Within 14 Days of Receipt of the First Report of Injury:

The insurer must provide the injured worker with a written statement of worker's rights under the law, Statement of Rights (Form C-430S). This must be provided within 14 days after the employers' notification of injury/illness or with the first check, whichever is earlier (WCL §110 [2]). If the insurer requires the injured worker to use a provider within a network for diagnostic tests it must provide the injured worker with the name and contact information from the network (WCL §13-a[7][b]).

Whichever of the Three is Greater:

• Within 18 Days After the First Day of Disability, or
• Within 10 Days After the Employer First Has Knowledge of the Alleged Accident, or
• Within 10 Days After the Employers' Notification of Injury/Illness

The insurer begins the payment of benefits if lost time exceeds seven days. If the claim is being disputed, the insurer must inform the Workers' Compensation Board (and the claimant and claimant's representative, if any). Until the controversy is resolved, the insurer does not have to pay indemnity or medical benefits, although the health care provider must continue to treat during this period.

If the claim is not disputed but payment is not being made for specific reasons stated on the notice, (e.g., that there is no lost time or that the duration of the disability is less than the seven-day waiting period), the insurer must also notify all the parties (WCL §25 [1] and 12 NYCRR §300.22).

The insurer files the appropriate First Report of Injury (FROI) or Subsequent Report of Injury (SROI) transaction with the Board indicating either that payment has begun or the reasons why payments are not being made. A copy of the FROI or SROI transaction must be transmitted to the claimant and claimant's attorney/licensed representative, if any, simultaneously with the filing with the Board. If the employee does not notify the employer timely, this notice may be filed within 10 days of learning of the accident.

Within 25 Days of the Notice of Indexing:

Where controverted

When the Board notifies an employer or its insurer that a workers' compensation case has been indexed against the employer, and the employer or insurer decides to controvert the claim, a notice of controversy shall be filed with the Board within 25 days from the date of mailing of the notice of indexing. Failure to file the notice of controversy within the prescribed 25 day time limit could bar the employer and its insurer from pleading certain defenses to the claim (WCL §25[2][b]).

Where not controverted

If the right to compensation is not controverted but payment has not begun because no compensation is presently due, a partial denial shall be filed with the Board not later than 25 days after the Board has transmitted a notice of indexing a case to the employer or its insurer.

Every Two Weeks:

The insurer continues to make payments of benefits to the injured employee (if the case is not being disputed). The insurer must notify the Board with a SROI transaction when compensation is stopped or modified (WCL §25 [1][d]).

Before the Employee has Lost 12 Weeks of Time from Work (Continuous or Intermittent):

The insurer considers the necessity of rehabilitation treatment for the injured employee. Carrier's Report on Rehabilitation (Form R)

Hearings:

Notices of hearings will ordinarily be sent by the Board to the insurer for the employer, or directly to the employer if self-insured. An employer having knowledge of a hearing is not obligated to attend unless a hearing notice is sent to the employer, specifically requesting attendance, or unless a representative of insurer requests attendance.