This amendment takes effect January 1, 2027. The Board is proposing regulations to help implement this law.

This proposal will be published soon in the State Register and posted to the Board’s website. There will be a 60-day public comment period following publication in the State Register.

Questions?

Email regulations@wcb.ny.gov with questions.

The Board has underscored that payers who do not properly reimburse providers for CPT code 99080 may be subject to penalties from the Board. Today, the Board is advising what providers should do if the offset is not paid, and the proper way for payers to object to an offset.

Effective March 31, 2026, in situations where the bill for services/treatment was paid or paid in part, but the offset code was not, providers may submit a Request for Decision on Unpaid Medical Bill(s) (Form HP-1.0). The Board may issue an administrative award on the payer for failure to pay the offset, including a $50 penalty for each instance of nonpayment for which a Form HP-1.0 is submitted, per WCL §13-g. 

For payers, if the only code on a bill they are objecting to is 99080, the payer should note this objection in the Explanation of Benefits. It is not appropriate to use a Notice to Health Care Provider and Claimant of an Insurer’s Refusal to Pay All (or a portion) of a Medical Bill Due to Valuation Objection(s) (Form C-8.4) or Notice of Objection to a Payment of a Bill for Treatment Provided (Form C-8.1B) for this situation.

Note: the only valid objections to payment of the 99080 offset on a bill for which the medical services or goods were reimbursed (all or in part) is that the requested offset exceeds the regulatorily permissible amount, or that offset code 99080 appears more than once on the same bill.

CMS-1500 electronic submission mandate 

The requirement to submit CMS-1500 bills electronically via a Board-approved electronic submission partner went into effect August 1, 2025. If you have not obtained an electronic submission partner, you should do so immediately. 

The mandate applies to each individual provider in a practice who treats workers’ compensation patients.  

Payers can deny payment of services if the CMS-1500 form is not submitted through a Board-approved electronic submission partner and the Board will not enforce payment. 

Submitting the CMS-1500 electronically has significant benefits, namely, faster bill payments. Visit the CMS-1500 section of the Board’s website for a complete list of benefits. 

More information 

See our fact sheet for more information and visit wcb.ny.gov/CMS-1500 for complete details. 

Questions? Email CMS1500@wcb.ny.gov. 

This training will provide a brief overview of the transition, preview how the eForm will be completed, and showcase the simplicity of submitting Form RFA-2 in eCase. Board subject matter experts will be taking questions at the end of the webinar. 

Register now

There are two webinar dates available – please note that the same presentation will be delivered during both sessions. Register for your preferred session below or by visiting the upcoming webinars page:  

Tuesday, March 3, 2026
1:00 PM – 2:00 PM

Register now

Tuesday, March 10, 2026
10:00 AM – 11:00 AM

Register now

More information

Please review Subject Number 046-1800 for further details on the mandate.  

Submission options and full instructions for completing Form RFA-2 electronically can be found on the eForms webpage. 

Questions? Email OnBoard@wcb.ny.gov. 

The movement to an electronic submission process is part of the Board’s larger effort to reduce reliance on paper forms and streamline our processes.

How to Prepare

• If you haven’t already done so, take time now to register for eCase. The electronic RFA-2 can be submitted in eCase through an eForm, which will immediately validate and place the RFA-2 in the electronic case folder.
• Register for RFA-2 eForm webinars on the Board’s Upcoming Webinars page.
• Visit the RFA-2 eForm page on the Board’s website for additional resources, including training materials for submission via eCase, as well as additional submission options outside of eCase that leverage XML.

Please email eForms@wcb.ny.gov if you have any questions.

Freida D. Foster
Chair

Following the issuance of that Subject Number, the Board issued an announcement of additional administrative workdays in 2026 where the Board remains open, but hearings will not be held.

Today, we are noting two additional changes for the Rochester District office only:

• CLOSED on Friday, July 31
• OPEN on Friday, August 7

The updated list of closure dates is below. For ease of reference, the Board has created a 2026 Board Closures page on our website, available at wcb.ny.gov/boardclosures.

