§ 206 — Non-duplication of benefits

New York § 206

• Jurisdiction: New York
• Law WKC: Workers' Compensation
• Art. 9: Disability Benefits

Text

§ 206. Non-duplication of benefits. 1. No disability benefits shall be\npayable under section two hundred four or two hundred seven of this\narticle:\n (a) in a weekly benefit amount which, together with any amount that\nthe employee receives or is entitled to receive for the same period or\nany part thereof as a permanent disability benefit or annuity under any\ngovernmental system or program, except under a veteran's disability\nprogram, or under any permanent disability policy or program of an\nemployer for whom he or she has performed services, would, if\napportioned to weekly periods, exceed his or her weekly benefit amount\nunder this section, provided however, that there shall be no offset\nagainst the benefits set forth in this article if the claim for\ndisability benefits is based on a disability other than the permanent\ndisability for which the aforesaid permanent disability benefit or\nannuity was granted;\n (b) with respect to any week for which payments are received under the\nunemployment insurance law or similar law of this state or of any other\nstate or of the United States;\n (c) subject to the provisions of subdivision two of this section, for\nany period with respect to which benefits, compensation or other\nallowances (other than workers' compensation benefits for a permanent\npartial disability occurring prior to the disability for which benefits\nare claimed hereunder) are paid or payable under this chapter, the\nvolunteer firefighters' benefit law, or any other workers' compensation\nact, occupational disease act or similar law, or under any employers'\nliability act or similar law; under any other temporary disability or\ncash sickness benefits act or similar law; under section six hundred\neighty-eight, title forty-six, United States code; under the federal\nemployers' liability act; or under the maritime doctrine of maintenance,\nwages and cure.\n 2. If an employee who is eligible for disability benefits under\nsection two hundred three or two hundred seven of this article is\ndisabled and has claimed or subsequently claims workers' compensation\nbenefits under this chapter or benefits under the volunteer\nfirefighters' benefit law or the volunteer ambulance workers' benefit\nlaw, and such claim is controverted on the ground that the employee's\ndisability was not caused by an accident that arose out of and in the\ncourse of his employment or by an occupational disease, or by an injury\nin line of duty as a volunteer firefighter or volunteer ambulance\nworker, the employee shall be entitled in the first instance to receive\nbenefits under this article for his or her disability. If benefits have\nbeen paid under this article in respect to a disability alleged to have\narisen out of and in the course of the employment or by reason of an\noccupational disease, or in line of duty as a volunteer firefighter or a\nvolunteer ambulance worker, the employer or carrier or the chair making\nsuch payment may, at any time before award of workers' compensation\nbenefits, or volunteer firefighters' benefits or volunteer ambulance\nworkers' benefits, is made, file with the board a claim for\nreimbursement out of the proceeds of such award to the employee for the\nperiod for which disability benefits were paid to the employee under\nthis article, and shall have a lien against the award for reimbursement,\nnotwithstanding the provisions of section thirty-three of this chapter\nor section twenty-three of the volunteer firefighters' benefit law or\nsection twenty-three of the volunteer ambulance workers' benefit law\nprovided the insurance carrier liable for payment of the award receives,\nbefore such award is made, a copy of the claim for reimbursement from\nthe employer, carrier or chair who paid disability benefits, or provided\nthe board's decision and award directs such reimbursement therefrom.\n 3. No family leave benefits shall be payable under section two hundred\nfour of this article:\n (a) During periods when the employee is receiving total disability\npayments pursuant to a claim for workers' compensation, volunteer\nfirefighters' benefits or volunteer ambulance workers' benefits, except\nthat when the employee is receiving payments for partial disability or\nreduced earnings under such laws, the family leave benefit, when\ncombined with the benefits under such laws shall not exceed the average\nweekly wage in the employment for which family leave benefits are\nsought;\n (b) To an employee who is not employed or is on administrative leave\nfrom his or her employment;\n (c) To an employee during periods where the employee is collecting\nsick pay or paid time off from the employer; and\n (d) for any day in which claimant works at least part of that day for\nremuneration or profit for the covered employer or for any other\nemployer while working for remuneration or profit, for him or herself,\nor another person or entity, during the same or substantially similar\nworking hours as those of the covered employer from which family leave\nbenefits are claimed, except that occasional scheduling adjustments with\nrespect to secondary employments shall not prevent receipt of family\nleave benefits.\n 4. Unless otherwise expressly permitted by the employer, benefits\navailable under 29 U.S. Code Chapter 28 (The Family and Medical Leave\nAct) must be used concurrently with family leave benefits. For a\nsubsequent unrelated disability, an employee may seek benefits up to the\nmaximum number of available weeks permitted in this article.\n 5. A covered employer is not required to permit more than one employee\nto use the same period of family leave to care for the same family\nmember.\n