A letter arrives from the Workers’ Compensation Board headed Notice of Proposed Conciliation Decision, and the first question most injured workers have is whether something has gone wrong.
Usually it has not. In most cases this letter is a sign that your claim is not being fought over. But it is also a document with a 30-day clock attached, and what it says about your wages, your dates out of work and your injuries can quietly become final if nobody looks at it.
Here is what the notice is, what to check before the 30 days run out, and when it is worth having someone review it.
What Conciliation Is
Conciliation is the Board’s informal track for resolving straightforward claims without a hearing. It applies to claims that are not being disputed by the employer or its insurance carrier, and where the expected duration of benefits is 52 weeks or less.
That first condition is the reassuring part. A claim the carrier is actively contesting does not go to conciliation at all — a controverted claim is sent instead for a pre-hearing conference in front of a Workers’ Compensation Law Judge. So if your file landed in conciliation, the carrier is generally not challenging that you were hurt at work.
The case is handled by a conciliator rather than a judge. The conciliator reviews the file, contacts the parties for anything missing — medical reports, wage information, documentation — and then proposes how the claim should be resolved.
What the Proposed Decision Actually Is
The proposed conciliation decision sets out findings and awards: what the Board is prepared to establish about your claim and what it proposes to pay. It goes to every party in the case. If you have an attorney, it also contains the fee proposed for your representative.
The word to hold onto is proposed. Within 30 days of the date the Board mails it, any party may submit written comments on the decision or ask for a meeting of the parties. That window is the entire point of the document. It exists so the people who actually lived the claim can say “this figure is wrong” before the figure becomes permanent.
What Happens If You Do Nothing
If nobody objects, the proposed decision stops being a proposal.
For a claimant who is represented, it becomes final at the end of that period and stands as an award of the Board for all purposes. For a claimant who is unrepresented, there is an additional step: a Workers’ Compensation Law Judge must review the proposed decision and approve or disapprove it before it takes effect.
That extra review is a genuine protection, and it is worth knowing you have it. But understand what it is and is not. A judge reviewing your file is checking that the decision is consistent with what is in that file. The judge is not in a position to know that you also worked Saturdays at a second job, or that you hurt your shoulder as well as your back and only the back was written down. Those are the things that make a decision wrong in a way no amount of file review will catch.
What to Check Before the 30 Days Run Out
Three things account for most of the problems we see in these decisions.
1. The average weekly wage
Your average weekly wage drives every dollar in the case, and it is the figure most often set too low. Check it against what you actually earned, not just your base rate. Overtime belongs in the calculation. So do shift differentials and regular bonuses.
Concurrent employment matters most of all. If you were working a second job when you were injured, those earnings can raise your wage rate — and they are routinely left out, because nothing in the process asks about a job your injury employer did not know you had. An understated wage reduces every weekly payment and every award that follows from it.
2. The periods and the degree of disability
Read the dates. Do the periods the decision covers actually match the time you were out of work or on reduced earnings? Gaps and wrong end dates are common, particularly where you returned to work briefly and then came back out.
Then read the percentage. A degree of disability that does not match what your treating doctor has been reporting is worth questioning, because that percentage multiplies against your wage rate to produce what you are actually paid.
3. The body parts the claim is established for
This is the one that causes the most trouble later. Check which sites of injury the decision names. If you hurt your back and your knee in the same accident but the decision only establishes the back, your knee treatment is not covered by that claim — and the longer the omission sits unchallenged, the harder it is to add.
It is also worth noticing whether the decision addresses permanency at all, or only the time you missed. A decision that resolves lost wages says nothing about a schedule loss of use award or a classification you may still be entitled to. If your claim is an old one that went quiet years ago rather than one moving through conciliation now, the permanency question may never have been reached at all — see our guide to whether an old claim can still be reopened.
If Something Is Wrong
Say so, in writing, within the 30 days. You can submit written comments on the proposed decision or request a meeting of the parties with the conciliator.
Objecting is not a hostile act and it does not put your benefits at risk. It is the mechanism the process was built around. Where the parties cannot reach agreement, the case moves onto the hearing calendar, which may include a pre-hearing conference — in other words, it goes in front of a judge, which is where a genuine dispute belongs.
What you should not do is let the 30 days pass while you think about it. Reopening a settled figure afterwards is a great deal harder than correcting a proposed one.
Do You Need a Lawyer for This?
Not always, and it would be dishonest to suggest otherwise. Plenty of proposed conciliation decisions are simply correct. The claim is not disputed, the wage is right, the dates match, the injury is what the decision says it is. If you read it against your own records and everything lines up, that may well be the end of it.
It is worth having someone look at it when:
- the average weekly wage looks lower than what you were earning, or you had a second job;
- a body part you injured is missing from the decision;
- the periods or the degree of disability do not match your medical records;
- you have a lasting impairment and the decision says nothing about permanency;
- or you simply cannot tell whether the numbers are right, which is the most common situation of all.
A consultation costs nothing, and reviewing a proposed decision against your own account of the claim is a short conversation. The one thing worth avoiding is spending the 30 days deciding whether to ask.
Frequently Asked Questions
Is a proposed conciliation decision good news or bad news?
Generally good. Conciliation is for claims that are not being disputed by the employer or carrier. A contested claim goes to a pre-hearing conference before a judge instead.
How long do I have to respond?
Thirty days from the date the Board mails the proposed decision. Within that window any party may submit written comments or request a meeting of the parties.
What happens if I don’t respond?
If you are represented, the decision becomes final and stands as an award of the Board. If you are unrepresented, a Workers’ Compensation Law Judge reviews it first and either approves or disapproves it.
Is a conciliator the same as a judge?
No. A conciliator handles the informal track and proposes a resolution based on the file. A Workers’ Compensation Law Judge presides over hearings and decides contested issues. If conciliation does not resolve the claim, it moves to the hearing calendar.
Will objecting slow my benefits down?
Raising a genuine problem is what the 30-day period is for, and correcting a wage rate or adding an injured body part at this stage is far faster than trying to fix it after the decision is final.
Can I get a lawyer after I’ve already received the notice?
Yes. You are entitled to an attorney of your own choosing at any point in an open claim, including after a proposed decision has been issued — and including where you already have one you are unhappy with.
Have Someone Read It Before the Clock Runs
If you have received a notice of proposed conciliation decision and you are not certain the numbers in it are right, a free consultation will tell you. We will read it against what actually happened in your claim and tell you plainly whether it looks correct — and if it does, that answer costs you nothing either.
The Law Offices of Frank J. Dito, Jr. represents injured workers in workers’ compensation claims throughout New York. Call 718.701.2776 (toll-free: 800.310.5520) or contact us to schedule a free consultation. Consultations are free and there is no fee unless you win.
Related reading: our guides to what to bring to a workers’ comp consultation and changing attorneys in the middle of a claim.
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