New Year, First New York Appellate Decision on Workers’ Comp: A 1977 Case Resurfaces

We have the first New York Appellate Decision on workers’ compensation for the new year!

And this is a real throwback case. 1977 accident. Total permanent disability established in 1991. That same year, the carrier agreed to cover non-WC coded physicians on gastroesophageal and gastrointestinal conditions. Fast forward to present day, and the claimant wants to continue with non-coded physicians with the carrier covering it. The Board held that the agreement by the carrier in 1991 regarding paying for non-coded physicians was unenforceable in workers’ compensation and is outside the jurisdiction of the Workers’ Compensation Board.

The 3^rd Dept held that the claimant failed to appeal the decision timely, instead choosing to go for reconsideration for full board review without filing a notice of appeal. While the carrier has been paying benefits for the past 49 years, they do not have to pay non-coded physician bills anymore.