May 15, 2025
Residents and Fellows Can Now Treat Injured Workers Under Supervising Faculty, Potentially Adding 20K Providers at Nearly 70 Hospitals Statewide
New Legislation Allows Workers' Compensation Insurers to Pay for Medical Treatment Without Accepting Liability, for Up to One Year
New York State Workers' Compensation Board Chair Clarissa Rodriguez announced new legislation signed by Governor Kathy Hochul on May 9, 2025, as part of the Fiscal Year (FY) 2026 Budget gives injured and ill workers across New York State greater access to timely medical care, in a broad range of medical specialties.
Effective immediately, resident and fellow physicians in programs that are accredited by the Accreditation Council on Graduate Medical Education (ACGME) are allowed to treat injured and ill workers in New York State under the appropriate supervision of faculty physicians, the same way they do for regular health insurance. This represents potentially 20,000 resident and fellow physicians, training in over 1,400 programs, at nearly 70 teaching hospitals across the state.
"We applaud Governor Hochul and members of the Legislature for passing this legislation, which will provide hardworking New Yorkers who are injured or become ill on the job with greater access to care," said Board Chair Clarissa Rodriguez. "The improvements we celebrate today will make it easier for injured workers to find a health care provider near them and reduce delays in treatment. We hope this will also create a pipeline of new physicians who will become Board authorized in our system after completing their specialty training."
Additionally, the new legislation signed as part of the FY 2026 Budget amends Section 21-a of the Workers' Compensation Law to permit workers' compensation insurers to pay for medical treatment, without accepting liability, for up to one year, beginning January 1, 2027. Section 21-a already permits insurers to accept claims without liability for up to one year when the claim involves lost time from work. This amendment extends the provision to "medical-only" claims, which account for over 60% of all workers' compensation claims. Extending Section 21-a to all claims will significantly help injured workers get timely medical care, avoid unnecessary claim denials and litigation, and provide swift payment for necessary medical treatment to the injured worker. The amendment also requires insurers to notify injured workers that such payments are being made and that their claim will automatically be accepted by the insurer at the one-year mark, unless the claim is controverted.
Comp Alliance Executive Director Michael Kenneally said, "As public employees often work in physically demanding and/or hazardous environments, timely access to healthcare following a workplace injury is especially important. The legislative initiatives in the FY 2026 Budget that expand the number of eligible providers and facilitate the handling of medical-only claims promise to help injured workers receive prompt medical attention and appropriate treatment, reducing the risk of long-term disability and helping them return to work sooner. A healthy, supported workforce leads to safer, more reliable public services, and we commend the Governor and the Legislature for their efforts."
The Board also plans to use its regulatory authority to increase its workers' compensation fee schedules (the amounts paid to health care providers for services in treating injured workers), to ensure providers in the system are paid at rates comparable to private health insurance. Increasing fee schedules also complements the many recent actions the Board has taken to improve the system to attract more providers, including:
- eliminating custom forms and transitioning to a universal billing form to reduce administrative burden.
- using an online system for prior authorization and requests to review medical billing disputes.
- quicker resolution of billing disputes and a significantly reduced need for provider depositions.
Worker Justice Center of New York Executive Director Alaina Evelyn Varvaloucas said, "These initiatives are an important step toward decreasing barriers faced by both workers and providers in engaging with the workers' compensation system. New York still has more work to do to make care accessible to all workers in all regions of the state, but every big endeavor starts with an important step."
Board Certified Occupational Medicine Physician Dr. Marc Wilkenfeld said, "The agreement is a win for injured workers in New York State. Greater access to qualified physicians will go a long way to improve care. With top-notch teaching hospitals across the state, this legislation will enhance treatment, leading to better outcomes for workers' compensation patients."
The Board has issued guidance to address the residents and fellows who are now able to treat in the New York State workers' compensation system and will adopt emergency regulations. It has also created a new welcome page which explains treatment guidelines, billing information, and specific resources to help these physicians get started.
About the 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.