Occ. Code 6612100
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COMPENSATION INVESTIGATOR 1, GRADE 16 |
6612100 |
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COMPENSATION INVESTIGATOR 2, GRADE 20 |
6612200 |
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COMPENSATION INVESTIGATOR 3, GRADE 23 |
6612300 |
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CHIEF WORKERS COMPENSATION INVESTIGATION, GRADE 25 |
6822510 |
New York State Department of Civil Service
Classification Standard
BRIEF DESCRIPTION OF CLASS SERIES
Positions in this series independently conduct field investigations to enforce compliance with the New York State Workers Compensation and Disability Benefits Laws. They investigate all aspects of uninsured workers compensation and disability benefits cases including fraudulent and no insurance claims, and no-dependency death cases. These positions also investigate non-compliant employers, including, but not limited to employers who fail to keep accurate records or intentionally misrepresent facts to evade coverage or premium.
These positions are found only in the Workers Compensation Board.
DISTINGUISHING CHARACTERISTICS
COMPENSATION INVESTIGATOR 1: full performance level; independently conducts field investigations to enforce compliance with both the Workers Compensation and Disability Benefits Laws.
COMPENSATION INVESTIGATOR 2: first supervisory level; supervises Compensation Investigators within an assigned District Office; personally conducts the more difficult investigations.
COMPENSATION INVESTIGATOR 3: second supervisory level; plans and supervises investigations activities within a geographic region.
CHIEF WORKERS COMPENSATION INVESTIGATION: one-position class; directs the workers compensation enforcement and investigative programs under the general direction of the Director of Compliance.
ILLUSTRATIVE DUTIES
COMPENSATION INVESTIGATOR 1
Investigates employers liability under the Workers Compensation and Disability Benefits Laws with regard to no-insurance cases.
§ Determines the proper legal employer entity and whether the employer had proper coverage on the date of accident.
§ Gathers information on employer-employee relationship between claimant and alleged employer.
§ Determines if penalties should be made against the employer.
§ Reviews accident and police reports, hospital records, county clerk filings or records and Secretary of States records for pertinent information, and makes site visits as necessary.
§ Obtains information regarding the assets of uninsured employers after entry of judgments.
Investigates the reasons for insurance policy cancellation, and ensures that the cancellation was lawful, and proper notification was provided to the employer and the Board.
§ Interviews employees and witnesses to obtain evidence to prosecute employers without coverage required by the Workers Compensation or Disability Benefits Laws.
§ Prepares and serves subpoenas where violations warrant such action.
§ Prepares prosecution forms for the Attorney Generals office for action against employers with no coverage.
§ Dockets and swears to complaints in criminal court, serves summons on uninsured employers, and appears as a witness in court at trials.
Investigates no-dependency death claims covered under the Workers Compensation Law.
§ Obtains medical records to determine cause of death and possible relationship to decedents work at time of accident.
§ Obtains police and coroner reports relating to the death.
§ Interviews any witnesses regarding the facts or circumstances of the death.
Issues stop-work orders (SWO) to violating employers.
§ Identifies employers through sweeps, independent leads or claims.
§ Visits the subjects and obtains evidence of employment, proper legal entity and lack of insurance coverage.
§ Prepares recommendation for SWO for approval by supervisor.
§ Prepares and serves SWOs according to procedures.
§ Prepares, signs and serves subpoenas on employers to provide records for further case development.
§ Evaluates documentation submitted by the SWO employer to determine if SWO should be lifted.
§ Conducts follow-up visits to ensure that a SWO employer has not resumed business operations.
§ Prepares recommendation for Attorney General prosecution against an employer who has violated a SWO.
Effects collection of double indemnity award when the injured is an illegally employed minor.
§ Contacts employers to obtain their share of the award.
§ Prepares reports on assets based on investigation when payment is not forthcoming.
Conducts inquiries into complaints received from the public and various governmental agencies regarding alleged violations of the Workers Compensation or Disability Benefits Laws.
§ Interviews employer, employee or the grievant to determine issues involved.
§ Speaks with witnesses such as attorneys, insurance brokers or accountants to secure evidence for prosecution of employees found violating the law.
§ Prepares and issues SWOs upon subject employers.
Prepares detailed written investigative reports and ensures that the evidence supports the case.
COMPENSATION INVESTIGATOR 2
Supervises Compensation Investigators 1 to ensure the effective and efficient enforcement of the Workers Compensation and Disability Benefits Laws, rules and regulations.
§ Distributes workload and sets priorities.
§ Provides on-the-job training to staff in such areas as techniques of investigations; Workers Compensation Board procedures and regulations; the legal requirements of investigations, the interpretation of relevant laws, rules and regulations and recent Workers Compensation Board and court decisions to be used as precedents.
§ Reviews completed investigation reports for adequacy of coverage, quality of findings and soundness of recommendations.
§ Evaluates and observes the work performance of the investigative staff; identify areas of substandard performance, and training needs; and counsels staff whose production level and quality fall below Board standards.
§ Coordinates the activities of the investigative staff with participating law enforcement or governmental agencies by providing and sharing facts and information relative to investigative operations.
§ Evaluates SWO recommendations submitted by Compensation Investigator 1 to determine if it should be issued.
§ Prepares reports; and personally conducts the more difficult and sensitive investigations.
COMPENSATION INVESTIGATOR 3
§ Oversees multiple Compensation Investigators 1 and 2 teams assigned to investigate and support the prosecution of no insurance workers compensation and disability benefit cases in addition to non-compliant employers in an assigned region.
§ Directs, controls and/or conducts special investigations of catastrophes.
§ Reviews complaints of alleged discrimination against employees who have filed for workers compensation benefits.
§ Prepares procedural recommendations and may represent the Chief Workers Compensation Investigation in matters relating to enforcement operations.
§ Prepares, analyzes, and distributes Enforcement Unit production reports to management and unit staff to monitor and improve program effectiveness.
CHIEF WORKERS COMPENSATION INVESTIGATION
§ Plans and directs all activities relating to the Boards enforcement and investigative program including both administrative and technical supervision over all district office enforcement units.
§ Advises the Director of Compliance and other Board management on enforcement and investigative matters.
§ Formulates policy, procedures and practices for Statewide Bureau operations that involve investigative and enforcement activities, stop-work orders, issuance of subpoenas, and initiation of penalties pursuant to Workers Compensation Laws, rules and regulations.
§ Establishes priorities for enforcement and investigation activities, assigns work, and supervises and evaluates the performance of Compensation Investigators 3; ensures all Compensation Investigators are properly trained.
§ Serves as liaison with the New York State Attorney General, New York State agencies and municipalities in regard to Workers Compensation law enforcement and compliance activities.
§ Reviews and approves production reports prepared by staff ensuring accuracy and completeness.
§ May interview employers, claimants and their counsel on workers compensation or disability benefits enforcement activities where complex or unusual circumstances exist.
MINIMUM QUALIFICATIONS
COMPENSATION INVESTIGATOR 1
COMPENSATION INVESTIGATOR 2
One year of service as a Compensation Investigator 1.
COMPENSATION INVESTIGATOR 3
One year of service as a Compensation Investigator 2.
CHIEF WORKERS COMPENSATION INVESTIGATION
One year of service as a Compensation Investigator 3.
Date: 3/10
NOTE: Classification Standards illustrate the nature, extent and scope of duties and responsibilities of the classes they describe. Standards cannot and do not include all of the work that might be appropriately performed by a class. The minimum qualifications above are those which were required for appointment at the time the Classification Standard was written. Please contact the Division of Staffing Services for current information on minimum qualification requirements for appointment or examination.