7  awards made pursuant to article fourteen of the civil service law.
     8    8. nothing in this article shall require an employer to use  the  same
     9  carrier  to provide benefits required by or permissible under this arti-
    10  cle for disability resulting from injury, sickness or pregnancy  of  the
    11  employee as it uses to provide benefits required by or permissible under
    12  this  article  for  family  care. An employer may use a different means,
    13  among those set forth in subdivisions one through five of this  section,
    14  to  provide  benefits  required by this article for disability resulting
    15  from injury, sickness or pregnancy of the employee, from the means  used
    16  to provide benefits required by this article for family care.

    17    § 13. The workers' compensation law is amended by adding a new section
    18  211-a to read as follows:
    19    §  211-a.  Public  employees; employee opt in. 1. For purposes of this
    20  section, "public employee" means any employee of the  state,  any  poli-
    21  tical  subdivision of the state, a public authority or any other govern-
    22  mental agency or instrumentality. "Public employer" means the state, any
    23  political subdivision of the state, a  public  authority  or  any  other
    24  governmental  agency or instrumentality thereof. "Employee organization"
    25  shall have the meaning set forth in section two hundred one of the civil
    26  service law.
    27    2. Public employers shall provide benefits for family care  to  public

    28  employees where an employee organization that represents those employees
    29  opts  in  to family care in accordance with the procedures and terms set
    30  forth in subdivision three of this section.
    31    3. An employee organization may opt in to the family care  benefit  on
    32  behalf of those employees it represents:
    33    a.  upon notice given prior to April first, two thousand twelve, which
    34  opt in shall become effective only on July first, two thousand twelve;
    35    b. at any time upon ninety days notice for any  employer  who  is  not
    36  providing  disability  benefits  for injury, sickness or pregnancy of an
    37  employee under section two hundred twelve of this  article,  or  who  is
    38  self-insured for such benefits;

    39    c.  for  any employer who is providing disability benefits for injury,
    40  sickness or pregnancy of an employee under section two hundred twelve of
    41  this article, upon notice at least ninety days prior to  the  expiration
    42  of the employer's insurance policy for such benefits, which opt in shall
    43  be  effective  only for the time period covered by any subsequent policy
    44  or renewal; or
    45    d. at any time as is mutually agreed upon between the employee  organ-
    46  ization and any public employer.
    47    An  employee organization that has opted in to the family care benefit
    48  may opt out of it within the time periods, and effective upon  the  same
    49  dates, set forth in this paragraph.

    50    4. In the absence of any contrary statement in  a collectively negoti-
    51  ated agreement under article fourteen of the civil service law, a public
    52  employer  may  require public employees who opt in under this section to
    53  contribute up to the family care cost, as defined in  subdivision  twen-
    54  ty-four  of section two hundred one of this article, per week in accord-
    55  ance with the procedure set forth in section two hundred  nine  of  this
    56  article.

        S. 7547                             7
 
     1    § 14. Subdivisions 1 and 2 of section 212 of the workers' compensation
     2  law,  subdivision  1  as  amended by chapter 740 of the laws of 1960 and
     3  subdivision 2 as amended by chapter 120 of the laws of 1969, are amended
     4  to read as follows:

     5    1.  Any  employer  not  required  by  this  article to provide for the
     6  payment of disability benefits to his employees,  or  to  any  class  or
     7  classes  thereof,  may  become  a  covered  employer or bring within the
     8  provisions of this article such employees or class or classes thereof by
     9  voluntarily electing to provide for payment of [such] benefits for disa-
    10  bility resulting from injury, sickness or pregnancy of  an  employee  or
    11  for  family  care,  or  both,  in  one  or more of the ways set forth in
    12  section two hundred eleven of this article; but such election  shall  be
    13  subject  to  the  approval of the [chairman] chair, and if the employees
    14  are required to contribute to the cost of such benefits the assent with-
    15  in thirty days before such approval is granted, of more than one-half of

    16  such employees shall be evidenced to the satisfaction of the  [chairman]
    17  chair.   On approval by the [chairman] chair of such election to provide
    18  benefits, all the provisions of this article shall become  and  continue
    19  applicable as if the employer were a covered employer as defined in this
    20  article.  The  obligation to continue as a covered employer with respect
    21  to employees for whom provision of benefits is not required  under  this
    22  article,  may  be discontinued by such employer on ninety days notice to
    23  the [chairman] chair in writing and  to  his  employees,  after  he  has
    24  provided  for  payment  of  benefits for not less than one year and with
    25  such provision for payment of obligations incurred on and prior  to  the
    26  termination  date as the chairman may approve.  Any election by a public

