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A03542 Summary:

BILL NOA03542A
 
SAME ASNo Same As
 
SPONSORReyes
 
COSPNSR
 
MLTSPNSR
 
Amd §15, Work Comp L
 
Provides the carrier or employer a credit against permanent partial disability benefits for temporary partial disability payments made in excess of 130 weeks.
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A03542 Text:



 
                STATE OF NEW YORK
        ________________________________________________________________________
 
                                         3542--A
 
                               2025-2026 Regular Sessions
 
                   IN ASSEMBLY
 
                                    January 28, 2025
                                       ___________
 
        Introduced  by M. of A. REYES -- read once and referred to the Committee
          on Labor -- recommitted to the Committee on Labor in  accordance  with
          Assembly Rule 3, sec. 2 -- committee discharged, bill amended, ordered
          reprinted as amended and recommitted to said committee
 
        AN  ACT to amend the workers' compensation law, in relation to providing
          the carrier or employer a credit against permanent partial  disability
          benefits  for  temporary partial disability payments made in excess of
          130 weeks
 
          The People of the State of New York, represented in Senate and  Assem-
        bly, do enact as follows:
 
     1    Section  1. Paragraph w of subdivision 3 of section 15 of the workers'
     2  compensation law, as amended by section 1 of subpart A of  part  NNN  of
     3  chapter 59 of the laws of 2017, is amended to read as follows:
     4    w.  Other  cases.  In all other cases of permanent partial disability,
     5  the compensation shall  be  sixty-six  and  two-thirds  percent  of  the
     6  difference  between the injured employee's average weekly wages and [his
     7  or her] such employee's wage-earning capacity  thereafter  in  the  same
     8  employment  or  otherwise.    Compensation under this paragraph shall be
     9  payable during the continuance of  such  permanent  partial  disability,
    10  without  the  necessity  for the claimant who is entitled to benefits at
    11  the time of classification to  demonstrate  ongoing  attachment  to  the
    12  labor  market,  but  subject  to  reconsideration  of the degree of such
    13  impairment by the board on its own motion or  upon  application  of  any
    14  party in interest however, all compensation payable under this paragraph
    15  shall  not  exceed  (i) five hundred twenty-five weeks in cases in which
    16  the loss of wage-earning capacity is greater than  ninety-five  percent;
    17  (ii)  five  hundred  weeks  in  cases  in which the loss of wage-earning
    18  capacity is greater than ninety percent but not  more  than  ninety-five
    19  percent;  (iii)  four  hundred  seventy-five weeks in cases in which the
    20  loss of wage-earning capacity is greater than  eighty-five  percent  but
    21  not  more than ninety percent; (iv) four hundred fifty weeks in cases in
 
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD03452-02-6

        A. 3542--A                          2
 
     1  which the loss of wage-earning capacity is greater than  eighty  percent
     2  but  not  more  than  eighty-five  percent; (v) four hundred twenty-five
     3  weeks in cases in which the loss of  wage-earning  capacity  is  greater
     4  than  seventy-five  percent  but not more than eighty percent; (vi) four
     5  hundred weeks in cases in which the loss  of  wage-earning  capacity  is
     6  greater  than  seventy  percent  but not more than seventy-five percent;
     7  (vii) three hundred seventy-five weeks in cases in  which  the  loss  of
     8  wage-earning  capacity  is  greater than sixty percent but not more than
     9  seventy percent; (viii) three hundred fifty weeks in cases in which  the
    10  loss of wage-earning capacity is greater than fifty percent but not more
    11  than  sixty percent; (ix) three hundred weeks in cases in which the loss
    12  of wage-earning capacity is greater than forty percent but not more than
    13  fifty percent; (x) two hundred seventy-five weeks in cases in which  the
    14  loss  of  wage-earning  capacity  is greater than thirty percent but not
    15  more than forty percent; (xi) two hundred fifty weeks in cases in  which
    16  the  loss  of  wage-earning capacity is greater than fifteen percent but
    17  not more than thirty percent; and (xii) two hundred twenty-five weeks in
    18  cases in which the loss of wage-earning capacity is fifteen  percent  or
    19  less.  For  a  claimant with a date of accident or disablement after the
    20  effective date of the chapter of the laws of  two  thousand  [seventeen]
    21  twenty-six  that amended this subdivision, where the carrier or employer
    22  has [provided] paid one hundred thirty weeks of compensation pursuant to
    23  subdivision five of this section [beyond one hundred thirty  weeks  from
    24  the  date  of  accident  or  disablement], all subsequent weeks in which
    25  compensation was paid solely  pursuant  to  subdivision  five  shall  be
    26  considered  to  be  benefit weeks for purposes of this section, with the
    27  carrier or employer receiving  credit  for  all  such  subsequent  weeks
    28  against the amount of maximum benefit weeks when permanent partial disa-
    29  bility  under  this  section  is determined. In the event of payment for
    30  intermittent temporary partial disability paid after one hundred  thirty
    31  weeks  from  the  date  of  accident  or disablement, such time shall be
    32  reduced to a number of weeks, for which the carrier will receive a cred-
    33  it against the maximum benefit weeks. For a  claimant  with  a  date  of
    34  accident  or  disablement after the effective date of the chapter of the
    35  laws of two thousand [seventeen] twenty-six that amended  this  subdivi-
    36  sion,  when permanency is at issue, and a claimant has submitted medical
    37  evidence that [he or she]  such  claimant  is  not  at  maximum  medical
    38  improvement,  [and  the  carrier  has  produced  or has had a reasonable
    39  opportunity to produce an  independent  medical  examination  concerning
    40  maximum  medical  improvement,]  and  the  board has determined that the
    41  claimant is not yet at maximum medical improvement,  the  carrier  shall
    42  not  receive  a  credit  for  benefit  weeks prior to a finding that the
    43  claimant has reached maximum medical improvement[,  at  which  time  the
    44  carrier  shall receive credit for any weeks of temporary disability paid
    45  to claimant after such finding against the maximum benefit weeks awarded
    46  under this subdivision]. For those claimants classified  as  permanently
    47  partially disabled who no longer receive indemnity payments because they
    48  have  surpassed  their  number  of  maximum benefit weeks, the following
    49  provisions will apply:
    50    (1) There will be a presumption that medical services  shall  continue
    51  notwithstanding  the  completion of the time period for compensation set
    52  forth in this section and the burden of going forward and the burden  of
    53  proof  will  lie with the carrier, self-insured employer or state insur-
    54  ance fund in any application before the board to discontinue or  suspend
    55  such services. Medical services will continue during the pendency of any
    56  such application and any appeals thereto.

        A. 3542--A                          3
 
     1    (2)  The board is directed to promulgate regulations that establish an
     2  independent review and appeal by an  outside  agent  or  entity  of  the
     3  board's  choosing  of  any  administrative  law judge's determination to
     4  discontinue or suspend medical services before a final determination  of
     5  the board.
     6    § 2. This act shall take effect immediately.
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