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Q: New York State Disability and Workers Comp ( Answered 5 out of 5 stars,   0 Comments )
Question  
Subject: New York State Disability and Workers Comp
Category: Business and Money > Small Businesses
Asked by: luvmycat-ga
List Price: $100.00
Posted: 12 Feb 2006 07:47 PST
Expires: 14 Mar 2006 07:47 PST
Question ID: 444817
We are a manufacturers rep agency incorporated in New York State.  We
have sales people who are regular employees and their field offices,
including secretaries, throughout the Eastern U.S., specifically GA,
SC, MA, NJ, OH, and Ontario, Canada.  Are our employees who live
outside of NY State covered by our NY State Disability and Workers
Comp insurance, which is thru NYS?  Can you please include a link to
any NY Gov website that specifically answers this question?

Request for Question Clarification by pafalafa-ga on 12 Feb 2006 09:36 PST
lmc-ga,

My decidedly non-professional understanding of the rules is that
workers who are permantly stationed in states other than NY are NOT
covered by NY's mandatory workers comp/disability rules and regs.

I have written to the Workers Comp Board for confirmation of this, and
I'll let you know what their response is when I hear from them.

In the mean time, you may want to check the details of your workers
comp insurance policy, as they may or may not have extended coverage
to out-of-state employees, even though such coverage is not mandatory.
(Such an extension wouldn't have come free -- if they are charging you
a per-employee fee, and have counted the out of state employees, then
they may, in fact, be covered).

Again, I'll let you know what I learn.


pafalafa-ga

Clarification of Question by luvmycat-ga on 12 Feb 2006 11:20 PST
After nearly 2 months of trying, we have not been able to get a copy
of our declarations page to see what's covered and what's not, or any
answers from the NYS Disability or Workers Comp offices - so we don't
know at this time if we have an extension for out of state employees. 
It's good to know this may be an option.  You wrote that out of state
coverage is not mandatory for a company in NYS.  Please clarify this. 
Does this mean that we are not required to have disability/workers
comp insurance on our employees in GA, for example, and it would be
entirely up to them to get it personally?  Thank you for your help.
Answer  
Subject: Re: New York State Disability and Workers Comp
Answered By: pafalafa-ga on 13 Feb 2006 11:28 PST
Rated:5 out of 5 stars
 
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

Request for Answer Clarification by luvmycat-ga on 14 Feb 2006 05:40 PST
Thank you very much.  This is the only paragraph that applies to us in his answer:

   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.

He says "Generally".  Our people have offices in their homes.  We, as
a company, do not operate offices outside of NY State.  I'll ask him
directly for clarification on this issue.

You found a person that answers quickly and politely, and at length
which is more than we were able to do.  We'll talk to him directly. 
There is no insurance carrier other than NY State.  Since there are no
riders in our policy regarding out of state employees, I assume we
don't have coverage on them.

Can you please tell me what the difference is between workers comp and
disability?  Are they both covered out of the same insurance policy? 
Or are they two entirely different things?  As we understand it right
now, they each pay up to $170/week maximum for injuries, for a total
max benefits of $340/week regardless of someone's income.

Thank you for your help.

LuvMyCat

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
luvmycat-ga rated this answer:5 out of 5 stars
Great summary and research.  Thank you!

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