2026 Board Holidays/Days Closed:

• New Year’s Day – Thursday, January 1
• Martin Luther King Jr. Day – Monday, January 19
• Washington’s Birthday – Monday, February 16
• Memorial Day – Monday, May 25
• Juneteenth – Friday, June 19
• Labor Day – Monday, September 7
• Columbus Day – Monday, October 12
• Veteran’s Day – Wednesday, November 11
• Thanksgiving Day – Thursday, November 26
• Christmas Day – Friday, December 25

Board Open, No Hearings (Except as Noted):

• Passover – Thursday, April 2
• Good Friday – Friday, April 3
• Rosh Hashanah – Friday, September 11 (a.m. hearings only; no p.m. hearings)
• Yom Kippur – Monday, September 21
• Day after Thanksgiving – Friday, November 27
• Christmas Eve – Thursday, December 24
• New Year’s Eve – Thursday, December 31

Floating Holiday (Board Open, Regular Hearing Schedule):

• Lincoln’s Birthday – Thursday, February 12

Additional Administrative Workdays (Board Open, No Hearings):

• Friday, January 2
• Friday, January 16
• Friday, February 6
• Friday, February 20
• Friday, March 6
• Friday, March 20
• Friday, April 17
• Friday, May 1
• Friday, May 15
• Friday, June 5
• Thursday, June 18
• Friday, July 3
• Friday, July 17
• Friday, July 31 (Rochester office only)
• Friday, August 7 (Exception: Rochester office will be open)
• Friday, August 21
• Friday, September 18
• Friday, October 16
• Friday, November 20
• Friday, December 18

What are the advantages of downloading your claims notices?

1. Instant access
   Claim notices such as Assembly, Indexing, Hearing, Decisions, and other system-generated communications are now available the morning after the Board processes files, significantly reducing delivery times compared to the traditional 3-4 business days via postal mail.
   
2. Enhanced automation capabilities
   The PDF files generated include information like WCB Case ID and form ID in their filenames, as detailed on our webpage. This data can be leveraged in your existing systems to develop automated workflows that streamline claim processing based on notice type and case specifics.
   
3. Flexibility
   Claim notices can be accessed either through an automated FTP transfer or a user-friendly download from your computer web browser – providing options designed to integrate smoothly into your existing systems and processes. More information about FTP and web browser downloads are available on the overview webpage.
   
4. Reliable delivery
   If your company relocates, or you have several locations, you no longer need to worry about mail forwarding or a notice going undelivered.
   
5. Streamlined record keeping and communication
   By downloading your claim notices, you/your company will have a record of all notices received along with the ability to email claims notices within your organization.

Visit the Download Claim Notices webpage to register today, view frequently asked questions, get support, and more.

Questions? Contact WCBTechnicalSupport@wcb.ny.gov.

Register for Download Claims Notices Now

Collaboration Shines a Light on State Government Working Together for the Benefit of New Yorkers

Traducción al español

Governor Kathy Hochul today announced a new collaboration between the New York State Workers’ Compensation Board and SUNY and CUNY, to support injured New Yorkers by promoting free community college for adult learners through the SUNY and CUNY Reconnect programs. Under the Governor’s SUNY and CUNY Reconnect initiative, New York State is providing free tuition, fees, books, and supplies for adults ages 25-55 who don’t already have a college degree and want to pursue an associate degree in a high-demand field. The New York State Workers’ Compensation Board is encouraging recently injured workers to apply by sending out over 5,000 mailers and launching a new webpage, wcb.ny.gov/reconnect, to raise awareness.

“SUNY and CUNY Reconnect are life-changing programs that have already helped thousands of New Yorkers seize new opportunities to earn degrees in high-demand fields,” Governor Hochul said. “As we work to expand these programs and include new degree opportunities, I also want to ensure that every eligible New Yorker is aware of the opportunities they have to earn a degree, secure a good job, and help move New York forward.”

