Claim of Rivera v. North Central Bronx Hospital
Opinion of the Court
The employer appeals, arguing that the Board improperly interpreted Workers’ Compensation Law § 13-a (7) by requiring it to reimburse claimant’s doctor for the EMG test. Added in
While the Board argues that its interpretation of the statute is entitled to deference, we view the issue as “one of pure statutory reading and analysis, dependent only on accurate apprehension of legislative intent” (Matter of Belmonte v Snashall, 2 NY3d 560, 566 [2004] [internal quotation marks omitted]; see Matter of LaCroix v Syracuse Exec. Air Serv., Inc., 8 NY3d 348, 352 [2007]). Nevertheless, we find no support for the employer’s contention that it should not have to pay anything to the provider. The statute itself is silent on the question of the appropriate response where a claimant fails to use an employer’s specified provider, and nothing in the legislative history suggests that nonpayment is the appropriate remedy (see Assembly Mem in Support, Bill Jacket, L 2007, ch 6 at 24). Rather, the determination to require the employer to pay its in-network rate is in accord with the overall goal of the Workers’ Compensation Law to provide “a swift and sure source of benefits to injured employees” (Crosby v State of NY., Workers’ Compensation Bd., 57 NY2d 305, 313 [1982]; see Matter of Simpson v Glen Aubrey Fire Co., 86 AD2d 909, 910 [1982]), as well as the specific provisions of the statute requiring employers to pay for medical expenses and preventing providers from collecting payment from injured workers (see Workers’ Compensation Law §§ 13 [a]; 13-f [1]). Further, allowing the employer to avoid any payment to the provider would harm medical providers who may not be aware that the employer has contracted with a specified provider and could, as a result, deter providers from participating in the workers’ compensation system (see Workers’ Compensation Law § 13-a [1]; [7] [b]). We also note that the employer did not argue before the Board that there would be any broader or indirect financial impact resulting from its paying the rate set with its specified provider to others, and no proof in the record before us supports that claim.
Mercure, J.P., Lahtinen, McCarthy and Egan Jr., JJ., concur. Ordered that the decision is affirmed, without costs.
Case-law data current through December 31, 2025. Source: CourtListener bulk data.