Workers' Compensation Claim Process / Resolution Filtered View

data.ny.gov | Last Updated 10 Jun 2019

This filtered view provides insights into the function of the adjudication process of the Workers’ Compensation Board. This filtered view contains information to answer commonly asked questions about worker injuries, such as: How many hearings were held for claims of a certain case type in a given year? How often are decisions involving carriers of a certain kind appealed? The Workers’ Compensation Board (WCB) administers and regulates workers’ compensation benefits, disability benefits, volunteer firefighters’ benefits, volunteer ambulance workers’ benefits, and volunteer civil defense workers’ benefits. The WCB processes and adjudicates claims for benefits; ensures employer compliance with the requirement to maintain appropriate insurance coverage; and regulates the various system stakeholders, including self-insured employers, medical providers, third party administrators, insurance carriers and legal representatives. Claim assembly occurs when the WCB learns of a workplace injury and assigns the claim a WCB claim number. The WCB “assembles” a claim in which an injured worker has lost more than one week of work, has a serious injury that may result in a permanent disability, is disputed by the carrier or employer, or receives a claim form from the injured worker (Form C-3).

Tags: wcb, compensation claims, assembled claims

This dataset has the following 12 columns:

Column NameAPI Column NameData TypeDescriptionSample Values
Current Claim Statuscurrent_claim_statustextPresent status of the claim whether newly assembled, re-opened, among several “in process” states, or closed.
Claim Injury Typeclaim_injury_typetextDescribes the Claim in terms of the type of award applicable: 1. NON-COMP – No compensation for the claim, 2. MED ONLY – The claims will pay out Medicals only, 3. TEMP TOTAL – Claim type involving loss of time, 4. PPD SCH LOSS – Scheduled Loss payment involving a part of body, 5. PPD NSL – Permanent Partial Non Scheduled Loss, 6. PTD – Permanent Total Disability 7. DEATH – A claim involving a deceased claimant.
Assembly Dateassembly_datecalendar_dateThe date the claim was first assembled. The WCB “assembles” a claim in which an injured worker has lost more than one week of work, has a serious injury that may result in a permanent disability, is disputed by the carrier or employer, or receives a claim form from the injured worker (Form C‐3).
Accident Dateaccident_datecalendar_dateInjury date of the claim.
First Appeal Datefirst_appeal_datecalendar_dateDate the claim was first appealed. A blank date means the claim has not yet been appealed.
Alternative Dispute Resolutionalternative_dispute_resolutiontextClaims subject to adjudication processes external to the Board - Y or N.
First Hearing Datefirst_hearing_datecalendar_dateDate the first hearing was held on a claim at a WCB hearing location. A blank date means the claim has not yet had a hearing held.
Highest Processhighest_processtextThe highest adjudication process the claim is currently in.
Hearing Counthearing_countnumberNumber of WCB hearings held on the claim.
Attorney/Representativeatty_rep_indtextIs the claim being represented by an Attorney/Representative (Y) or not (N)?
Carrier Typecarrier_typetextType of primary insurance provider whose coverage pertains to the injured worker (Private Carrier, State Insurance Fund, Self-insured, or Special Fund).
County of Injuryinjured_in_county_nametextName of the NY County where the injury occurred.