The New York State Workers’ Compensation Board launched a new partnership with the State University of New York (SUNY) and the City University of New York (CUNY) to promote the SUNY and CUNY Reconnect programs and support New Yorkers in need. To help injured workers learn new skills and find new careers following work-related injury or illness, the SUNY and CUNY Reconnect programs offer a lifeline to help them return to the workforce. The Workers’ Compensation Board’s Vocational Rehabilitation Counselors, who work closely with injured workers looking to return to the workforce, will assist in identifying eligible injured workers and connecting them to the free college programs.

NYS Workers’ Compensation Board Chair Freida D. Foster said, “It can be devastating when a worker’s injury or illness prevents them from going back to their same job. Free college through the SUNY and CUNY Reconnect programs can give these injured workers not just hope, but real skills and degrees, as they work toward a better future.”

SUNY Chancellor John B. King Jr. said, “Under Governor Hochul, New Yorkers have more opportunities than ever before to access an excellent and affordable education, earn a degree in a high-demand field, and achieve upward mobility while helping to power the state’s economic growth. This partnership with the Workers’ Compensation Board is an excellent example of Governor Hochul utilizing the many tools at her disposal to benefit New Yorkers and our state as a whole.”

The SUNY Board of Trustees said, “We applaud Governor Hochul for promoting the SUNY Reconnect program with injured New Yorkers who may be seeking new opportunities to enter the workforce as part of their recovery efforts. Through the strong support of Governor Hochul and state leaders, SUNY Reconnect has helped inspire thousands of New Yorkers to earn degrees as adult learners, and we will continue to provide opportunities at community colleges throughout the state.”

CUNY Chancellor Félix V. Matos Rodríguez said, “This partnership reflects our shared focus on meeting New Yorkers where they are in their lives and expanding access to higher education as a powerful pathway to economic mobility and a better future. We are excited that CUNY Reconnect is opening doors for injured workers to gain skills, earn degrees and re-enter the workforce with added confidence and purpose. We thank Governor Hochul for helping to extend the opportunities of higher education to even more New Yorkers.”

As part of Governor Hochul’s 2025 State of the State address, SUNY and CUNY Reconnect provides free tuition, fees, books, and supplies for students between the ages of 25 and 55 who are pursuing an associate’s degree in certain high-demand fields, including advanced manufacturing, artificial intelligence, cybersecurity, engineering, technology, nursing and allied health fields, green and renewable energy, and pathways to teaching in shortage areas. The Governor announced plans to expand the successful SUNY and CUNY Reconnect programs as part of her 2026 State of the State address.

As part of the FY27 Budget, Governor Hochul is proposing a $12.5 million investment for the expansion for eligible adult learners preparing for careers in logistics, air traffic control and transportation, and emergency management, as well as to make it easier for adult learners to return to college to pursue nursing if they already have a prior degree. This would bolster the Governor’s initial $47 million investment in FY26 to establish this scholarship program.

The Workers’ Compensation Board’s Vocational Rehabilitation team provides a wide range of support services for injured workers, including resume development, job search assistance, connecting with employers regarding light or alternative work duties, and more. The Board also has licensed clinical social workers on staff to help injured workers cope with difficulties that may accompany a work-related injury or illness. All services for injured workers are free. To learn more about the Board’s support services, visit wcb.ny.gov/content/main/Workers/lp_services.jsp.

The Governor’s 2026 State of the State also includes a proposal to further help injured workers by improving access to medical care. Rather than requiring special Board-authorization to treat injured workers, the Governor is proposing legislation that will enable all eligible licensed medical providers, in good standing, to treat injured workers.

About the State University of New York

The State University of New York is the largest comprehensive system of higher education in the United States, and more than 95 percent of all New Yorkers live within 30 miles of any one of SUNY’s 64 colleges and universities. Across the system, SUNY has four academic health centers, five hospitals, four medical schools, two dental schools, a law school, the country’s oldest school of maritime, the state’s only college of optometry, 12 Educational Opportunity Centers, over 30 ATTAIN digital literacy labs, and manages one US Department of Energy National Laboratory. In total, SUNY serves about 1.7 million students across its portfolio of credit- and non-credit-bearing courses and programs, continuing education, and community outreach programs. SUNY oversees nearly a quarter of academic research in New York. Research expenditures system-wide are nearly $1.5 billion in fiscal year 2025, including significant contributions from students and faculty. There are more than three million SUNY alumni worldwide, and one in three New Yorkers with a college degree is a SUNY alum. To learn more about how SUNY creates opportunities, visit suny.edu.

