[Code 1964, § 9-29.1]
The procedures established in this division shall be the exclusive
procedures used in administering the disability program for members
of the bureaus of fire and police under sections 207-a and 207-c of
the General Municipal Law.
[Code 1964, § 9-29.1(6)]
Failure to comply with the provisions of this division and section
207-a or 207-c of the General Municipal Law or to cooperate with the
commissioner of public safety or to provide information to the commissioner
shall be grounds for disciplinary action.
[Code 1964, § 9-29.1(1)]
(a)
A written incident report shall be filed with the chief of the bureau
of police or bureau of fire within 72 hours of the incident claimed
to give rise to the disability.
(b)
Application for disability benefits for a member may be made by the
member, the head of the bureau in which the member is employed or
some person acting on behalf of and authorized by the member. The
application shall be made on a form to be prescribed by the commissioner
of public safety.
(c)
No application for disability benefits shall be approved, however,
unless notice of application is received in the office of the commissioner
of public safety within 90 days after the incident which gave rise
to the disability. For good cause shown why the notice could not have
been filed, the commissioner, in the commissioner's discretion,
may excuse a failure to file the application. The notice must set
forth fully all of the following:
(d)
After the filing of an application, the member shall be given one
or more medical examinations. The commissioner of public safety shall
have exclusive authority to determine eligibility for benefits under
sections 207-a and 207-c of the General Municipal Law. Before making
a determination, the commissioner shall receive a written recommendation
from the chief of the bureau. A copy of the recommendation shall be
mailed to the applicant. The commissioner shall examine the facts
of each application and, to that end, shall have full power and authority
to:
(e)
If the applicant is claiming a disability for which the disability
period alleged is less than 10 working days, the commissioner of public
safety may make an initial determination, in the commissioner's
discretion, dispensing with the requirement for medical examination
and all other formal procedures contained in this section. However,
the determination shall not be construed to bind the city or the applicant
and may be reopened without prejudice in any subsequent proceeding
related to the disability.
(f)
Pending the determination of any application, time off taken by the
applicant and alleged to be attributable to the incident which gave
rise to the disability shall be charged to sick leave and vacation
time. However, after the exhaustion of applicant's available
sick leave and vacation time, the commissioner may, in the commissioner's
discretion, direct the payment of applicant's salary and wages
pending the determination upon a showing of hardship, if the applicant
indicates a preliminary likelihood of eligibility and the applicant
agrees in writing that, if there is a final determination of ineligibility,
the monies so allocated shall be repaid to the city.
(g)
After making a determination on any application, the commissioner
shall forthwith mail a written notice of the determination to the
applicant. The notice shall be mailed to the address given in the
application.
(h)
If the initial determination by the commissioner is that the applicant
is eligible for disability benefits, then the applicant shall be so
categorized and shall receive benefits retroactive to the date on
which the disability arose. Benefits shall continue so long as the
applicant remains disabled or until otherwise terminated pursuant
to law. Upon a determination of disability, the commissioner shall
have all the remedies provided by law.
(i)
If the initial determination of the commissioner is that the applicant
is not eligible for disability benefits, then, at any time within
60 days after the mailing of the notice, the applicant or the applicant's
counsel may serve a written demand on the commissioner for a hearing
and redetermination of the application. After the hearing the commissioner
shall make a final determination. A copy of the determination shall
be mailed to the applicant and the applicant's counsel, if any.
The final determination shall be subject to review only as provided
in article 78 [§ 7801 et seq.] of the Civil Practice Law
and Rules or an applicant or the city, within 10 days after receiving
the written decision, may file for arbitration under the terms of
the fire or police contract.
(j)
In connection with the proceedings of this section, the commissioner
shall not be bound by common law or statutory rules of evidence or
by technical or formal rules of procedure.
(k)
If it is finally determined that the applicant was not entitled to
disability benefits, the applicant shall immediately be ordered to
report for duty. Any time taken off by the applicant and attributable
to the incident which was claimed to give rise to the alleged disability
may, at the applicant's option, be charged to vacation time and,
if applicable, sick leave. If the applicant's sick leave and
vacation time is not sufficient to liquidate the time taken off, or
the applicant chooses not to apply the sick leave or vacation time,
then the balance shall be repaid to the city.
(l)
The commissioner, in any particular case, may designate a deputy
or any other person to perform the duties imposed upon the commissioner
under this procedure. If there is no commissioner serving at any given
time or if the commissioner is unable to perform the duties, the duties
of the commissioner shall be undertaken by the mayor.
