luvmycat-ga,
From what I gather from your note, and from the information below, it
seems like you'll certainly need to get information directly from your
insurance carrier as to the extent of coverage for workers in
different gelgraphical locations.
I asked the NYS Workers' Compensation Board for information, and
received a detailed response, along with contact information in case
you want any follow-up communication with the Board.
I trust the information below fully answers your question.
However, please don't rate this answer if you feel you'd like further
information. Instead, post a Request for Clarification, and I'll be
happy to assist you further.
Best of luck...hope nobody ever winds up needing disability/workers' comp!
pafalafa-ga
===============
[from the NYS Workers' Comp Board]
You asked a complicated question. I'll respond to it generally and then
ask that you call me directly for additional clarification based on your
specific situation.
Question:
"For a NY State company with some employees in out-of-state field offices,
are the out-of-state employees covered by Workers Comp? By Disability? "
Answer:
Each nation and each State within the United States has its own
requirements for workers' compensation insurance.
The NY workers' compensation insurance policy should cover NY employees
working out-of-state for up to 90 days of travel per year out-side of NYS.
However, you should verify this with the insurance carrier.
Further, to be prudent, a NY employer should check with local workers'
compensation officials in each nation and each State within the United
States that they are working in to see what the workers' compensation
insurance requirements are there. If a company has physical offices in
numerous states, workers' compensation insurance policy coverage is usually
required in each State and/or nation where those offices are located.
To provide you with additional guidance, the following are the NYS workers'
compensation and disability benefits requirements for an out-of-state
employer working in NYS. Please note that the requirements are more strict
than those referenced below if the out-of-state employer working in NYS is
getting a permit, license or contract from a NYS governmental entity.
NYS Workers Compensation Coverage Requirements
Generally, employers must have a workers compensation policy or a
combination of policies that cover each state in which they employ
individuals to cover on-the-job accidents and disabilities. As you are
probably aware, certain insurance carriers write policies that cover
multiple states. "Riders" found under sections "3A" and "3C" on the
Information Page of the policy specify the states of coverage. The
operations covered in each state are identified in attachments to the
policy.
In addition to any other state's workers compensation coverages, an
out-of-state employer needs to be specifically covered for NYS workers
compensation insurance when there are "sufficient contacts" between that
employer and the state. While there is no single determinative factor,
any of the following criteria could be the basis for finding "sufficient
contacts" requiring New York coverage:
- a physical location within New York State;
- $50,000 in payroll during a calendar year in New York State;
- one or more employees with a primary work location or hired
within New York State; or
- employees working in New York State for more than 90 days
during a calendar year.
If an out-of-state employer meets any of the above criteria, it is
required to carry a New York State workers compensation policy. When
New York is listed in Item 3A on the Information Page of an employer's
workers compensation insurance policy, the employer is fully covered
under the NYS Workers Compensation Law.
If an employer working in New York does not meet any of the above
criteria, the employer's employees will be covered when working in New
York by having "NY" listed in Item 3C on the Information Page of the
workers compensation insurance policy (the all-states section).
Out-of-state employers, including out-of-state employers from
monopolistic WC states that are working in NYS (employers from Ohio,
North Dakota, Washington, West Virginia & Wyoming) and foreign countries
(IE. Canada), who can not obtain 3C coverage on their home state's or
country's WC policies will NOT be penalized by the WCB for noncompliance
as long as their home state's or country's WC policy is in force and as
long as they do not meet any of the above criteria for specific New York
State workers compensation insurance. However, such out-of-state
employers will be liable to pay any workers compensation claims that are
found to be compensable under the NYS Workers Compensation Law.
