December 11, 2023

Understanding the Workers’ Comp Process in New York: How Does Workers’ Comp Work?

Imagine, John, a construction worker in New York City, has unfortunately fallen from scaffolding. He’s now facing weeks of recovery and the daunting prospect of lost wages. Like many, John wonders how he’ll make ends meet. Fortunately for John and countless others, New York’s workers’ compensation system exists to offer support during these challenging times.

New York’s workers’ compensation system benefits employees who suffer work-related injuries or illnesses. This article will explain how New York’s workers’ comp system works, who is eligible for benefits, what types of benefits are available, and how to file a workers’ compensation claim. Knowing your rights and responsibilities under New York workers’ comp law is crucial if you are injured on the job.

Understanding Workers’ Compensation Insurance

Workers’ compensation offers both medical coverage and wage replacement benefits to employees injured while on the job. It is a no-fault system, meaning workers do not have to prove employer negligence to receive benefits. This tradeoff between easy access to benefits and limitation on lawsuits is known as “the compensation bargain.”

New York employers are required to have workers’ comp insurance or be self-insured. This coverage pays benefits regardless of who was at fault for the injury or illness. Workers’ compensation is often called “workman’s comp” or “workers’ comp” for short.

Who Is Eligible for Workers’ Comp Benefits in New York?

All employees who suffer job-related injuries or illnesses are entitled to New York workers’ compensation benefits. This includes full-time, part-time, seasonal, and temporary employees.

Independent contractors and volunteers are not covered. Self-employed persons must purchase their own workers’ comp policy to receive benefits.

Workers’ comp covers physical injuries from accidents as well as occupational illnesses that develop over time from job conditions. Common examples include back injuries, broken bones, repetitive motion injuries, hearing loss, lung disease, cancer caused by workplace toxins, and stress disorders.

What Types of Benefits Does New York Workers’ Comp Provide?

There are several types of workers’ compensation benefits available in New York:

  • Medical Care: Pays for all reasonable and necessary medical treatment related to the work injury, including doctor visits, hospital services, physical therapy, prescriptions, assistive devices, and travel costs.
  • Temporary Disability Benefits: Provides partial wage replacement if you miss more than seven days of work. Pays 2/3 of average weekly wages up to the state maximum.
  • Permanent Disability Benefits: Pays wage benefits if you suffer a permanent impairment that diminishes your earning capacity. Based on type and severity of disability.
  • Vocational Rehabilitation: Offers job training and placement services if you cannot return to your previous job after maximum medical improvement.
  • Death Benefits: Provides wage replacement and burial expenses to dependents of workers who die from work-related injuries or illnesses.

How Do I File a Compensation Claim?

Here are the steps to take if you are injured at work in New York:

  • Report the injury to your employer immediately. There are time limits for reporting claims.
  • Get medical treatment and tell the doctor your injury is work-related. Your employer/insurer must authorize treatment.
  • Notify your employer of the doctor’s orders for time off or modified duty. Complete the employer’s incident report form.
  • File a C-3 form with the New York Workers’ Compensation Board to open a claim within two years. This starts the benefits process.
  • Attend hearings as needed. Communicate with your insurer, doctors, and the Board during your claim.
  • Return to work as soon as medically able. Your employer may have light-duty options.

When Uncertainty Strikes, Seek Experienced Guidance: It’s in such challenging moments that the expertise of a workers’ compensation attorney becomes invaluable. Consider partnering with a firm like O’Connor Law PLLC. Their experience and knowledge can be the beacon you need, ensuring your rights are protected, and you receive the compensation you rightfully deserve.

What Happens After An Injured Worker Returns to Work?

In many cases, an injured worker is able to return to work after receiving medical treatment. Return-to-work programs are designed to help injured employees on the job safely and effectively transition back into the workplace.

These programs may involve modified work duties or schedules, physical therapy, or other accommodations. It’s important to note that return-to-work programs vary from state to state and may depend on the severity of the injury and the type of work the employee does.

If a worker cannot return to work due to their injury, they may be eligible for long-term or lump-sum benefits. The amount and type of compensation may depend on the severity of the injury and its impact on the worker’s ability to earn an income.

Frequently Asked Questions:

Can I switch my workers’ compensation doctors?

Yes, employees are entitled to have their own physician in the workers’ compensation claim process. However, the insurance carrier must authorize a change of doctors. Your New York workers comp lawyer can assist you in requesting a doctor more suited to treating your injury if there are issues with the insurance company’s provider.

What if I was injured at work but my employer does not have comp insurance?

New York employers are required by state law to have workers’ compensation insurance coverage. The lack of comp insurance is illegal. In this situation, you can file a claim with the Uninsured Employers Fund administered by the Workers’ Compensation Board to still receive benefits.

Can I still get New York workers’ compensation if I was injured as an independent contractor?

Typically independent contractors are exempt from workers’ comp coverage. However, if you can demonstrate you were misclassified and functioned as an actual employee, you may still be able to receive benefits by filing a claim. An experienced NY workers compensation attorney can help assess your situation.

Who makes decisions on my workers’ compensation case?

Judges at the New York Workers’ Compensation Board make the final rulings on your claim for benefits. They will evaluate evidence on work-relatedness of injury, degree of disability, and whether treatment is appropriate. Having a knowledgeable NY workers’ comp lawyer represent you can persuade the judge rule in your favor.