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A08482 Summary:

BILL NOA08482A
 
SAME ASSAME AS S06376-A
 
SPONSORCruz
 
COSPNSRBronson, Jacobson, Santabarbara, Sayegh, Griffin
 
MLTSPNSR
 
Amd §15, Work Comp L
 
Prohibits insurance carriers and employers from withholding certain benefits from injured workers based on a claim that such workers have voluntarily withdrawn from the labor market by not seeking alternate employment that their injury or illness does not preclude them from performing.
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A08482 Text:



 
                STATE OF NEW YORK
        ________________________________________________________________________
 
                                         8482--A
                                                                Cal. No. 213
 
                               2025-2026 Regular Sessions
 
                   IN ASSEMBLY
 
                                      May 16, 2025
                                       ___________
 
        Introduced  by M. of A. CRUZ, BRONSON, JACOBSON, SANTABARBARA, SAYEGH --
          read once and referred to the Committee on Labor -- ordered to a third
          reading, amended and ordered reprinted, retaining  its  place  on  the
          order of third reading

        AN  ACT to amend the workers' compensation law, in relation to prohibit-
          ing insurance carriers and employers from withholding certain benefits
          from injured workers based on attachment to the labor market
 
          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 injured employee's wage-earning capacity thereafter in  the
     8  same  employment  or otherwise.  Compensation under this paragraph shall
     9  be 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
    22  which the loss of wage-earning capacity is greater than  eighty  percent
 
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD10555-03-6

        A. 8482--A                          2
 
     1  but  not  more  than  eighty-five  percent; (v) four hundred twenty-five
     2  weeks in cases in which the loss of  wage-earning  capacity  is  greater
     3  than  seventy-five  percent  but not more than eighty percent; (vi) four
     4  hundred  weeks  in  cases  in which the loss of wage-earning capacity is
     5  greater than seventy percent but not  more  than  seventy-five  percent;
     6  (vii)  three  hundred  seventy-five  weeks in cases in which the loss of
     7  wage-earning capacity is greater than sixty percent but  not  more  than
     8  seventy  percent; (viii) three hundred fifty weeks in cases in which the
     9  loss of wage-earning capacity is greater than fifty percent but not more
    10  than sixty percent; (ix) three hundred weeks in cases in which the  loss
    11  of wage-earning capacity is greater than forty percent but not more than
    12  fifty  percent; (x) two hundred seventy-five weeks in cases in which the
    13  loss of wage-earning capacity is greater than  thirty  percent  but  not
    14  more  than forty percent; (xi) two hundred fifty weeks in cases in which
    15  the loss of wage-earning capacity is greater than  fifteen  percent  but
    16  not more than thirty percent; and (xii) two hundred twenty-five weeks in
    17  cases  in  which the loss of wage-earning capacity is fifteen percent or
    18  less. For a claimant with a date of accident or  disablement  after  the
    19  effective  date of [the] section one of subpart A of part NNN of chapter
    20  fifty-nine of the laws of  two  thousand  seventeen  that  amended  this
    21  subdivision,  where  the  carrier  or employer has provided compensation
    22  pursuant to subdivision five of this section beyond one  hundred  thirty
    23  weeks  from the date of accident or disablement, all subsequent weeks in
    24  which compensation was paid shall be considered to be benefit weeks  for
    25  purposes  of this section, with the carrier or employer receiving credit
    26  for all such subsequent weeks against  the  amount  of  maximum  benefit
    27  weeks  when  permanent  partial  disability under this section is deter-
    28  mined. In the event of payment for intermittent temporary partial  disa-
    29  bility  paid after one hundred thirty weeks from the date of accident or
    30  disablement, such time shall be reduced to a number of weeks, for  which
    31  the carrier will receive a credit against the maximum benefit weeks. For
    32  a  claimant  with  a date of accident or disablement after the effective
    33  date of [the] section one of subpart A of part NNN of chapter fifty-nine
    34  of the laws of two thousand seventeen  that  amended  this  subdivision,
    35  when  permanency  is  at  issue,  and  a  claimant has submitted medical
    36  evidence that [he or she]  such  claimant  is  not  at  maximum  medical
    37  improvement, and the carrier has produced or has had a reasonable oppor-
    38  tunity  to produce an independent medical examination concerning maximum
    39  medical improvement, and the board has determined that the  claimant  is
    40  not  yet at maximum medical improvement, the carrier shall not receive a
    41  credit for benefit weeks prior  to  a  finding  that  the  claimant  has
    42  reached  maximum  medical  improvement,  at which time the carrier shall
    43  receive credit for any weeks of temporary disability  paid  to  claimant
    44  after  such finding against the maximum benefit weeks awarded under this
    45  subdivision. For those claimants  classified  as  permanently  partially
    46  disabled  who  no  longer  receive  indemnity payments because they have
    47  surpassed  their  number  of  maximum  benefit  weeks,   the   following
    48  provisions will apply:
    49    (1)  There  will be a presumption that medical services shall continue
    50  notwithstanding the completion of the time period for  compensation  set
    51  forth  in this section and the burden of going forward and the burden of
    52  proof will lie with the carrier, self-insured employer or  state  insur-
    53  ance  fund in any application before the board to discontinue or suspend
    54  such services. Medical services will continue during the pendency of any
    55  such application and any appeals thereto.

        A. 8482--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.  Section 15 of the workers' compensation law is amended to add a
     7  new subdivision 10 to read as follows:
     8    10. Effect of attachment to labor  market.  Benefits  or  compensation
     9  otherwise  due  under this section shall not be withheld, diminished, or
    10  conditioned upon an injured worker's demonstration of attachment to  the
    11  labor market.
    12    § 3. This act shall take effect immediately.
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