Key Takeaway
New York court clarifies that only a triable issue of fact regarding employment status is needed to refer workers compensation cases to the Workers Compensation Board.
This article is part of our ongoing workers compensation coverage, with 22 published articles analyzing workers compensation issues across New York State. Attorney Jason Tenenbaum brings 24+ years of hands-on experience to this analysis, drawing from his work on more than 1,000 appeals, over 100,000 no-fault cases, and recovery of over $100 million for clients throughout Nassau County, Suffolk County, Queens, Brooklyn, Manhattan, and the Bronx. For personalized legal advice about how these principles apply to your specific situation, contact our Long Island office at (516) 750-0595 for a free consultation.
New York’s workers compensation system operates on the principle of exclusivity — when an injury occurs during the course of employment, workers compensation benefits typically become the sole remedy available to injured workers. This means that traditional personal injury lawsuits are generally barred in favor of the streamlined workers compensation process. However, determining whether an injury actually falls under workers compensation coverage can be complex, particularly when employment status or the circumstances of an accident are disputed.
The threshold for referring these disputed cases to the Workers Compensation Board has been a subject of ongoing litigation. Courts must balance the need for thorough investigation with the practical realities of case management. Workers compensation defense requires substantiation in many instances, but the question remains: how much evidence is needed to trigger the board’s jurisdiction?
This procedural question becomes particularly important in no-fault insurance cases, where insurance companies often raise workers compensation as a defense to avoid paying benefits. Understanding when cases must be referred to the Workers Compensation Board helps clarify the boundaries between different insurance systems.
Jason Tenenbaum’s Analysis:
Great Health Care Chiropractic, P.C. v Lancer Ins. Co., 2014 NY Slip Op 50340(U)
All that is required is: ” triable issue as to whether plaintiff’s assignor had been acting in the course of his employment at the time of the accident and that, therefore, workers’ compensation benefits might be available.”
A triable issue of fact is all that is needed to kick a WC case to the board.
Also, note that the opinion again places this Court more in line with the Appellate Division which has usually held that a certificate of conformity is well plainly not needed.
Key Takeaway
This decision establishes a relatively low threshold for workers compensation referrals — courts need only find that there’s a genuine factual dispute about whether someone was working when injured. The ruling also reinforces that formal certificates of conformity aren’t required, streamlining the referral process and aligning trial courts with appellate precedent. This impacts both workers compensation coverage disputes and cases where police reports trigger workers compensation inquiries.
Legal Update (February 2026): Since this 2014 post, the Workers Compensation Board has implemented several procedural reforms and regulation amendments that may affect the threshold standards and referral processes discussed. Practitioners should verify current Workers Compensation Law provisions, board regulations, and recent appellate decisions regarding jurisdictional determinations and the interplay between workers compensation and no-fault insurance coverage disputes.
Legal Context
Why This Matters for Your Case
New York's Workers' Compensation Law provides benefits to employees injured on the job, regardless of fault. The system covers medical treatment, lost wages (typically two-thirds of average weekly wages subject to a statutory maximum), and permanency awards for lasting disabilities. Claims are filed with the Workers' Compensation Board, where administrative law judges hear contested cases.
However, employers and their insurers frequently challenge claims through Independent Medical Examinations, surveillance investigations, and appeals to the Workers' Compensation Board panel. Attorney Jason Tenenbaum has represented injured workers throughout Long Island and New York City for over 24 years, handling everything from initial claim filings through Board hearings, Third Department appeals, and third-party personal injury lawsuits against property owners and contractors. This article provides the expert legal analysis that workers and practitioners need to navigate the complexities of New York workers' compensation law.
About This Topic
Workers Compensation Law in New York
New York's workers compensation system provides benefits for employees injured on the job, covering medical treatment, lost wages, and disability payments regardless of fault. But navigating the Workers Compensation Board process, understanding benefit calculations, and overcoming employer and insurer challenges requires experienced legal guidance. These articles analyze workers compensation case law, the intersection of workers comp with personal injury claims, and the procedural requirements that govern the system.
22 published articles in Workers Compensation
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Frequently Asked Questions
How does workers' compensation work in New York?
New York Workers' Compensation Law requires most employers to carry insurance that covers employees injured on the job, regardless of fault. Benefits include medical treatment, wage replacement (typically two-thirds of average weekly wages, subject to a statutory maximum), and permanency awards for lasting disabilities. Claims are filed with the Workers' Compensation Board, and disputes are heard by administrative law judges. Employers and their insurers frequently contest claims through IMEs and surveillance.
Can I sue my employer for a workplace injury?
Generally, no. Workers' compensation is the exclusive remedy for workplace injuries in New York — you cannot sue your employer for negligence. However, there are exceptions: you can file a third-party lawsuit against someone other than your employer who contributed to your injury (such as a property owner, contractor, or product manufacturer). You may also have a claim if your employer intentionally caused the injury or if the employer lacks workers' compensation coverage.
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About the Author
Jason Tenenbaum, Esq.
Jason Tenenbaum is the founding attorney of the Law Office of Jason Tenenbaum, P.C., headquartered at 326 Walt Whitman Road, Suite C, Huntington Station, New York 11746. With over 24 years of experience since founding the firm in 2002, Jason has written more than 1,000 appeals, handled over 100,000 no-fault insurance cases, and recovered over $100 million for clients across Long Island, Nassau County, Suffolk County, Queens, Brooklyn, Manhattan, the Bronx, and Staten Island. He is one of the few attorneys in the state who both writes his own appellate briefs and tries his own cases.
Jason is admitted to practice in New York, New Jersey, Florida, Texas, Georgia, and Michigan state courts, as well as multiple federal courts. His 2,353+ published legal articles analyzing New York case law, procedural developments, and litigation strategy make him one of the most prolific legal commentators in the state. He earned his Juris Doctor from Syracuse University College of Law.
Disclaimer: This article is published by the Law Office of Jason Tenenbaum, P.C. for informational and educational purposes only. It does not constitute legal advice, and no attorney-client relationship is formed by reading this content. The legal principles discussed may not apply to your specific situation, and the law may have changed since this article was last updated.
New York law varies by jurisdiction — court decisions in one Appellate Division department may not be followed in another, and local court rules in Nassau County Supreme Court differ from those in Suffolk County Supreme Court, Kings County Civil Court, or Queens County Supreme Court. The Appellate Division, Second Department (which covers Long Island, Brooklyn, Queens, and Staten Island) and the Appellate Term (which hears appeals from lower courts) each have distinct procedural requirements and precedents that affect litigation strategy.
If you need legal help with a workers compensation matter, contact our office at (516) 750-0595 for a free consultation. We serve clients throughout Long Island (Huntington, Babylon, Islip, Brookhaven, Smithtown, Riverhead, Southampton, East Hampton), Nassau County (Hempstead, Garden City, Mineola, Great Neck, Manhasset, Freeport, Long Beach, Rockville Centre, Valley Stream, Westbury, Hicksville, Massapequa), Suffolk County (Hauppauge, Deer Park, Bay Shore, Central Islip, Patchogue, Brentwood), Queens, Brooklyn, Manhattan, the Bronx, Staten Island, and Westchester County. Prior results do not guarantee a similar outcome.