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This entry was published on 2016-04-08
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SECTION 205
Disabilities, family leave and periods for which benefits are not payable
Workers' Compensation (WKC) CHAPTER 67, ARTICLE 9
§ 205. Disabilities, family leave and periods for which benefits are
not payable. 1. No employee shall be entitled to disability benefits
under this article:

(a) For more than twenty-six weeks minus any days taken for family
leave during any fifty-two consecutive calendar weeks during a period of
fifty-two consecutive calendar weeks or during any one period of
disability, or for more than twenty-six weeks;

(b) for any period of disability during which an employee is not under
the care of a duly licensed physician or with respect to disability
resulting from a condition of the foot which may lawfully be treated by
a duly registered and licensed podiatrist of the state of New York or
with respect to a disability resulting from a condition which may
lawfully be treated by a duly registered and licensed chiropractor of
the state of New York or with respect to a disability resulting from a
condition which may lawfully be treated by a duly licensed dentist of
the state of New York or with respect to a disability resulting from a
condition which may lawfully be treated by a duly registered and
licensed psychologist of the state of New York or with respect to a
disability resulting from a condition which may lawfully be treated by a
duly certified nurse midwife, for any period of such disability during
which an employee is neither under the care of a physician nor a
podiatrist, nor a chiropractor, nor a dentist, nor a psychologist, nor a
certified nurse midwife; and for any period of disability during which
an employee who adheres to the faith or teachings of any church or
denomination and who in accordance with its creed, tenets or principles
depends for healing upon prayer through spiritual means alone in the
practice of religion, is not under the care of a practitioner duly
accredited by the church or denomination, and provided such employee
shall submit to all physical examinations as required by this chapter.

2. No employee shall be entitled to family leave benefits under this
article:

(a) For more than twelve weeks, or the maximum duration permitted as
set forth in paragraph (a) of subdivision two of section two hundred
four of this article, during a period of fifty-two consecutive calendar
weeks, or for any period in which the family leave combined with the
disability benefits previously paid exceeds twenty-six weeks during the
same fifty-two consecutive calendar weeks;

(b) For any period of family leave wherein the notice and medical
certification as prescribed by the chair has not been filed. At the
discretion of the chair or chair's designee pursuant to section two
hundred twenty-one of this article, the family member who is the
recipient of care may be required to submit to a physical examination by
a qualified health care provider. Such examination shall be paid for by
the carrier; and

(c) As a condition of an employee's initial receipt of family leave
benefits during any fifty-two consecutive calendar weeks in which an
employee is eligible for these benefits, an employer may offer an
employee who has accrued but unused vacation time or personal leave
available at the time of use of available family leave to choose whether
to charge all or part of the family leave time to accrued but unused
vacation or personal leave, and receive full salary, or to not charge
time to accrued but unused vacation or personal leave, and receive the
benefit as set forth in section two hundred four of this article. An
employer that pays full salary during a period of family leave may
request reimbursement in accordance with section two hundred
thirty-seven of this article. With the election of either option, the
employee shall receive the full protection of the reinstatement
provision set forth in section two hundred three-b of this article, and
shall concurrently use available family medical leave act and paid
family leave credits. In no event can an employee utilize family leave
beyond twelve weeks, or the maximum duration permitted as set forth in
paragraph (a) of subdivision two of section two hundred four of this
article, per any fifty-two week period set forth in this article. This
paragraph may not be construed in a manner that relieves an employer of
any duty of collective bargaining the employer may have with respect to
the subject matter of this paragraph.

3. No employee shall be entitled to disability or family leave
benefits under this article:

(a) for any disability occasioned by the wilful intention of the
employee to bring about injury to or the sickness of himself or another,
or resulting from any injury or sickness sustained in the perpetration
by the employee of an illegal act;

(b) for any day of disability or family leave during which the
employee performed work for remuneration or profit;

(c) for any day of disability or family leave for which the employee
is entitled to receive from his or her employer, or from a fund to which
the employer has contributed, remuneration or maintenance in an amount
equal to or greater than that to which he or she would be entitled under
this article; but any voluntary contribution or aid which an employer
may make to an employee or any supplementary benefit paid to an employee
pursuant to the provisions of a collective bargaining agreement or from
a trust fund to which contributions are made pursuant to the provisions
of a collective bargaining agreement shall not be considered as
continued remuneration or maintenance for this purpose;

(d) for any period in respect to which such employee is subject to
suspension or disqualification of the accumulation of unemployment
insurance benefit rights, or would be subject if he or she were eligible
for such benefit rights, except for ineligibility resulting from the
employee's disability;

(e) for any disability due to any act of war, declared or undeclared;

(f) for any disability or family leave commencing before the employee
becomes eligible to benefits under this section.

4. An employee may not collect benefits concurrently under both
subdivisions one and two of this section.

5. In any case in which the necessity for family leave is foreseeable
based on an expected birth or placement, the employee shall provide the
employer with not less than thirty days notice before the date the leave
is to begin, of the employee's intention to take family leave under this
article, except that if the date of the birth or placement requires
leave to begin in less than thirty days, the employee shall provide such
notice as is practicable. In any case in which the necessity for family
leave is foreseeable based on planned medical treatment, the employee
shall provide the employer with not less than thirty days notice, before
the date the leave is to begin, of the employees intention to take
family leave under this article, except that if the date of the
treatment requires leave to begin in less than thirty days, the employee
shall provide such notice as is practicable.