NYS Disability Benefits Coverage Requirements
An out-of-state employer needs a New York State disability benefits
insurance policy if the employer employs one or more individuals on each
of at least 30 days in a calendar year in New York State. If an
out-of-state employer meets this criterion, the employer is required to
carry a New York State disability benefits policy. (The employer has
four weeks from the completion of the 30th day of work by one or more
individuals to obtain the disability benefits policy.) If an
out-of-state employer does not employ one or more individuals on each of
at least 30 days in a calendar year in New York State, NYS disability
benefits coverage is not required. (Independent contractors are not
considered to be employees under the Disability Benefits Law.)
It may be appropriate to check the yellow pages, contact your insurance
broker, carrier or agent, check with your trade association, or conduct
additional research to find the most appropriate insurance coverage for
your company. In addition, a NYS workers' compensation and/or disability
benefits insurance policy may be obtained from the NYS Insurance Fund by
calling 1-888-875-5790.
Please note that this letter is for informational purposes. Only the
Board, in its adjudicatory function, is authorized to determine
entitlement to benefits based on the specific facts of a case and its
application of the Law.
Please call me at (518) 486-6307 if you have any questions or require
any additional information. Hope you have a great week!
Steve
Steve Carbone
Bureau of Compliance
NYS Workers' Compensation Board
(518) 486-6307
steve.carbone@wcb.state.ny.us
===============
That's clear as mud...right? Unfortunately, that's the way the law
often is. However, it does seem that you'll need to bet specifics
from your insurance provider, and at least now you have a direct
contact at the WCB should you need to follow up.
Again, let me know if there's anything else I can do for you.
paf |
Clarification of Answer by
pafalafa-ga
on
14 Feb 2006 12:31 PST
I'm glad the information I gave you was useful (at least, in part). I
think you'll find your contacts with Mr. Carbone should help clarify
any outstanding issues or questions you may have.
You mentioned that "There is no insurance carrier other than NY
State..." I'm not sure of your meaning here, but it certainly is the
case that there are several hundred private insurers that handle
workers comp and disability policies, as well as an official NY State
Insurance Fund that can also issue policies.
As for the other questions you asked, I think you'll find answers to
most, if not all of them, at this site for the NYS Workers
Compensation Board:
www.wcb.state.ny.us
In particular, have a look at this document:
http://www.wcb.state.ny.us/content/main/Small_Business/CompCoverage.htm
Workers' Compensation Coverage--Requirements for Employers
and this more comprehensive handbook:
http://www.wcb.state.ny.us/content/main/Small_Business/employer_handbook.pdf
Employers? Handbook
A Guide to the Workers? Compensation System for the New York State Business Owner
which includes the following:
==========
What Does Workers? Compensation Insurance Buy?
When purchasing workers? compensation insurance, an employer is buying
the following protections:
· Medical services needed to treat the job injury or illness
· Temporary disability payments to the employee to help replace lost wages
· Permanent disability payments to the employee to compensate for
permanent effects of the injury
· A death benefit for the employee?s survivors in the event of a fatal injury
· Legal representation for the employer by the insurance carrier
· Protection for the employer against most lawsuits for on-the-job
injuries/illnesses
The employer must pay for the cost of insurance coverage; it is
illegal to require employees
to pay any of the costs associated with workers? compensation premiums or injuries.
==========
What are Disability Benefits?
New York is one of a handful of states that require employers to
provide disability benefits coverage to
employees for an off-the-job injury or illness. Coverage for
disability benefits can be obtained through an
insurance carrier or by becoming authorized by the Workers?
Compensation Board to self-insure.
Disability benefits are temporary cash benefits paid to an eligible
wage earner, when he/she is disabled by
an off the job injury or illness. The Disability Benefits Law provides
weekly cash benefits to replace, in part,
wages lost due to injuries or illnesses that do not arise out of or in
the course of employment. Disability
benefits are also paid to an unemployed worker to replace unemployment
insurance benefits lost because of
illness or injury.
==========
Hope that does the trick.
But as always, if there's anything else I can do for you, just say the word...
paf
|
Clarification of Answer by
pafalafa-ga
on
17 Mar 2006 11:11 PST
Well, whaddya know...?
