Hamberger & Weiss LLP


Board Continues Program to Replace C-4 Forms with CMS-1500

The Board continues its initiative to replace the C-4 family of forms with the CMS-1500 form, as we have reported in the past. The Board has held webinars, released a training video, and published FAQs for stakeholders to review and familiarize themselves with the new procedure. Those publications are available on the Board’s website here.
Most claims decisions after full implementation of the CMS-1500 initiative will depend on the health provider’s narrative report, for which the Board provides its expectations on its website. We expect that there will be some “growing pains” as the New York workers’ compensation community moves from the “check the box” C-4 forms to the need for detailed narratives. Our clients should remember to review future medical narratives carefully because defenses to a claim for benefits may arise based on omissions in the medical narrative, such as the failure to indicate a claimant’s degree of disability. 

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