New York Codes, Rules and Regulations
Title 12 - DEPARTMENT OF LABOR
Chapter V - Workers' Compensation
Subchapter J - VOLUNTEER FIREFIGHTERS' AND VOLUNTEER AMBULANCE WORKERS
Part 403 - CONTROVERTED CLAIMS FOR BENEFITS FOR DEATH OR DISABILITY DUE TO DISEASE OR MALFUNCTION OF THE HEART OR OF ONE OR MORE CORONARY ARTERIES
Section 403.1 - Priority processing of controverted claims for benefits by volunteer firefighters for death or disability due to disease or malfunction of the heart or of one or more coronary arteries

(a) All claims for benefits shall be filed with the chair on a form prescribed by the chair, completed with such information as may be required therein. After receipt of the prescribed form, a notice of indexing shall be mailed on an expedited basis.

(b)

(c) All controverted claims shall be entitled to priority processing as required by section 61 of the Volunteer Firefighters' Benefit Law and shall be processed in accordance with this section, provided, however, that the 90-day period for expedited determination of a claim pursuant to subdivision 2 of section 61 of the Volunteer Firefighters' Benefit Law shall commence from and be conditioned upon the board's receipt of a completed claim. For purposes of this section, a completed claim in a controverted case shall include a completed claim form as set forth in subdivision (a) of this section, prima facie medical evidence and a notice of controversy submitted to the chair.

(d) Notwithstanding any other provisions of this Title to the contrary, an employer or carrier initially controverting a claim on the issue of whether the claimant has a causally related disability due to disease or malfunction of the heart or of one or more coronary arteries, and desiring to have the claimant examined by its consultant, shall have the claimant examined either prior to the first scheduled pre-hearing conference or within 30 days after receipt of a prima facie medical report stating that claimant has a causally related disability due to disease or malfunction of the heart or of one or more coronary arteries, whichever is later. In the event the carrier or employer fails to have the claimant timely examined in accordance with the foregoing, the carrier or employer shall not be granted an adjournment by the Workers' Compensation Law judge for the purpose of obtaining a consultant's report with respect to the issue of causally related disability as set forth in such prima facie medical report, unless it is determined that the failure of the carrier to have the claimant examined was due to circumstances which were solely within the control of the claimant.