I received another reply just today from the NYS Board, regarding your
question. Here it is:
=====
The employer is a New York company which has some employees working in
out-of-state field offices. The company requests clarification regarding
its obligation to provide compensation and disability coverage for those
employees. The question appears to be whether it is sufficient for the
employer to carry only New York State coverage. There is no clear cut
rule. He asks you what is really a complicated legal question; the answer
to which depends on which state or states or other governmental entities
will have jurisdiction to adjudicate a claim for workers' compensation
benefits filed by any of those out-of-state employees. If more than one
state will have jurisdiction to resolve a claim for benefits, the employer
needs to obtain workers' compensation and disability coverage effective in
each of those states or face possible assessments and penalties for failure
to secure payment of compensation. The Board does not render opinions with
respect to what coverage satisfies the requirements of any other state or
governmental entity.
Jurisdiction is the general power of a governmental entity to exercise
authority over persons and things within its geographical territory. The
New York State Workers' Compensation Board has jurisdiction over
work-related injuries occurring in New York State. Rutledge v Kelly &
Miller Bros., 18 NY2d 464 (1966). The question of which governmental
entity has jurisdiction over a particular claim for workers' compensation
benefits becomes more complicated when the injury does not occur in New
York State, the employer or the employee is not physically located in New
York State, and/or the employee is not a New York State resident. When
such jurisdictional questions arise in the context of claims filed in New
York, the New York State Workers' Compensation Board must determine whether
there are "sufficient contacts" with New York State which invest the Board
with the requisite authority to adjudicate a particular claim. Rutledge v
Kelly & Miller Bros., 18 NY2d 464 (1966); Nashko v Standard Water Proofing,
Co. 4 NY2d 199, 200-201(1958).
On the other hand, if the Board should determine that it does not have
jurisdiction over a claim filed in New York by an employee located, working
and injured in Georgia, New York Law will not apply, and the guidance
provided to you in a previous response by Steve Carbone from the Board's
Bureau of Compliance is inapplicable. Such a determination means only
that the claim is not subject to New York's law. The injured employee may
also file a claim in Georgia, which would have jurisdiction. In the
example provided, an employer who has employees residing and working in
Georgia is subject to Georgia's Workers' Compensation and Disability laws
and rules, and the prudent employer needs to comply with workers'
compensation insurance requirements in that state.
When an employee is injured in the United States, a State or the federal
government (in the case of longshoreman, railroad workers etc) will have
jurisdiction over that claim. There are instances where more than one state
may have jurisdiction (so called "concurrent" jurisdiction). Every state
has a workers compensation system in place. While I am not familiar with
each state's laws, there is a website that offers a link to each state's
workers' compensation agency. www.comp.state.nc.us/ncic/pages/all50.htm.
Also it is important to note that in New York, while employees may
contribute to a disability benefits plan, WCL §211, it is the employer, not
the employee, who is responsible for securing payment of compensation. WCL
§50.
While the employer's situation presents a complicated legal question, it is
not unusual, and Workers' Compensation insurance carriers routinely write
insurance policies that offer coverage in multiple states. It is important
for the employer to examine the Information Page of its workers
compensation and disability benefits insurance policy or policies. As
previously recommended by Steve Carbone, the employer should contact its
carrier for a copy of its insurance policy. If the carrier is not
responsive, a complaint can be filed with the New York State Insurance
Department, Consumer Services Bureau, at 800-342-3736. The employer can
ensure that it has the appropriate coverage by providing its insurance
carrier with clear and accurate information about its employees, e.g.,
where they reside, where they work, how their work is supervised, etc. I
hope that this response is helpful.
Very truly yours,
Deborah A. Ferro
Deputy Counsel
Workers' Compensation Board
20 Park St. Rm 401
Albany, New York 12207
Tel: (518) 473-8626
=====
Hope that's helpful, some.
paf
|
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