You are out of work. Your doctor has you out. The claim has not been denied. And no money is coming. You call the adjuster and get voicemail, or you get a person who says it is being reviewed. Weeks go by. Rent does not wait for the carrier’s review.
There is a specific thing you can do about this, and almost nobody knows it exists.
The law gives you a hearing in 45 days
Workers’ Compensation Law § 25(2)(a) says that where a claim has been filed with medical evidence of a work-related injury, the claimant is disabled and not working, is otherwise entitled to compensation, the employer is not paying, the claim has not been controverted, and efforts to resolve it with the carrier have not worked, then the claimant “may request, in the format prescribed by the chair, a hearing to be held within forty-five days of the board’s receipt of such request.”
That language came in with the 2017 reform package, signed April 10, 2017. The Board explained how it works in Subject No. 046-937, and it said plainly what the point was: to make sure a prompt hearing happens “in cases of acute need, where the claimant is not being paid.”
Not a hearing eventually. Not a hearing when the calendar allows. Forty-five days from the day the Board receives the request.
Everything on this list has to be true
This is not a general-purpose hearing request, and the Board says so directly — these hearings “are not to be utilized as general purpose hearings to resolve other issues.” All seven of the following have to be in place:
- A workers’ compensation claim has been filed.
- Medical evidence of a work-related injury or illness has been submitted.
- You are not working in any capacity.
- You are not otherwise barred from receiving compensation.
- The employer or carrier is not paying you as the law requires.
- The claim is not being controverted. A controverted claim has its own expedited track, so it does not belong here.
- You, or your attorney, have already tried to resolve it with the carrier and you are still not being paid.
That last one is not a formality. The Board calls outreach “a required element” and says there must be a demonstrated good faith attempt to resolve the payment issue before resorting to a hearing. A request filed without it is a defective request.
First, let the carrier’s clock run out
The carrier has a deadline of its own. Under § 25(1)(b) payment has to start within 18 days of the disability, or within 10 days of the employer learning about it, whichever period is longer. Until that window has closed, there is nothing to complain about yet, and a 45-day request filed early is premature by definition.
So the sequence is: the carrier’s time runs out, you reach out and get nowhere, and then the request goes in.
When this is the wrong tool
The Board lists the situations where a 45-day hearing cannot be requested, and one of them surprises people:
- Before the 18-day or 10-day period has run.
- Where the Board has already issued a decision finding no compensable lost time.
- Where the employer is paying you directly and the award would only reimburse or credit the employer.
- Where you are receiving an indemnity payment at all — even if it is not the full rate.
Read that last one twice. If the carrier is paying you something, even a badly reduced something, this particular remedy is off the table. Being underpaid is a real problem with real answers, but it is a different problem from not being paid.
It is also worth knowing that a carrier is sometimes allowed to stop or reduce benefits. Board Rule 12 NYCRR § 300.23 sets out when — a report from your own doctor saying you are not disabled is one example. If that is what happened, the reason the payments stopped is the thing to attack.
The form, and the box almost nobody checks
If you are unrepresented, the form is the RFA-1W, Request for Assistance by Injured Worker. The current version is dated 5-22. In the Compensation Payments section there is a check box “a” — you are not working as of a date and not receiving payments — with sub-items confirming that you filed a claim, your employer is not paying your wages, your claim has not been denied, no decision bars you from compensation, and you have tried to resolve it with the insurer.
If you have an attorney, the form is the RFA-1LC, and it carries a dedicated check box requesting the 45-day hearing, with the conditions printed right beside it.
The box is the whole thing. An RFA-1 that describes the same facts in the narrative but leaves the box unchecked is an ordinary request that goes in the ordinary queue.
What a baseless request costs
The Board was blunt about the downside, and it is worth knowing before anyone files one on your behalf.
If the request is baseless, premature or inappropriate, the judge may impose costs and attorney’s fees of $500 per violation under Workers’ Compensation Law § 114-a(3), for raising an issue without reasonable grounds. On top of that, the claimant’s attorney gets no fee at all on the matter, even if an award is made — the Board’s view being that misusing a 45-day request wastes hearing time meant for people in genuine need.
These penalties are not imposed against an unrepresented claimant. The Board says so in terms. If you are handling your own claim and you check the box in good faith and get it wrong, you are not exposed to this.
The list of things that draw a § 114-a(3) finding is instructive, because it is mostly carelessness: a form not accurately or completely filled out; no claim filed or no medical evidence; the statutory waiting periods not yet run; a claim that is controverted in whole or in part; an existing direction of no further compensable lost time; a claimant who is not out of work; and an attorney who never reached out to the carrier first. The Board singled out one habit in particular — filing the request as a matter of course upon being retained, before any of the elements are met.
What happens next
A Workers’ Compensation Law Judge holds the hearing, looks at the request and the evidence, and if payments are due, orders them. The hearing itself works like any other, only sooner.
Often the request never reaches a hearing, and that is a good outcome, not a wasted filing. Carriers that have been slow-walking a file tend to find it when a 45-day clock is attached. If the carrier starts paying voluntarily before the hearing date, no formal stipulation is needed — the parties simply tell the Board the hearing is no longer necessary. If an award had already been made, or the parties want it in writing, that goes in on a Form C-300.5 stipulation.
Why you have probably never heard of this
Because it is narrow, because it has teeth pointed at whoever files it carelessly, and because it lives in one paragraph of § 25(2)(a) and one 2017 bulletin rather than anywhere an injured worker would naturally look. The result is that people who fit it perfectly sit at home for months waiting for a hearing date that a checked box would have produced in six weeks.
Frequently asked questions
How fast is 45 days, really?
The statute measures it from the Board’s receipt of the request, not from the date you sign the form. Filing electronically rather than mailing paper is the difference between those two dates being the same day and being a week apart.
The carrier has not denied my claim, but it has not accepted it either. Do I qualify?
Possibly — that is exactly the gap this was written for. What matters is whether the claim has been controverted. Silence is not a controversy, and a carrier that has neither paid nor filed a notice of controversy within its statutory window is the situation the Legislature had in mind.
I am getting a partial check. Can I use this?
No. Receiving an indemnity payment rules it out even where the rate is too low. An underpayment is a real issue and there are ways to raise it, but not this way.
I am working a few hours a week. Does that disqualify me?
Yes, for this remedy. The requirement is that you are not working in any capacity. Reduced earnings while working is a different track entirely.
Can I file this myself?
Yes, on the RFA-1W, and the § 114-a(3) penalties do not apply to an unrepresented claimant. The harder part is judging whether all seven elements are actually in place, because a request that does not fit gets treated as an ordinary one and you lose weeks finding out.
What counts as trying to resolve it with the carrier?
A documented, good faith attempt — a call you can date, an email, a letter. The Board requires it to be demonstrated, which in practice means it needs to be something you can point to, not something you remember doing.
If you are out of work and not being paid
Do not sit on it. The elements either line up or they do not, and that is a ten-minute conversation, not a project. Call 718.701.2776 or 800.310.5520.
This page describes New York law in general terms and discusses published statutes and Board guidance. It is not legal advice about your claim, and reading it does not make us your attorneys.
