Education

At the end of 2023 the New York State Workers’ Compensation Board (the Board) announced their plan to begin indexing every complete workers’ compensation case by mid-2024. We are writing today to inform you that process will begin shortly.

What does this mean for carriers? Every case with an Employee Claim (Form C-3) or First Report of Injury (FROI) and a medical report of treatment will be indexed by the Board. Additionally, following indexing, any denial of the claim must be filed with the Board within 25 days of the date of indexing or defenses listed in Workers’ Compensation Law Section 25(2)(b) will be barred.

Due to this indexing, we foresee an increase in workload for all carriers, third-party administrators and self-insurers due to a potential increase in claim denials. As the process moves forward, we have the following recommendations for our partners:

• All parties should ensure their adjusters are prepared for the possible influx of work. This means the examiners will need to review their cases and be timely in responding to each case to ensure the preservation of their right to deny a claim if proper and necessary.

• If there is no medical report in the file, we do not expect the case to be indexed.

• However, if there is a medical report in the case all parties need to ensure the examiner has had an opportunity to fully investigate the case and to have come to a determination as to whether to accept or deny it.

• Examiners should contact their defense counsel to collaborate on making final determinations.

• Carriers, third-party administrators, and self-insured employers should also attempt to gauge how many unindexed claims they have so they can determine if they need to dedicate a specific task force or team to this in the coming months.

For more information on this announcement or to collaborate on case denial or acceptance, please contact clientservices@jonesjonesllc.com.

We are all familiar with the dread that accompanies an open case. Countless hours and dollars are spent going back and forth with the opposing party, not to mention the stress and headache of ongoing litigation. Focused on resolving this dread, and the related costs, Jones Jones LLC attorneys across New York and New Jersey take a different approach, applying a settlement-first mindset to all cases and handling of workers’ compensation claims. Whether the venue was in live court in New Jersey, virtual hearings in New York or around a conference table in downtown Manhattan — our attorneys’ mission to close claims resulted in several major wins in June.

New Jersey Wins:

Partner Christine Diana and Associate Kristina Jones settled nine workers’ comp claims in a single morning during a recent court appearance. They capitalized on our firm’s unique approach once it was clear all parties were physically present under tenuous conditions. A quick look at some of those wins include:
• A 55-year-old safety officer with multiple claims had already undergone bilateral bicep tendon repair. Rather than leave this claim open to high-cost medical treatment for many years, Christine Diana strategically negotiated a successful settlement in person.
• Kristina Jones used live testimony from an injured worker who had suffered an occupational disease to bilateral ankles with bilateral ankle replacement to successfully close a case with a Section 20. “The ability to take the gentleman’s testimony and understand his thought process made it easier for me to assess his settlement needs and close this case with a full and final settlement,” she said.

Success in New York:

In New York, Partners Rosanna Shamash, Ian Leaderman, and Samantha Sharpe held a settlement conference with a self-insured employer. The settlement conference culminated in dozens of full and final Section 32 settlements. They strategized with the client directly, sought immediate authority to settle claims and conferenced with injured worker attorneys in the moment. “It was a hugely satisfying day resulting in many settlements, including closure of claims that have been open for several years,” said Samantha.

Managing Partner Sarah Thomas has made it a mission to instill a settlement approach to claims for the last decade. “These successes are a culmination of the continued cultural shift our firm has taken seriously in the settlement space within workers’ comp. We are constantly available to push the envelope – to ask the hard questions – and dig deeper as to why a workers’ comp claim may not be settling. We are always pushing a claim towards a settlement where possible. And when faced with a challenge, our team attacks it head on. Nothing stops a Jones Jones attorney,” she said.

Proud of the firm’s 100-year history and ability to constantly pivot and stay ahead of all workers’ compensation changes and nuances, Executive Partner Matthew Jones explained the settlement focus is part of the firm’s intentional culture, “We talk about settlement approach, best practices and share each other’s wins during our attorney meetings. Learning from one another about best practices for obtaining a settlement using an out-of-the-box approach for a client is exciting. It culminates in a finality that is best for the client, best for the injured worker and rewarding for those of us trying to do our best for our client.”

If you are interested in seeing how a settlement conference can impact your caseload, or if you would like to discuss a settlement strategy-contact settlements@jonesjonesllc.com or sthomas@jonesjonesllc.com. The Jones Jones LLC team is excited to navigate you and your team through the settlements of NY and NJ!

New York state workers’ compensation law is in a time of unprecedented change. Our Managing Partner Sarah Thomas shares her views in the New York Law Journal on several of the proposed changes that may well have a deleterious effect on many industries operating within the state.

Sarah Thomas, our managing partner offers her thoughts on settling claims involving surgery to Workers’ Compensation Experts.  Read more insight on this process from Sarah here.