    27  employer to provide family care benefits made prior to July  first,  two
    28  thousand twelve shall be effective on that date.
    29    2.  Notwithstanding  the  definition of "employer" and "employment" in
    30  section two hundred one of this article, the state, a public  authority,
    31  a  municipal  corporation or a fire district or other political subdivi-
    32  sion may become a covered employer under this article by complying  with
    33  the  provisions  of  subdivision one of this section and may discontinue
    34  such status only as provided in [that] such subdivision.
    35    § 15. Subdivisions 1, 2, 3 and  4  of  section  217  of  the  workers'
    36  compensation law, subdivision 1 as amended by chapter 167 of the laws of
    37  1999, subdivisions 2 and 3 as amended by chapter 270 of the laws of 1990

    38  and  subdivision  4  as  added  by  chapter 600 of the laws of 1949, are
    39  amended to read as follows:
    40    1. Written notice and proof of disability shall be  furnished  to  the
    41  employer  by  or  on behalf of the employee claiming benefits or, in the
    42  case of a claimant under section two hundred seven of this  article,  to
    43  the  chair, within thirty days after commencement of the period of disa-
    44  bility. Additional proof shall be furnished thereafter from time to time
    45  as the employer or carrier or chair may require but not more often  than
    46  once each week. Such proof shall include:
    47    (a) in the case of disability resulting from injury, sickness or preg-
    48  nancy  of  the  employee,  a  statement  of disability by the employee's
    49  attending [physician or attending podiatrist or  attending  chiropractor

    50  or  attending  dentist  or attending psychologist or attending certified
    51  nurse midwife, or in the case of an employee who adheres to the faith or
    52  teachings of any church or denomination, and who in accordance with  its
    53  creed,  tenets  or  principles  depends  for healing upon prayer through
    54  spiritual means alone in the practice  of  religion,  by  an  accredited
    55  practitioner,  containing  facts  and  opinions as to such disability in
    56  compliance with regulations of the chair.] health care provider;

        S. 7547                             8
 
     1    (b) in the case of family care for bonding with a new child,  a  birth
     2  certificate,  certificate of adoption, or other competent evidence show-

     3  ing that the employee is the parent of a child within twelve  months  of
     4  that  child's  birth  or  placement for adoption or foster care with the
     5  employee;
     6    (c) in the case of benefits for care of a family member with a serious
     7  health condition:
     8    (i)  a statement by the family member's health care provider, contain-
     9  ing facts and opinions as to such health condition  in  compliance  with
    10  regulations of the chair; and
    11    (ii) a statement subscribed by the employee and affirmed by him or her
    12  as  true  under  penalties  of  perjury, or other equivalent documentary
    13  proof, that the employee is a primary care giver for the  family  member
    14  during the time of disability.

    15    Failure  to  furnish notice or proof within the time and in the manner
    16  above provided shall not invalidate the claim but no benefits  shall  be
    17  required to be paid for any period more than two weeks prior to the date
    18  on which the required proof is furnished unless it shall be shown to the
    19  satisfaction  of  the  chair  not  to  have  been reasonably possible to
    20  furnish such notice or proof and that such notice or proof was furnished
    21  as soon as possible; provided, however, that no benefits shall  be  paid
    22  unless  the  required proof of disability is furnished within twenty-six
    23  weeks after commencement of the period of disability.  No limitation  of
    24  time  provided  in  this  section shall run as against any person who is
    25  mentally incompetent, or physically incapable of providing  such  notice
    26  as  a  result of a serious medical condition, or a minor so long as such

    27  person has no guardian of the person and/or property.
    28    2. An employee claiming benefits for the employee's  injury,  sickness
    29  or  pregnancy,  or  the family member of such employee in any case where
    30  the employee claims family care benefits  for  providing  care  to  that
    31  family  member  shall,  as  requested by the employer or carrier, submit
    32  himself or herself at intervals, but not more  than  once  a  week,  for
    33  examination  by a [physician or podiatrist or chiropractor or dentist or
    34  psychologist or certified nurse midwife] relevant health  care  provider
    35  designated  by  the  employer or carrier. All such examinations shall be
    36  without cost to the employee or family member and shall  be  held  at  a
    37  reasonable time and place.

