Heightened benefits for “line of duty injuries.”
New York Municipal Law provides for additional benefits for some firefighters, police, and municipal employees who are injured at work. Instead of getting just 66.6% of their wages, subject to caps ($150 minimum, $803.21 maximum per week at the time of this writing) these injured workers get their full, pre-injury salary, plus medical benefits, not subject to any “maximum” benefit.
Who does this apply to?
Firefighters, law enforcement, and some municipal employees who are injured or made ill as a result of the performance of their duties are entitled to the payment of full salary and medical treatment. New York Municipal Law Section 207-a (firefighters) and §207-c (police, some municipal workers).
When do they get this benefit?
To obtain this benefit, these injured workers must show a direct causal relationship between their job duties and the resulting illness or injury. The case law has established a two part test:
- The individual must have been injured or made ill as a result of performance of duties; and
- the workers must be unable to perform their duties as a result of the injury.
King v. City of Newburgh, 84 AD2d 388, 393 (2d Dep’t 1982).
This benefit may be limited by a deadline to file the application for “207-c” benefits which can be set in a collective bargaining agreement or the employer’s rules. Even if the condition is pre-existing or non-work related, the law enforcement or municipal employee may be entitled to benefits as long as they can show that the current disability is related to a work injury.
What if the injury did not arise out of line-of-duty event?
There are situations where the injury did not arise out of a line-of-duty event but would still be compensable under the workers’ compensation law. For example, an injury arising out of a recreational event. In those cases, the employee will not be able to show that their employment activity exposed them to a “heightened risk” and they will not be entitled to 207-a or -c full-wage continuation benefits. Instead, they will likely be eligble for “regular” workers’ compensation benefits.
How are these §207-a or §207-c benefits terminated?
- Benefits (medical and lost time) can be stopped is the claimant refuses to attend an IME. Under the statute, if the claimant refuses to accept medical or hospital care, or refuses to allow the employer to “inspect” the employee’s condition, these are considered a “waiver” of the § 207-c benefits. An IME is an “inspection” and if the claimant refuses to attend, benefits can be stopped after a hearing.
- Refusal to perform light duty work that is offered. If an employee refuses to accept a light duty assignment, benefit can be terminated even without a hearing. One caveat: the light duty position must be “consistent with the employee’s prior status” meaning job duties must be substantially similar.
- Lost time (salary or wage replacement) benefits stop when a “health authority” or “physician” certifies that the claimant is “recovered and is physically able to perform her regular duties.”
- Benefits end with the award of a disability pension. This is true even if the pension is for a partial disability.
Does the political entity have Section 29 lien rights?
Yes, if the employee recovers at law against an actual tortfeasor, the municipality can assert their right to reimbursement for all benefits issued under Section 207-a or 207-c. This includes “pain and suffering” awards obtained by the injured firefighter or police officer. The claimant must obtain consent to settle the third-party (civil) claim. WCL § 29(5).