About The City University of New York

The City University of New York is the nation’s largest urban public university, a transformative engine of social mobility that is a critical component of the lifeblood of New York City. Founded in 1847 as the nation’s first free public institution of higher education, CUNY today has seven community colleges, 11 senior colleges and eight honors, graduate and professional institutions spread across New York City’s five boroughs, serving 247,000 undergraduate and graduate students and awarding 50,000 degrees each year. CUNY’s mix of quality and affordability propels almost six times as many low-income students into the middle class and beyond as all the Ivy League colleges combined. More than 80 percent of the University’s graduates stay in New York, contributing to all aspects of the city’s economic, civic and cultural life and diversifying the city’s workforce in every sector. CUNY’s graduates and faculty have received many prestigious honors, including 13 Nobel Prizes and 26 MacArthur “genius” grants. The University’s historic mission continues to this day: provide a first-rate public education to all students, regardless of means or background. To learn more about CUNY, visit https://www.cuny.edu.

About the NYS Workers’ Compensation Board

Workers’ compensation is insurance that provides lost wage benefits and/or medical care for work-related injuries or illnesses. These benefits are available to every eligible worker in New York State, regardless of citizenship or immigration status. The Workers’ Compensation Board oversees the administration of workers’ compensation, disability benefits, and Paid Family Leave in New York State. Its mission is to protect the rights of employees and employers by ensuring the proper delivery of benefits and by promoting compliance with the law. Learn more at www.wcb.ny.gov.

Contact the Governor’s Press Office

Contact us by phone:

Albany: (518) 474-8418
New York City: (212) 681-4640

Contact us by email:

Press.Office@exec.ny.gov

Notice of Controversy and PHC Statements must be timely filed

The failure to file a timely notice of controversy using First Report of Injury 04-Denial (Form FROI-04) or Second Report of Injury 04-Denial (SROI-04) potentially results in the payer waiving several defenses to the claim, and failure to file a timely Pre-Hearing Conference Statement (PHC Statement) can potentially result in the payer waiving all defenses to the claim. The Board may excuse the untimely filing of a notice of controversy upon a “showing of good cause” based upon evidence of “mistake, inadvertence, omission, irregularity, defect or surprise, or based upon newly discovered evidence” (WCL § 25(2)(b)). Likewise, the Board may excuse the untimely filing of a PHC Statement  “if the Workers’ Compensation Law Judge finds, based on the affidavit of the insurance carrier’s legal representative (or if the insurance carrier does not have a legal representative, then by the insurance carrier), that the conduct at issue was due to good cause and the insurance carrier exercised good faith and due diligence” (12 NYCRR 300.38(f)(4)). If a payer believes the untimely filing of a notice of controversy or a PHC Statement should be excused, they should be prepared to submit relevant supporting evidence at the PHC.

PHC should be used to stipulate facts and frame legal issues

Parties are encouraged to stipulate to uncontested facts, frame all legal issues, and identify proposed witnesses at the PHC. For example, the law specifies “[a] legal representative appearing on behalf of a party must be authorized to enter into stipulations and a settlement or a person authorized to do so shall be available during the pre-hearing conference” (12 NYCRR 300.38(g)(12)). However, if a payer indicates it intends to submit video evidence into the record, the parties may stipulate that the evidence can be entered into the record without the testimony of a witness to authenticate the video, thereby reducing the number of necessary witnesses and potentially resulting in quicker resolution of the claim.

