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 3rd 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.
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