    38    3. The chair may direct the claimant who seeks disability benefits for
    39  his  or  her  injury,  sickness  or  pregnancy, or the claimant's family
    40  member where the claimant seeks disability benefits for family leave  to
    41  provide care to that family member to submit to examination by a [physi-
    42  cian  or podiatrist or chiropractor or dentist or psychologist] relevant
    43  health care provider designated by him or her in any case in  which  the
    44  claim  to  disability  benefits is contested and in claims arising under
    45  section two hundred seven of this article, and in  other  cases  as  the
    46  chair or board may require.
    47    4.  Refusal  of  the  claimant  or family member without good cause to

    48  submit to any such examination shall disqualify [him] the claimant  from
    49  all  benefits  hereunder  for  the  period of such refusal, except as to
    50  benefits already paid.
    51    § 16.  Section 221 of the workers'  compensation  law,  as  separately
    52  amended  by chapters 425 and 500 of the laws of 1985, is amended to read
    53  as follows:
    54    § 221. Determination of  contested  claims  for  disability  benefits.
    55  Within  twenty-six weeks of written notice of rejection of claim, denial
    56  of rights under section two hundred three-a or two  hundred  three-b  of

        S. 7547                             9
 
     1  this  article,  the employee may file with the [chairman] chair a notice
     2  that his or her claim for disability benefits has not been  paid,  [and]

     3  or  that  the  employee has been denied rights guaranteed by section two
     4  hundred  three-a  or  two  hundred  three-b of this article. In cases of
     5  denial of benefits, the employee shall submit  proof  of  disability  or
     6  eligibility  for  family  care  and  of his or her employment, wages and
     7  other facts reasonably necessary for  determination  of  the  employee's
     8  right  to  such  benefits or proof of denial of rights under section two
     9  hundred  three-a  or  two  hundred  three-b  of  this  article   or   of
    10  retaliation.   Failure to file such notice within the time provided, may
    11  be excused by the [chairman] chair if it can be shown to  the  satisfac-
    12  tion  of  the  [chairman]  chair not to have been reasonably possible to

    13  furnish such notice and that such notice was furnished as soon as possi-
    14  ble.  On demand of the [chairman] chair the employer  or  carrier  shall
    15  forthwith deliver to the [chairman] chair proof of disability, including
    16  if  relevant the original or a true copy of the attending physician's or
    17  attending podiatrist's or accredited practitioner's statement, wage  and
    18  employment  data  and all other papers in the possession of the employer
    19  or carrier with respect to such claim or complaint.
    20    The board shall have full power and authority to determine all  issues
    21  in  relation  to every such claim for disability or family care benefits
    22  required or provided under this article, or with respect  to  denial  of
    23  rights  under section two hundred three-a or two hundred three-b of this

    24  article or including ordering payment of  benefits,  damages  and  rein-
    25  statement  and  shall  file its decision in the office of the [chairman]
    26  chair.  Upon such filing, the [chairman] chair shall send to the parties
    27  a copy of the decision. Either party may present evidence and be repres-
    28  ented by counsel at any hearing on such claim.    The  decision  of  the
    29  board shall be final as to all questions of fact and, except as provided
    30  in  section  twenty-three  of  this chapter, as to all questions of law.
    31  Every decision of the board shall be complied with  in  accordance  with
    32  its  terms  within ten days thereafter except in case of appeal, and any
    33  payments due under such decision shall draw simple interest from  thirty
    34  days after the making thereof at the rate provided in section five thou-

    35  sand four of the civil practice law and rules.
    36    §  17.  Subdivision 2 of section 229 of the workers' compensation law,
    37  as added by chapter 271 of the laws of  1985,  is  amended  to  read  as
    38  follows:
    39    2.  Whenever  an  employee  of  a covered employer who is eligible for
    40  benefits under section two hundred four of this article shall be  absent
    41  from  work due to a disability as defined in subdivision nine of section
    42  two hundred one of this article for more than  seven  consecutive  days,
    43  the  employer shall provide the employee with a written statement of the
    44  employee's rights under this article in a form prescribed by the [chair-
    45  man] chair. The statement shall be provided to the employee within  five
    46  business  days  after  the employee's seventh consecutive day of absence

    47  due to disability or within five business days after the employer  knows
    48  or  should know that the employee's absence is due to disability, which-
    49  ever is later. Each covered employer shall provide each employee with  a
    50  typewritten,  printed  or  electronic notice in a form prescribed by the
    51  chair, stating that the employer has provided for the payment  of  disa-
    52  bility  benefits  as  required by this article within thirty days of the
    53  effective date of the chapter of the laws of two thousand  eleven  which
    54  amended  this  subdivision.    Each  covered employer shall provide such
    55  notice to all new employees within thirty days of  their  first  day  of
    56  work.

