Education

The New York State Workers’ Compensation Board has provided an update on the December 2024 Mental injury legislation, providing clarity for employers, insurers, and legal counsel alike on the interpretation of extraordinary work-related stress. For context, on December 6, 2024, Governor Hochul signed legislation amending Section 10 of the Workers’ Compensation Law (WCL) with respect to claims for mental injuries resulting from work-related stress, subject to a chapter amendment agreed to by the Legislature and the Governor (Laws of New York, 2024, Chapter 546, Approval Memorandum 21 [enacting S6635/A5745]).

On February 14, 2025, the Governor signed a chapter amendment (Laws of New York, 2025, Chapter 79 [enacting S755/L1677]). The amendment says that covered employees must demonstrate that the mental disorder arose out of extraordinary work-related stress attributable to a distinct work-related event or events directly related to the employment and occurring during the performance of the employee’s job duties.

The new amendment will take effect June 4, 2025.

What this Means for Employers and Insurers

The key in this new amendment is the word extraordinary. Defining what constitutes extraordinary will come down to each case or judge and cannot be definitively determined until litigation begins in June. The same can be said for the word distinct when referring to distinct work-related events or an event. While the definition and impact of these terms won’t be clarified until June, there are other impacts that these amendments bring, including:

• The amendments to WCL § 10 in S6635/A5745 were superseded by the chapter amendment signed on February 14, 2025 (S755/L1677) and are no longer in effect.
• The amendments to WCL § 10 in S755/L1677 that go into effect on June 4, 2025, will apply to all pending claims, regardless of the date of accident.
• Prior to June 4, 2025, pending claims will be decided based on existing law.

Of note, a new paragraph (c) will be added to subdivision (3) of WCL § 10, providing:

(c) The board may not disallow a claim by a covered employee upon a factual finding that the stress was not greater than that which usually occurs in the normal work environment where a claim for post-traumatic stress disorder (PTSD), acute stress disorder or major depressive disorder resulting from work-related stress is filed upon submission of medical evidence based on the criteria contained in the version of the Diagnostic and Statistical Manual of Mental Disorders in effect on the date of accident, or as otherwise adopted by the board, provided that such adoption shall be no more stringent than the current or immediately preceding version of the Diagnostic and Statistical Manual of Mental Disorders. Such covered employee must demonstrate that such disorder arose out of extraordinary work-related stress attributable to a distinct work-related event or events directly related to the employment and occurring during the performance of the employee’s job duties.

What Jones Jones is Doing

Jones Jones will continue to monitor New York State Workers’ Compensation Law for additional updates, as well as work closely with legislators, judges, clients and others to clarify how the term work-related stress is now interpreted. We will also continue to closely watch any upcoming mental injury workers’ compensation cases or decisions made on mental health injuries to prepare for the potential influx of newly filed claims.

For more information on this new legislation, please visit the New York State website. If you have questions about how this new legislation may impact you, or if you have a mental injury connected to extraordinary work-related stress claim, please contact us at clientservices@jonesjonesllc.com

The legislation signed by New York Governor @Kathy Hochul on Dec. 6 and a February 14 amendment are set to take effect June 4, 2025, amending Section 10 of the Workers’ Compensation Law (WCL) with respect to claims for mental injuries resulting from work-related stress. Jones Jones will continue to monitor the NYSWCB for additional updates and prepare to take necessary action for the potential influx of newly filed claims.

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Dear Valued Clients,

As many of you know, Jones Jones has litigated workers’ compensation cases in the aviation and retail spaces for years. We have successfully settled a number of cases and secured positive outcomes in others in both sectors. As these types of cases continue to manifest, we recognized a need for established practices in these spaces to best address the needs of our clients in this space and to further refine our expertise and build on our track record in both sectors.

As of February 5th, 2024, we are pleased to announce the launch of the new Aviation and Retail practices at Jones Jones LLC. Our aim is to expand our service offerings while continuing to innovate and provide excellence as part of our core tenets.

The Aviation Practice

The Aviation Practice will span both New York and New Jersey, led by Partner Simeon Stamm. The practice will manage and oversee claims handling and litigation, specializing in training teams in best practices related to workers’ compensation litigation in the aviation space. The practice will have a special focus on industry trends and emerging risks and will approach all claims through both a workers’ compensation and general liability lens.

The Retail Practice

The Retail Practice will also span both New York and New Jersey, led by Partner Yvie Cherenfant. The practice will also manage and oversee claims handling and litigation and will specialize in workers’ compensation litigation for brick-and-mortar retail businesses, including but not limited to:

• • Grocery Stores
  • Convenience Stores
  • Big Box Retailers
  • E-Commerce Sites
  • And more

The practice will have a special focus on effective settlement of active cases and industry specific risks and will approach all claims with a focus on workers’ compensation and general liability matters.

Both practice areas will be supported by me and Executive Partner Matthew Jones in New York and Operations Partner Kristina Jones in New Jersey. Both are fourth generation Jones family attorneys.

For more information about Jones Jones LLC or to inquire about the Aviation or Retail practices, please visit https://jonesjonesllc.com/ or contact us at clientservices@jonesjonesllc.com.

Signed,
Sarah Thomas
Managing Partner
Jones Jones LLC

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FROM THE DESK OF MANAGING PARTNER SARAH THOMAS

Dear Valued Clients,

Jones Jones is aware that with the most recent updates from the New York Workers’ Compensation Board (the Board), including new employee/employer identification guidance, new claim conciliation procedures for additional sites of injury and consequential injuries, and expanded desk reviews for Section 32 waiver agreements, there will be an increase in proposed decisions from the Board.

