It’s not news to most New York Workers’ Compensation claimants and certainly not news to physicians and other health care providers that the Workers’ Compensation Board has been imposing increasingly rigorous paperwork requirements on providers without a commensurate increase in the amount providers can charge and the fee schedule was already set at a rate where many providers considered seeing Workers’ Comp claimants as a money-losing proposition.  

This was something that could only last so long.  This afternoon Robert E. Beloten, the Chair of the NY Workers’ Compensation Board, announced in Subject Number 046-398 that there is a provider shortage in the Rochester Area or more specifically in Monroe, Livingston, Steuben, Allegheny, Wyoming and Ontario counties.  As a measure to deal with that shortage, Mr. Beloten temporarily rescinded statewide the mandate that providers file a C-4 form in order to be paid for seeing claimants.  Providers’ bills will be enforced if they are submitted on universal claim forms (CMS-1500 or HCFA-1500) with sufficiently detailed office or narrative notes.

Hopefully this reduction in mandatory paperwork will stem the tide of providers turning away Comp claimants.   Let’s also hope that this temporary measure is made permanent.

I would only caution claimants who are temporarily disabled and who have lost time from work that if your doctor is no longer submitting the C-4 form, it’s a really great idea to remind him or her to document your degree of disability in the office or narrative note.  That little bit of advice will go a long way to making sure you get paid for your lost time.

Thanks for reading,

Eric L. Johnson, Esq.
Workers’ Compensation and Disability Attorney
Ziff Law Firm, LLP
303 William St., Elmira, NY 14901
Tel: (607) 733-8866
Fax: (607) 732-6062
Toll Free: 1-800-943-3529