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Contested New York State Workers’ Compensation Cases

November 27, 2011 By Paul Giannetti

The next several articles will give a summary of several issues which commonly arise in controverted cases.  Hopefully, they can provide a general roadmap to claimants caught up in the litigation process before the Workers’ Compensation Board.

There is no substitute for having legal counsel review, prepare, and prosecute your claim and we always recommend that claimants make an effort to learn as much as they possibly can about their legal rights and responsibilities under the New York State Workers’ Compensation Law.

The first topic involves the concept of controverted cases.

Under the New York State Workers’ Compensation Law, the insurance carrier must file form C-7 to contest or deny a claim for benefits.  Most commonly, a C-7 form is filed within 25 days after a claim has been indexed or set up by the Workers’ Compensation Board.  If the C-7 is filed more than 25 days after the indexing, the insurance carrier may loose some of its legal defenses.

A copy of form C-7 can be found at www.wcb.state.ny.us/content/main/forms/c7.pdf

Practically speaking, if you receive a C-7 you should immediately consult with an attorney since your case is being controverted.  A controverted case means that the insurance carrier wants to present evidence in an attempt to deny your claim.  It also means that your claim will process through several phases and will likely take an extended period of time before a ruling is made by the Administrative Law Judge regarding your entitlement to benefits.

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