What This Means for Insurers

Proposed decisions from the Board have the same weight as decisions from a Law Judge and must be thoroughly evaluated. After a proposed decision is investigated, action will oftentimes need to be taken. Such actions include, but are not limited to:

• Review of a medical file
• Request for testimony of the claimant or a lay witness
• Request for cross-examination of a doctor
• Objection to the board decision.

These actions, and others are necessary and important for ensuring you receive the best outcome possible, regardless of the proposed decision. Jones Jones intends to continue partnering with our clients to ensure they are properly supported in the wake of these changes.

Steps Jones Jones is Taking

A team of Jones Jones attorneys is prepared to review each proposed decision in detail and act on those that might impact a client’s case. Proposed decisions could influence an increase in body part establishment, prompt issue awards such as schedule loss of use, or even act as the catalyst to begin permanency litigation. At Jones Jones, we will do all we can to ensure there are no negative effects on your case due to proposed decisions.

Any client who receives a proposed decision from the Board should forward the file to clientservices@jonesjonesllc.com where we will review the decision on your behalf and take appropriate measures. Our goal at Jones Jones is to strive toward excellence each day with you, our clients. For more information regarding recent updates from the Board, please visit our blog page. For any questions regarding these updates or if you have a proposed decision from the Board for review, please email clientservices@jonesjonesllc.com

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New York Governor Kathy Hochul recently signed new legislation allowing any New York worker to file for workers’ compensation for specific types of mental injury connected to extraordinary work-related stress. Bill S.6635/A.5745 expands an existing law enacted in 2017 which allowed for only first responders facing post-traumatic stress disorder (PTSD) to file for such benefits.

The new law will take effect on Jan. 1, 2025.

What this Means for Insurers

New York workers will experience expanded access to mental health benefits regarding work-related stress. This also means state insurers and employers can expect to see an increase in work-related stress claims as more employees file for coverage. Resulting cost increases in response to related claims and the burden of proof for work-related stress claims will likely also transfer to the employer.

Action by Jones Jones

As this new legislation takes effect, Jones Jones expects there to be an increase in related mental health claims. In anticipation of a surge of new claims, Jones Jones will closely monitor any changes related to the new law and any other changes that may come about because of this legislation. We will also closely watch any upcoming mental injury cases or decisions made on mental health injury cases to prepare for the influx of newly filed claims.

This development creates a new world for the workers’ compensation industry in New York. While we don’t know exactly how these new claims will shape future litigation, we can and will look to other states, such as Connecticut, with similar laws that may provide guidance. Regardless, Jones Jones will continue to provide the same level of excellence, experience, innovation and efficiency we have delivered for more than 100 years.

For more information on this new legislation, please visit the New York State website. If you have questions about how this new legislature may impact you, or if you have a mental injury connected to extraordinary work-related stress claim, please contact us at concierge@jonesjones.com.

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The Jones Jones construction team is pleased to share that to resolve confusion around Employee Claims (Form C-3) and reduce delays in cases where the identity of the proper employer or insurance payer is not immediately known, the New York State Workers’ Compensation Board (the Board) has created a new process to be used when the employer and payer are in dispute.

The New Procedure

Henceforth, when a complete C-3 form is filed, the law judge will direct the scheduling of a subsequent hearing, moving such claims forward more quickly.

While law judges currently direct the filing of a C-3 form at a hearing to collect data and move the form forward, a large percentage of all pre-hearing conferences were placed in “No Further Action (NFA)” status in 2023 due to the failure to file a complete C-3 form. Law judges directing the filing of a C-3 form prior to a hearing will ensure claimants and their legal representatives file the complete C-3 form with the Board.

Key Information and Filings

In claims where the proper employer and insurance payer are in dispute, certain information will be critical. Important information on the C-3 form includes:

• Field B-1: The name of the employer or as much of it that is known
• Field B-6: The full name of the person who hired the claimant or as much of it that is known
• Field D-3: The full address where the accident occurred
• Field D-5: A detailed description of the claimant’s work at the time of injury

Additional information important to determining the identity of the proper employer and insurance payer include:

• Form PH-16.2: The Pre-hearing Conference Statement must be completed and include any evidence relevant to the identification of the proper employer such as:
  • Pay stubs,
  • Phone numbers,
  • Text messages, etc.
• Form MV-104 (NYS DMV Report of Motor Vehicle Accident): If the work-related injury was the result of a motor vehicle accident this form must be presented to the Board if the case is controverted on the issue of whether the injury occurred in the course of employment.

Questions of Liability

When compensation is withheld solely because a controversy exists on the question of liability as between carriers, the Board may direct that any carrier shall immediately pay compensation, without prejudice, pending further development of the record on the issue of the proper carrier (see WCL Section 25[1][f]). Due to this it will be in the best interest of carriers to cooperate with the full extent of the Board’s efforts to determine the proper employer in a case.

What Jones Jones is doing:

To best cooperate with the Board and expedite all claims where the identity of the proper employer or insurance payer is not immediately known, Jones Jones will work to have any hearing that is scheduled without a properly filed C-3 closed with no hearing. Additionally, our PH16.2 team, led by Partner Stacee Vaikness will thoroughly review all C-3 forms for proper information and will contact the board to seek cancellation of any improperly set hearings.

The cancellation of hearings with improperly filed C-3 forms or inaccurate information will help move properly filed C-3 form hearings forward. Excellence is one of the four tenets we live by at Jones Jones, and we strive to have that excellence present in every aspect of every case we work, including the details of forms filed, such as the C-3. We will work to ensure every C-3 form filed and subsequent hearing moves as efficiently as possible by confirming all the necessary information is present.

For more information on this new process, please visit the Board’s webpage. If you have questions about how this new procedure may impact you, or if you have a case where the identity of the proper employer or insurance payer is not immediately known, please contact us at clientservices@jonesjonesllc.com

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