New York State Worker's Compensation Board

What New York State Worker's Compensation Board does

The New York State Workers' Compensation Board (NYS WCB), founded in 1914 and headquartered in Schenectady with additional offices in Albany and Menands, is a New York State government agency with 501-1000 employees that administers workers' compensation, disability benefits, and Paid Family Leave programs across all 62 counties of New York State. It serves five primary stakeholder groups — injured workers, employers, healthcare providers, payers (insurers, TPAs, and self-insured employers), and legal representatives — and operates under statutory authority granted by the Workers' Compensation Law.

The Board runs an integrated digital platform consisting of eCase (case management), eClaims (electronic claims filing via the IAIABC EDI R3.1 standard for FROI/SROI), Medical Portal (provider interface with Drug Formulary), OnBoard (prior authorization requests for medication, DME, and treatment/testing), Virtual Hearings (remote adjudication), and eForms (mandatory RFA-2). It maintains the Medical Treatment Guidelines, Medical Fee Schedule, Impairment Guidelines, and Drug Formulary, and enforces a mandatory electronic CMS-1500 billing standard through Board-approved clearinghouses. NY State Identity Service (login.ny.gov) handles authentication across services.

The Board does not generate commercial revenue. It is funded through employer assessments levied under the Workers' Compensation Law, with separate transaction and authorization fees from insurers, TPAs, self-insured employers, and providers. Current Chair is Freida D. Foster; the Board sits within the executive branch of New York State government.

Name

New York State Worker's Compensation Board

Legal name

New York State Workers' Compensation Board

Website

https://wcb.ny.gov

Company type

Public

Founded year

1914

Operating status

Operating

Headcount range

501–1,000 employees

Short description

The New York State Workers' Compensation Board is a state government agency administering workers' compensation, disability benefits, and Paid Family Leave across all 62 counties of New York, serving workers, employers, healthcare providers, insurers, and TPAs through its statutory authority and integrated digital platforms (eCase, eClaims, Medical Portal, OnBoard).

Ownership category

akta.pro rank

Product category

Workers' Compensation Administration

NAICS

Administration of Human Resource Programs (except Education, Public Health, and Veterans' Affairs Programs) (92313)

SIC

Hospital & Medical Service Plans (6324)

akta.pro primary industry

Work Injury & Workers’ Compensation / Occupational Injury Benefits (BPAIAKAJ)

akta.pro secondary industries

Labor, Employment Standards & Occupational Licensing Boards (BPAIAOAF), Disability & Leave Administration (STD/LTD/FMLA/Paid Leave) (HLAEALAM)

Keywords

• Workers compensation
• Disability benefits
• Paid family leave
• Claims adjudication
• Medical billing

Headquarters

HQ city

Schenectady

HQ country

United States

HQ region

North America

Offices3 records

Markets served

GTM type

B2B and B2C

Offering type

Services

Cost components

Personnel, Operations, Technology or R&D, Infrastructure, Marketing or Sales

Revenue model

1. Employer Assessments: The Board is funded through employer assessments levied under Workers' Compensation Law. Governor Hochul's legislation allows the Board to use employer assessments to administer grant programs for district attorneys to establish dedicated workers' compensation fraud units.
2. Insurance Carrier/Payer Fees: Insurers and third-party administrators pay fees related to eClaims filings, trading partner registration, and compliance monitoring. Carriers face penalties for late proof of coverage filings under WCL sections 54 and 227(b).
3. Self-Insurance Fees: Self-insured employers pay fees for self-insurance eligibility, group self-insurance administration, and compliance assessments.
4. Provider Authorization Fees: Healthcare providers seeking Board authorization to treat injured workers complete training requirements and registration through the Medical Portal.

Pricing tiers

Go-to-market motion1 record

Distribution channels5 records

Marketing channels6 records

Core offering

The New York State Workers' Compensation Board administers workers' compensation, disability benefits, and Paid Family Leave programs through interconnected web-based platforms including eCase (case management), eClaims (IAIABC EDI R3.1 electronic claims filing), Medical Portal (healthcare provider interface), OnBoard (prior authorization requests), and Virtual Hearings (remote adjudication). The Board processes claims, authorizes healthcare providers, regulates insurance carriers and TPAs, and adjudicates disputes for all 62 counties of New York State.

Product overview

The NYS Workers' Compensation Board operates a platform-based ecosystem consisting of multiple interconnected online services. The core systems include eCase (case management), eClaims (EDI-based claims filing using IAIABC R3.1 standard), Medical Portal (healthcare provider interface), and OnBoard (prior authorization requests). These are complemented by self-service tools like the Provider/IME Search, Employer Coverage Search, and Virtual Hearings. The Board transitioned to the CMS-1500 universal billing form (mandatory since 2022, with full electronic submission required since August 2025) and manages extensive reference resources including Medical Treatment Guidelines, Impairment Guidelines, Medical Fee Schedules, and a Drug Formulary. The eForms system handles electronic document submissions including the RFA-2 form (mandatory since April 2026).