[Code 1964, § 9-29.1(2)]
(a)
If an individual receiving disability benefits is not eligible for
or not granted state accidental disability retirement and the commissioner,
after examining the medical report submitted on the application and
all other relevant evidence, determines that the applicant is capable
of performing certain specified light-duty assignments within the
meaning of the General Municipal Law, the commissioner shall instruct
the applicant in writing to report for duty at a certain date to undertake
light-duty assignment by mailing notice to the applicant at the address
given in the application. The notice shall include the specific job
assignment, the number of hours to be worked and a copy of any medical
report informing the commissioner that the member may perform light
duty. Failure to report for light duty will result in immediate suspension
of all disability pay and other benefits. If the applicant disagrees
with the determination of the commissioner with respect to light duty,
the applicant shall serve upon the commissioner, within 10 days of
the date of the mailing of the notice, a notice of appeal and demand
for a hearing to review this determination. The commissioner may stipulate
with the applicant that pay and/or benefits may be continued pending
the appeal providing the applicant agrees to reimburse the city for
pay and other benefits should the determination be sustained. After
the service of the demand, the commissioner shall hold a hearing upon
the appeal at which the applicant may be represented by counsel. The
commissioner shall have the same powers upon the hearing as upon the
original application. After the hearing the commissioner shall make
a final determination. A copy of the determination shall be mailed
to the applicant and the applicant's counsel, if any. The final
determination shall be subject to review only as provided in article
78 [§ 7801 et seq.] of Civil Practice Law and Rules or the
individual or the city, within 10 days after receiving notice, may
file for arbitration under the terms of the fire and police contract.
(b)
If it is finally determined that the member was capable of and should
have begun the light-duty assignment on the date contained in the
original notice, then the final determination shall provide for a
forfeiture of disability benefits retroactive to that date and all
amounts collected for wages and salary while the member was not actively
engaged in the duties of an employee of the bureau during the time
the determination was pending shall be refunded to the city. The member
may, at the member's option, receive a credit in the amount of
repayment to the extent that the member has available vacation time
and, if applicable, sick leave.
[Code 1964, § 9-29.1(3)]
If a member receiving disability benefits refuses or fails to
appear, without just cause, for light-duty assignment without following
the appeal procedures set forth in this division, or is discovered
to be engaged in outside employment within the meaning of the General
Municipal Law, it shall be determined that the person shall immediately
forfeit entitlement to disability benefits, retroactive to the date
of the refusal or failure to appear or the commencement of prohibited
outside employment, whichever is applicable. The value of any benefits
improperly received shall be repaid to the city. If the member disagrees
with the determination, the appeals procedure set forth in relation
to light duty shall be applicable.
[Code 1964, § 9-29.1(4)]
(a)
The commissioner of public safety shall make periodic review
of members receiving disability benefits for the purpose of determining
whether or not they continue to be entitled to disability benefits,
and the commissioner shall have the authority to order a member back
to work if the member is no longer disabled or back to light duty
if it is determined the member is able to perform light duty.
(b)
The commissioner may review the case of a person receiving benefits
equivalent to those afforded pursuant to section 207-a or 207-c of
the General Municipal Law prior to the enactment of this procedure
where no actual finding of eligibility was ever made by a court or
administrative body.
(c)
If, for any lawful reason, the commissioner shall determine
the recipient is no longer or never was eligible for benefits under
section 207-a of the General Municipal Law, the commissioner shall
terminate benefits as of the date of the eligibility. A notice of
the determination and the reasons for the determination shall be served
upon the recipient by mail. If the recipient disagrees with the determination
of the commissioner, the recipient may appeal the determination under
the procedures provided with respect to light duty. The termination
of benefits under this section shall only be as of the date of the
determination of ineligibility.
[Code 1964, § 9-29.1(5)]
By law, a member of the bureau who is disabled in the performance
of duties is entitled to all disability-related medical care and hospital
care furnished as a result of the disability. However, no bills or
claims for medical services rendered pursuant to section 207-a or
207-c of the General Municipal Law shall be paid unless the following
procedure is complied with:
(1)
Except for an emergency, a member receiving disability benefits
shall notify the commissioner of public safety or the chief or deputy
chief of the bureau before incurring any expense for medical services
alleged to be related to the disability. Any member incurring medical
expenses or hospital care without this prior notification assumes
the risk that the claim may be disallowed by the commissioner.
(2)
On each bill or claim for medical services, the person rendering
the services shall certify on the bill or claim the nature of the
services rendered, the nature of the injury or illness necessitating
the services and that the services rendered were required as a consequence
of the incident that gave rise to the disability.
