Compensation Claims Referee (NY HELPS), WCB Item #875

Under the direction of the Senior Workers' Compensation Claims Referee, the duties of the Workers' Compensation Claims Referee will include, but are not limited to, the following:

• Conducts hearings and render decisions on claims arising under the Workers' Compensation Law, Disability Benefits Law, Volunteer Firefighters Benefit Law, Volunteer Ambulance Workers' Law and Paid Family Leave Act.
• At such hearings, they ascertain the substantial rights of the parties; consider and evaluate documentary evidence and testimony, both lay and medical, given at hearing; orders medical examinations of claimants; determine questions of fact and of law, and make findings and decisions.
• When claimant is not represented by counsel, assists the claimant in the pursuit of his/her claim; questions claimant and his/her witnesses and cross-examines carrier's witnesses on claimant's behalf.
• Confers with claimants, their representatives, and carriers at preliminary hearings to establish issues in controversy, to determine witnesses needed and their availability, to establish time required for taking testimony, and to set definite dates for trial hearings.
• In cases involving difficult and controversial medical issues, they may require the examination of a claimant by an impartial specialist in accordance with law and Board rules; determines specialty in field of medicine in which impartial specialist must be qualified; prepares findings of fact and indicates the specific questions for opinion by the designated impartial specialist.
• Directs reimbursement to disability benefit carriers in controverted workers' compensation cases where award is made to claimant and where notice of line is on file; orders reimbursement to employers where advance payment of compensation was made, and claim is made for reimbursement; orders reimbursement to New York City or New York State Retirement systems for benefits paid during pending of a workers' compensation controversy.
• Directs investigation is required relative to physical conditions involving injurious exposures in cases of occupational disease; reviews evidence submitted to determine dependency status and make appropriate decisions.
• For particular claims cases, such as those involving the Special Fund, death of the claimant, and apportionment between carriers, takes all testimony and develops the record, and renders decisions indicating the proper party to receive the award.
• Exercises discretion in determining the need for adjournment of cases.
• Identifies claims cases involving novel or important questions of law or a question of public policy, exercises the privilege of certifying such questions to the Board, submitting his/her findings of fact and the question presented by the record for decision.
• Hears cases wherein the Board has approved an application for rehearing or reopening or restored the case to the calendar for any other reason.
• Receives and analyzes evidence of the purpose of arriving at a decision or for submission of such evidence to the Board for its own decision.
• Reserves decision where circumstances require the same, reviews higher court rulings and renders a written memorandum of decision after due deliberation.
• Studies latest decisions of the courts and recent amendments to the Workers' Compensation Law and correlates other laws of the State of New York and of the United States in the formulation of decisions.
• Administers oaths, takes affidavits, and depositions.
• Issues subpoenas to compel the attendance of witnesses and the production of books, contracts, papers, documents, and other evidence.
• Impose penalties in accordance with provisions of law.
• Awards fees to claimants' attorneys or licensed representatives; sets attendance fees for doctors scheduled to testify.
• Exercises control of the record taken at hearings and orders transcriptions of minutes as necessary.
• Presides over discrimination hearings where it is alleged that an employer fired or discriminated against an employee for filing or attempting to file a workers' compensation or disability benefits claim, or for testifying or attempting to testify in a workers' compensation or disability benefits proceeding.
• Presides over discrimination hearings under the Paid Family Leave Act where it is alleged that an employer fired or discriminated against an employee for filing or attempting to file a Paid Family Leave Act claim, or for testifying or attempting to testify in a Paid Family Leave Act proceeding.
• Presides over cases in which the employer is noninsured.

Makes all appropriate awards, determines penalties, and orders security deposits by the noninsured employer.

• Determines payor of medical bills and when appropriate orders workers' compensation carrier to reimburse private health insurer for bills they have paid.
• Reviews and approves stipulations always ensuring the claimants' rights are fully protected.
• Conducts hearings relating to denials of authorization for medical treatments; rules on legal objections to medical bills raised by carriers.
• Drafts informal resolutions.
• Reviews and finalizes informal resolutions and Orders of the Chair.
• Performs related duties as required.

The judge will cover in-district with a possibility out-of-district coverage.

Minimum Qualifications

This title is part of the New York Hiring for Emergency Limited Placement Statewide Program (NY HELPS).

For the duration of the NY HELPS Program, this title may be filled via a non-competitive appointment, which means no examination is required but all candidates must meet the minimum qualifications of the title for which they apply. At this time, agencies may recruit and hire employees by making permanent non-competitive appointments and the official probationary period will begin.

At a future date (within one year of permanent appointment), it is expected employees hired under NY HELPS will have their non-competitive employment status converted to competitive status, without having to compete in an examination. Employees will then be afforded with all of the same rights and privileges of competitive class employees of New York State. While serving permanently in a NY HELPS title, employees may take part in any promotion examination for which they are qualified.

Non-Competitive Minimum Qualifications:

Five years of full-time, professional level legal experience, subsequent to admission to the New York State Bar, which must have included three years of full-time experience in the practice of Workers’ Compensation Law, Volunteer Firefighters’ Benefit Law, Volunteer Ambulance Workers’ Benefit Law, Personal Injury Law, or Insurance Claims Law. Qualifying experience includes: experience as an attorney representing claimants, workers’ compensation insurance carriers, self-insured employers, State Insurance Fund, or the Special Funds Conservation Committee before the Workers’ Compensation Board; experience as an attorney representing plaintiffs or defendants in personal injury actions; experience as an attorney representing applicants in social security disability matters; and/or as a judge in a court of record; or as an administrative hearing officer presiding over adversarial proceedings, arbitration, or fact finding within a private or public tribunal. Qualifying experience includes: experience as an administrative law judge with a federal, state, or municipal agency; experience as a city court, town, or village justice.

Promotion:

Must be a qualified employee of the New York State Workers’ Compensation Board and have had two years of permanent competitive or 55-b/55-c service as a Senior Attorney.

Individuals certified eligible for the 55b/c program under the Governor’s Program to Hire Persons/Veterans with Disabilities pursuant to Section 55b/c of the Civil Service Law will also be considered. To be considered, you must meet the minimum qualifications and provide a copy of your letter of eligibility with your response. Candidates must meet the non-competitive minimum qualifications listed above.

Transfer Qualifications:

Candidates must have one year permanent or 55 b/c service in a title designated as appropriate for transfer in accordance with Section 52.6 of the Civil Service law.