Differentiator

Problem solved

Functional benefit

Products and services

• eCase Online case management system for workers, employers, providers, payers, and representatives to view and manage workers' compensation cases, download claim notices, and access case-related documents.
• eClaims Electronic claims filing system based on the IAIABC EDI R3.1 standard, enabling insurance carriers, TPAs, and self-insured employers to submit First Report of Injury (FROI) and Subsequent Report of Injury (SROI) data to the Board via SFTP flat file or web data entry, with Agreement to Compensate (ATC) code tracking.
• Medical Portal Web-based application enabling Board-authorized healthcare providers, payers, pharmacy benefit managers, and medical review organizations to submit medical information, view Board information, access the Drug Formulary, and manage prior authorization requests under WCL medical guidelines.
• OnBoard Prior Authorization Request (PAR) system for medication, durable medical equipment, and medical treatment/testing — part of the new business information system moving key authorization processes from paper to online. Includes MTG confirmation, MTG variance, special services, non-MTG treatments, medication PARs, and DME PARs.
• Virtual Hearings Online video conference platform for conducting workers' compensation hearings remotely, allowing parties to participate in Board adjudication proceedings in place of in-person appearances.
• CMS-1500 Electronic Billing System State-mandated universal medical billing form system requiring healthcare providers to submit CMS-1500 bills electronically through Board-approved XML submission partners (clearinghouses/billing services) for workers' compensation treatment reimbursement.

Quantifiable outcome

• OnBoard reached 2 million PAR submissions (November 2024)
• +2 more outcomes

Segments6 records

Ideal customer profiles4 records

Technology focussed No

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Integration3 records

Feature5 records

Scale indicators3 records

Recent moves6 records

Expansion highlights5 records

Direct peers

• California Workers' Compensation Appeals Board: California's statewide workers' compensation adjudicatory body, operating under the Division of Workers' Compensation. Directly comparable to NYS WCB as the analogous state-level regulatory and dispute-resolution agency for workers' compensation claims on the U.S. West Coast.
• Washington State Department of Labor & Industries: Washington's state agency administering workers' compensation, workplace safety, and labor standards under a state-fund model. Comparable to NYS WCB for combining regulatory authority with benefits administration across a single statewide jurisdiction.
• Massachusetts Department of Industrial Accidents: Massachusetts state agency adjudicating workers' compensation disputes and administering the state's workers' comp system. Comparable as a Northeastern state-level peer with overlapping adjudicatory, regulatory, and digital-services responsibilities.
• Florida Division of Workers' Compensation: Florida's state regulatory office overseeing workers' compensation compliance, carrier oversight, and claims administration. Comparable to NYS WCB as a state-level regulator managing employer coverage requirements, carrier compliance, and provider oversight.
• Ohio Bureau of Workers' Compensation: Ohio's exclusive state-fund workers' compensation insurer and regulator — the largest state-run workers' comp system in the U.S. Comparable to NYS WCB for its scale, digital services portfolio, and combined regulatory-plus-administration footprint.
• Pennsylvania Bureau of Workers' Compensation: Pennsylvania's state bureau administering workers' compensation law, claims adjudication, and employer compliance. Comparable to NYS WCB as a similarly structured Northeastern state agency with regulatory, adjudicatory, and provider-licensing functions.
• New Jersey Division of Workers' Compensation: New Jersey's state division administering workers' compensation law, claim adjudication, and employer compliance. Comparable as a neighboring Northeastern state regulatory body with similar case-management, medical, and payer oversight functions.
• Texas Division of Workers' Compensation: Texas state agency that administers workers' compensation for non-subscribing employers and regulates the workers' comp system. Comparable as another large-state regulatory/administrative body with overlapping regulatory scope and a digital services portfolio.

Broad incumbents

• Sedgwick: Large private-sector third-party administrator and claims management firm serving workers' compensation, disability, and absence management. Comparable to NYS WCB's eClaims, Medical Portal, and OnBoard systems as a major third-party operating layer that interacts with the Board's regulated workflows.
• State Compensation Insurance Fund (California): California's state-run workers' compensation insurance carrier. Comparable to NYS WCB as a state-affiliated workers' compensation entity — though operating as an insurer rather than a regulator, it shares the same statutory mandate space and serves overlapping payer/provider stakeholders.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat4 records

Key risks6 records

Key highlights7 records

Customer concentration

• Xx.com/nysworkerscomp

Compliance1 record

Revenue estimate

Valuation estimate

Number of profiles

Profiles1 record

Funding overview

Funding rounds

Investors

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

M&A

Investments

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Frequently asked questions about New York State Worker's Compensation Board