New York City Department of Law

Workers' Compensation Division: Action Needed to Improve the Administration and Management of the Workers' Compensation Program

New York City is self-insured, and the claims of all employees of City agencies, excluding uniformed workers of the Departments of Sanitation, Police and Fire, and certain employees of the BE, HHC,and CUNY, are administered by the City Law Department's Workers' Compensation Division (WCD). WCD's mission is to ensure that employees are paid promptly for lost earnings and that costs are contained by ensuring that employees and medical providers do not receive more than they are entitled to under the NY State Workers' Compensation Law. Our review of a sample of 50 claims selected from WCD's data base files revealed that WCD did not effectively administer or manage the workers's compensation claims. WCD often processed claims without the information needed to make a proper determination as to the compensability of the claims. In addition, the City did not meet the ten-day requirement for reporting certain accidents to the State Workers Compensation Board and may be subject to administrative fines and penalties of as much as $39.9 million. Eleven of our 19 recommendations address the need for a system that will ensure that all City agencies provide WCD with timely and complete reports of accidents and that WCD take the appropriate action upon receipt of the information. The Law Department generally disagreed with our conclusions and recommendations. It indicated that the audit results did not accurately depict WCD's efforts or its effectiveness in administering in claims. A-20-93