Prima facie medical evidence

In most controverted claims, for a claim to be established, the claimant must submit medical evidence that their injuries are causally related to their employment. At the PHC, a claim will move forward to trial as long as the record contains “prima facie medical evidence” (12 NYCRR 300.38(g)(3)(i)), defined as “a medical report referencing an injury, which includes traumas and illnesses” (12 NYCRR 300.1(a)(9)). However, medical evidence that satisfies the minimal standard to be considered prima facie medical evidence may not constitute sufficient evidence of causal relationship to support the establishment of the claim. In this situation, the claimant’s representative may decide that it is in their client’s best interest not to move forward to trial until they can submit additional medical evidence in support of the claim.

PHC depositions and decisions

When depositions are ordered at the PHC, the parties should be summarizing them at the end of the last deposition in the claim, unless the Judge has ordered the parties to submit summations into the record or at the next scheduled hearing.
There should be no ambiguity in the decision of a PHC. Parties should know and understand their obligations at the close of the PHC. If parties do not understand their obligations, they should request clarification on the record.

Questions?

If you have any questions regarding the guidance in this issue of Efficiency Enhancements, please write to outreach@wcb.ny.gov. 

Although virtual hearings will remain the standard practice for hearings, anyone who would like an in-person hearing or an appointment for other services in the Queens location can do so following the instructions below.

As a reminder, all Board locations currently open to the public are available by appointment only. For more information, please see the locations page of our website.

Requesting in-person hearings at the Queens location

Any party attending a Queens district virtual hearing can now request to have their next workers’ compensation hearing in person at the Queens location. The district your hearing is scheduled for is located under the abbreviation “SC” for service center on the top right of your hearing notice.

If granted, the next hearing will be scheduled on or after March 2, 2026. Such requests should be made directly to the Workers’ Compensation Law Judge during a scheduled virtual hearing. Otherwise, hearings will remain virtual.

In-person hearings will bring the injured worker, their legal representative (if applicable), and other parties (if they so choose) together at the Queens location for their hearing. 

Legal representatives and attorneys: if your client requests an in-person hearing, you will be required to physically accompany them or find an appropriate substitute

Services at the Queens location

Beginning March 2, 2026, injured workers and other stakeholders may request in-person appointments at the Queens office for support services and other Board resources. This includes:

• Free appointments with our Vocational Rehabilitation Counselors or Licensed Master Social Workers
• Using Board computers for case-related activities or to complete a Certificate of Attestation of Exemption from New York State Workers’ Compensation and/or Disability Benefits Insurance Coverage (Form CE-200)

To request an appointment:

• Call the Board’s Customer Service line at (844) 337-6301 or
• Email VocRehab@wcb.ny.gov or SocialWorkers@wcb.ny.gov for the relevant support needed

Note: You cannot request an in-person hearing using the appointment phone line and/or email addresses. In-person hearing requests must be made to the Judge during a scheduled virtual hearing.

As with other Board locations, reopening the Queens office by-appointment enables the Board to maintain our virtual efficiencies while providing an important public service to those who request in-person services.

Thank you, and we look forward to welcoming you back to the Queens office soon! 

More information

Questions? Contact the Board’s Customer Service line at (844) 337-6301. 

Over the past few years, the Board has focused on improving health care in the workers’ compensation system and enhancing the experience of treating providers. We’ve made some great changes, and more are on the way!

Join Medical Director Dr. James Tacci and others from the Board’s Medical Director’s Office to get the latest on:

• An update to the Board’s Medical Fee schedules – now available for public comment
• New regulations on resident/fellow physician billing 
• New regulations on depositions
• Governor Hochul’s 2026 State of the State proposal to further expand injured workers’ access to care through universal authorization
• And more!

These one-hour sessions are free and always include time at the end to answer your questions.

Tuesday, February 17, 2026
12:00 p.m. – 1:00 p.m.
Register here

Tuesday, May 12, 2026
12:00 p.m. – 1:00 p.m.
Register here

While we’d love to have you join us for a live session, we will be posting a recording on the provider section of our website afterward for anyone unable to attend.

More information

The What Providers Need to Know section of the Board’s website walks health care providers through getting started in the workers’ compensation system, treating injured workers, billing for services, and more.

It also includes a Provider updates section that features the latest news for health care providers.

Having trouble?

If you are having trouble registering for or attending either of these webinars, check out these Webinar FAQs.