What is arbitration?
Arbitration is a method to resolve disputes outside of the court system. A dispute is submitted to an impartial person (known as the Arbitrator) who will render a decision, known as an award. Awards are made in writing and are final and binding on the parties in the case.
What does desk arbitration mean?
In a desk arbitration, the decision is based SOLELY on written documentation and evidence submitted by the interested parties to the Arbitrator.
There is no oral or in-person hearing.
Am I eligible for arbitration?
If you are an eligible employee working in New York State and your request for Paid Family Leave (PFL) was denied, you may dispute the denial by filing a Request for Arbitration.
How are the arbitrators appointed?
NAM (National Arbitration and Mediation) offers a panel of experienced and qualified arbitrators to resolve New York State PFL claim-related disputes. The arbitrators have been reviewed and approved by the New York State Workers' Compensation Board (the "WCB"). The arbitrators on NAM's PFL panel are former judges and attorneys admitted to practice law in New York State, have knowledge of Paid Family Leave Benefits Law and take an annual oath of office.
When can I request for arbitration?
A request for arbitration can be submitted online or by mail to NAM within 26 weeks of written notice of denial of the claim for paid family leave.
Do I need an attorney to request an arbitration?
No. The process for submitting a request for arbitration does not require the use of an attorney. However, if you chose to be represented by an attorney, you will be required to provide your attorney's contact information on the Request for Arbitration form. If represented, your attorney can also complete your Request for Arbitration on your behalf.
How can I initiate a request for arbitration?
All requests for arbitration can be initiated by submitting a complete Request for Arbitration to NAM (online or by regular mail) and the responding party along with a filing fee of $25.
The Applicant is required to attach copies of all documents previously submitted to the carrier or self-insured employer as proof of eligibility, and the Denial Letter.
If the request is initiated to dispute the identity of the proper insurance carrier or to establish coverage for a paid family leave period, the Applicant must attach documentation to support the request.
If a request for arbitration is being made under the assumption that the employer did not have paid family leave insurance or was not self-insured, the Applicant is also required to send a copy of the Request for Arbitration to the WCB.
What happens after I initiate a request for arbitration?
Within two business days of receipt of a complete Request for Arbitration (which must include a complete Request for Arbitration form, a copy of the Denial Letter, documentation supporting the claim for PFL benefits and the required filing fee), NAM will acknowledge receipt of the Request for Arbitration by notifying all parties.
Any request for arbitration which is not accompanied by the necessary documents or filing fee will be returned by NAM with an acknowledgment stating there will be no further action on the claim. An incomplete request for arbitration may be completed and resubmitted to NAM based on instructions contained in the acknowledgement letter, provided that the statutory timeframe for submitting a claim has not expired.
Within 14 days after receipt of acknowledgment from NAM of the complete Request for Arbitration form, the responding party is required to submit a response to the request for arbitration to NAM and to all other parties. The response must include a complete Response to Request for Arbitration form, a copy of the Denial Letter, documentation supporting the denial of the request for PFL benefits and the required arbitration fee.
Can I withdraw my request for arbitration?
If you are an Applicant requesting arbitration, you may unilaterally withdraw your request for arbitration prior to receipt of a response from the opposing party by filing such request for withdrawal with NAM and sending a copy to all other parties. The $25 filing fee paid to NAM, however, shall not be refundable.
If a response has already been filed with NAM and the other parties, a request for arbitration may be withdrawn upon mutual consent of the parties. The request for withdrawal shall be in writing and signed by all parties and sent to NAM. In such case, all fees paid or payable to NAM shall not be refundable.
How is an arbitrator assigned to my case?
NAM shall select the arbitrator from the approved panel of PFL arbitrators. Arbitrators will be selected from the panel on a rotational basis. Once selected, NAM shall contact the selected arbitrator to conduct a conflict check by requesting that the arbitrator disclose any circumstance likely to affect impartiality, including any bias, or any actual or apparent conflict of interest from financial or personal interest in the arbitration. If an arbitrator informs NAM that there is an actual or potential conflict, NAM would select a different arbitrator at that point.
NAM shall forward the name and biography of the selected arbitrator to each party in writing, no later than 14 days after sending the acknowledgement letter.
Either party may object to the appointment of the selected arbitrator by submitting an objection and grounds, in writing, to NAM. Within seven days after receipt of the objection, NAM shall determine whether the arbitrator shall be disqualified. NAM shall notify the parties of its decision, which shall be final and binding. In the event an arbitrator shall resign, be disqualified or be otherwise unable to perform his or her duties, NAM shall appoint another arbitrator.
Can I be required to furnish additional documentation or attend an oral hearing?
Yes. Paid family leave disputes shall be resolved by desk arbitration unless the arbitrator, after review of the parties' submissions, finds further development of the record necessary. A request for further development may include, but not be limited to, submission of additional documentary evidence such as sworn affidavits or a telephone conference to determine what evidence should be submitted. In the event that the submission of such additional evidence is not adequate to resolve the issue, further development of the record may include an oral hearing. NAM shall notify the parties of the location, date and time of the oral hearing.
If the arbitrator determines that further development of the record is necessary, he/she must obtain the consent of the carrier or self-insured employer before proceeding further. In the event the carrier and/or self-insured employer do NOT consent to the arbitrator's request to further develop the record, the arbitrator will be required to request and obtain the consent of the WCB to proceed with further development of the record.
When and how will the arbitrator render his/her decision?
The arbitrator shall render a decision in writing no later than 14 days after submission of all evidence or from the closing of the oral hearing. The arbitrator shall specify the basis of the decision. The decision may include any stipulation made by the parties. NAM shall deliver a copy of the decision to each party.
If I am represented by an attorney, how will the attorney fee be handled?
Awards in favor of a represented Applicant will specify the portion of the award to be paid to the Applicant's attorney as a fee commensurate with the services rendered.
To apply for a fee, an Applicant's attorney must complete the portion of the Request for Arbitration form relating to attorneys' fees and attach a detailed description of services rendered and time spent. If an oral hearing is held, the attorney may apply for an additional fee.
If an Applicant indicates in the request for arbitration that he or she objects to the fee, the Applicant may submit a written statement to NAM within 14 days.
The arbitrator will determine the amount of an Applicant's attorney's fee having due regard for the time spent, complexity of the case, the financial status of the Applicant and the quality of the legal services rendered.
In case I prevail, when can I expect payment of my award?
Awards shall be paid to the prevailing party no later than 10 days after filing of the decision. Any awards remaining unpaid after said 10-day period shall draw simple interest from 10 days after the making of the award at the rate provided in section 5004 of the Civil Practice Law and Rules.
Can the arbitrator's decision be enforced or appealed in a court of law?
Any decision of an arbitrator, made pursuant to the provisions of the PFL regulations, may be enforced, vacated, or modified in accordance with the applicable provisions of sections 7509, 7510, 7511, and 7514 of the Civil Practice Law and Rules. No other provisions of Article 75 of the Civil Practice Law and Rules, except as may be otherwise provided in the PFL regulations, shall be applicable to arbitration pursuant to the PFL regulations.
The arbitrator and NAM shall not be made parties to a court proceeding relating to an arbitration. The WCB shall not be made a party to a court proceeding related to an arbitration award unless its presence as a party is pertinent to any issue raised in the litigation.
The participation of a party in such an arbitration proceeding shall be a waiver of any claim against an arbitrator or NAM for any act or omission in connection with any arbitration conducted pursuant to the PFL regulations.