Objective

To determine whether the Metropolitan Transportation Authority’s (MTA) self-insured agencies administer their workers’ compensation plans to ensure they meet the self-insurers’ regulatory obligations, including those related to employee claimants. We reviewed actions taken by the following three constituent agencies: New York City Transit (excluding Staten Island Railway), MTA Bus Company, and Triborough Bridge and Tunnel Authority. The audit period was from July 1, 2015 to June 30, 2018.

About the Program

Every year, tens of thousands of New Yorkers suffer an injury or occupational illness related to their work. Almost all employees are covered by the Workers’ Compensation Law (Law), which ensures that such employees receive speedy and adequate replacement benefits as well as medical coverage. The Workers’ Compensation Board (WCB) was created to adjudicate claims and ensure that employers provide coverage to their injured employees. Virtually all employers in New York State must provide workers’ compensation, and are required to buy insurance against the cost of occupational injury and illness by using a private insurance carrier, or the State Insurance Fund, or by electing to self-insure or participating in group self-insurance. Three of the MTA’s agencies – New York City Transit, MTA Bus Company, and Triborough Bridge and Tunnel Authority – are self-insured and administer their own workers’ compensation claims in accordance with the Law.

Key Findings

We found that there is room for improvement in how the MTA’s three self-insured agencies are administering their workers’ compensation plans to ensure they meet the self-insurers’ obligations.

• Inconsistent processes and application of the Law across agencies have resulted in late, inaccurate, or sometimes missed administration of benefits, placing an undue financial burden on injured employees. Each of the three self-insured agencies administers its own plan and uses its own procedures for processing claims, and the MTA does not monitor the procedures being used. From July 1, 2015 to June 30, 2018, the three agencies were penalized 547 times by the WCB, totaling $576,030, for violations of the Law, including late payments, late reporting to the WCB, and late objections to claims. We found workers’ compensation payments made beyond the time frames required by Law, including one payment made 33 days late.
• Workers’ compensation payment processing for the three self-insured agencies is complex and requires a coordinated effort among several departments. While officials and key employees understand their roles and responsibilities, no one clearly understands the entire process.

Key Recommendations

• Create and implement a workers’ compensation manual to guide claims processing for all self-insured agencies.
• Develop a common procedure for processing payments for workers’ compensation claims for the three constituent agencies.