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Board Eliminates Need to File C-8.1A with C-4AUTH Denial

In a welcome change, the Board has announced that Form C-8.1A will no longer need to be filed in cases where a carrier denies a request for authorization of a special service with Form C-4AUTH. In the past, a carrier’s denial of treatment requested by an attending physician on a C-4AUTH form required completion of 2 forms, as well as a conflicting medical opinion, resulting in the perverse and uniquely New York requirement of requiring 3 documents from the carrier to deny one request from the provider. The Board announcement is a step in the right direction, reducing the paperwork burden on carriers and eliminating a redundant form.

The Board’s announcement appears to be a policy statement following a decision in Matter of J&A Concrete Corporation, 2017 NY Work. Comp. G1078502 (filed 9/5/17), which held that the filing of a C-8.1A would be “redundant and unnecessary” where the carrier has already filed a C-4AUTH denial coupled with the filing of a contrary supporting medical opinion. This change is effective immediately.

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