        S. 7547                            10
 

     1    § 18. The workers' compensation law is amended by adding a new section
     2  239-a to read as follows:
     3    §  239-a.  Family  care study and monitoring.   1.   The department of
     4  insurance shall study, and report to the governor and both houses of the
     5  legislature by April first, two thousand twelve, on the feasibility  and
     6  impact of community rating disability insurance or any aspect thereof.
     7    2.  There  shall  be  created  the family care advisory council, which
     8  shall consist of fifteen members to be  appointed  by  the  governor  as
     9  follows: two on recommendation by the New York state american federation
    10  of  labor-congress  of  industrial  organizations,  one of whom shall be
    11  representative of public employee organizations certified under  article

    12  fourteen of the civil service law, participating in the paid family care
    13  plan,  one  of  whom  is  representative  of unions representing workers
    14  employed in the private sector; two who are representatives of organiza-
    15  tions that represent either covered business or public employers in  New
    16  York  state  participating  in  the paid family leave plan; two on nomi-
    17  nation of the speaker of the assembly; one on nomination by the minority
    18  leader of the assembly; two on nomination by the temporary  president of
    19  the senate; one on nomination by the minority leader of the senate;  and
    20  the superintendent of insurance, commissioner of labor  and chair of the
    21  workers'  compensation board, who shall serve as members ex officio. The

    22  commissioner of labor shall serve as chair of the  council.  The  super-
    23  intendent  of  insurance  and  chair  of the workers' compensation board
    24  shall consult regularly with the council on the  implementation  of  the
    25  family  care  benefit. The department of labor, the insurance department
    26  and the workers' compensation board shall provide all necessary  person-
    27  nel and logistical support as may be necessary to complete the duties of
    28  the  advisory  council. The council or any of its members may issue such
    29  recommendations or reports as they deem warranted  on  the  family  care
    30  benefit,  including on the scope of the benefit, problems with the bene-
    31  fit; funding of the benefit    including  pass-through  costs;  possible

    32  statutory  amendments and regulatory changes; usage rates; outreach; and
    33  community rating. Any such recommendations or reports shall be  provided
    34  to  the  governor, superintendent of insurance, speaker of the assembly,
    35  temporary president of the senate and minority leaders of the senate and
    36  assembly.  Each member of the commission shall serve  a  term  of  three
    37  years.  An appointment to fill a vacancy shall be made for the remainder
    38  of the affected term. Members shall receive no compensation.
    39    § 19. Paragraph 3 of subsection (a) of section 1113 of  the  insurance
    40  law is amended to read as follows:
    41    (3) "Accident and health insurance," means (i) insurance against death
    42  or  personal  injury  by  accident  or by any specified kind or kinds of

    43  accident and insurance  against  sickness,  ailment  or  bodily  injury,
    44  including  insurance  providing  disability benefits pursuant to article
    45  nine of the workers' compensation law,  including  any  insurance  under
    46  that  article  for  family  care benefits, disability benefits resulting
    47  from injury, sickness or pregnancy of an employee,  or  all,  except  as
    48  specified in item (ii) [hereof] of this paragraph; and (ii) non-cancell-
    49  able  disability insurance, meaning insurance against disability result-
    50  ing from sickness, ailment or bodily  injury  (but  excluding  insurance
    51  solely against accidental injury) under any contract which does not give
    52  the  insurer the option to cancel or otherwise terminate the contract at
    53  or after one year from its effective date or renewal date.

    54    § 20. This act shall take effect immediately; provided, however, that:

        S. 7547                            11
 
     1    (a) Sections two, three, four, five, six,  seven,  eight,  nine,  ten,
     2  eleven,  twelve,  thirteen,  fourteen,  fifteen,  sixteen, seventeen and
     3  nineteen of this act shall take effect January 1, 2012.
     4    (b)  Paragraph  a  of  subdivision  3 of section 211-a of the workers'
     5  compensation law, as added by section  thirteen  of  this  act  allowing
     6  public employees to opt in to family care benefits prior to July 1, 2012
     7  and  subdivision  1  of  section 212 of the workers' compensation law as
     8  amended by section fourteen of this act allowing public employers to opt
     9  in to family care benefits prior to July  1,  2012,  shall  take  effect
    10  immediately.
    11    (c)  Effective  immediately,  the addition, amendment and/or repeal of

    12  any rules or regulations necessary for the implementation of this act on
    13  its effective date are authorized and directed to be made and  completed
    14  on or before such effective date.
Go to top