New York Workers’ Comp FAQs
Banville Law’s workers’ compensation lawyers have helped thousands of injured New York employees secure the financial compensation they’re entitled to. Throughout the years, we’ve come to identify the most common concerns injured workers have while planning for their recovery.
We’ve compiled a list of some of these common questions here. You may be able to find answers to some of your concerns here. However, remember that every work injury or illness claim has unique circumstances and must be evaluated on an individual basis.
- What Is Workers’ Compensation Insurance?
- Are All Workers Entitled To Workers’ Compensation?
- What Are The Requirements For Filing A Claim?
- Is It Easy To Get Workers’ Compensation Benefits In New York?
- What Should I Do If My Claim Has Been Denied?
- What Is The Time Limit For Filing A Claim?
- How Much Can I Get For Workers’ Comp?
- What Types Of Injuries & Illnesses Qualify For Workers’ Compensation?
- What If I’m Disabled And Unable To Work?
- What Are My Options If I’ve Lost The Use Of A Body Part?
- What Forms Of Compensation Are Available For Hearing & Vision Problems?
- What Are The Requirements For An Occupational Illness Claim?
- Do Mental Health Problems Qualify For Workers’ Comp?
- Can I See My Own Doctor?
- Can You Ever Sue Your Employer For A Work Injury?
- Are Personal Injury Lawsuits Available For Work Injuries?
- Are Preexisting Conditions Covered By Workers’ Compensation?
- Will I Need A Lawyer To Help Me Get Benefits?
- What If I Can’t Afford A Lawyer?
- When Should I Speak With A Lawyer?
- Can Families Recover Workers’ Comp After The Death Of A Loved One?
- What If I Caused My Own Accident?
- Can I Collect Social Security & Workers’ Comp At The Same Time?
- What Happens If My Employer Doesn’t Have Insurance?
- Are Independent Contractors Covered?
- Why Are So Many Workers’ Comp Claims Denied?
- Should I Speak With An Insurance Representative?
- Can I Trust The Insurance Company?
- What Benefits Are Available For Public Employees?
- Can I Be Fired For Reporting An Injury?
- What Are My Options After A Construction Work Injury?
- What Should I Do Following A Work Injury?
What Is Workers’ Comp Insurance?
Workers’ compensation is intended to protect employees who get injured on the job or suffer a from a work-related illness. These benefits provide financial compensation for a portion of lost wages and medical costs related to the injury.
Are All Workers Entitled To Workers’ Compensation?
Anyone who is classified as an employee is entitled to workers’ compensation when a work-related injury requires medical treatment and/or days missed from work. There are some exceptions for independent contractors and some public employees, but these workers often have other options for financial compensation after a work injury.
What Are The Requirements For Filing A Claim?
In order to apply for worker’s compensation in New York, you must report the injury to your employer and the Workers’ Compensation Board, and make sure to receive medical treatment as soon as possible. You’ll be required to provide medical reports and other documents as evidence for the nature and severity of your injuries.
Is It Easy To Get Workers’ Compensation Benefits In New York?
Your experience with the workers’ compensation system will vary depending on the circumstances of your injury, who your employer is, and whether or not you have legal representation, among other factors. Some injured workers receive financial compensation with few headaches, but others are forced to spend months or even years tied up with insurance companies and uncooperative employers.
What Should I Do If My Claim Has Been Denied?
Don’t give up. It’s common for initial claims to be denied. You’ll be forced to go through a difficult appeals process, but you can still recover the benefits you deserve. You’ll likely need to provide additional evidence and negotiate with the insurance company, but an experienced work injury lawyer can help you through the process.
What Is The Time Limit For Filing A Claim?
There are a few different time limits for workers’ compensation claims in New York:
- For work-related injuries, you must file a claim within 2 years of your accident. You should report your injury to your employer within 30 days, but ideally as soon as possible.
- For occupational diseases, you must file a claim either two years from the date of the disability or two years from when you knew or should have known that your disease was work related – whichever date is later.
- For occupational hearing loss, you must wait three months from the date you were removed from a harmful noise environment or three months after you’ve left the job where the harmful noise exposure occurred.
How Much Can I Get For Workers’ Comp?
If your claim is accepted, you’ll receive 2/3 of your average weekly wage, up to a maximum benefit. These payments are reduced to 2/3 because they are untaxed and payments are intended to match your post-tax income.
So if you were making $900 per week, you’d receive $600 per week in workers’ compensation payments.
These benefits will also cover the cost of any medical expenses related to your injury.
Sometimes injured workers require additional compensation outside of the maximum benefits. In some cases, these employees may be eligible for other forms of financial compensation.
What Types Of Injuries & Illnesses Qualify For Workers’ Compensation?
Any injury, illness, or occupational impairment which was directly caused by and occurred during work qualifies for workers’ compensation. However, proving that an injury is work-related is just one of many complications injured workers run into when applying for benefits. Additionally, some employers may try to dissuade their workers from filing claims. Remember that any work-related ailment is eligible, and that you have a right to workers’ compensation as an employee in New York.
What If I’m Disabled And Unable To Work?
If you’re temporarily or permanently unable to work, you may be eligible to recover specific disability benefits under workers’ compensation. Depending on the nature of your injury, you’d be eligible for one of the following forms of compensation:
- Temporary Total Disability – Available if you’re disabled to the point where you can’t work temporarily.
- Temporary Partial Disability – For workers who have lost partial earning capacity temporarily.
- Permanent Total Disability – Available for workers who have permanently and completely lost their capacity to work.
- Permanent Partial Disability – Available if you’ve permanently lost part, but not all, of your earning capacity.
Some workplace injuries and illnesses may also qualify for Social Security Disability benefits.
What Are My Options If I’ve Lost The Use Of A Body Part?
If you’ve lost full or partial function in a limb or body part, or suffered a work-related amputation, you would be eligible for benefits under “schedule loss of use”. These benefits would either be classified as partial permanent disability or total permanent disability, depending on the severity of your injuries.
Those who have suffered amputations also qualify for Social Security Disability benefits. Like workers’ compensation, SSD is a complex system which often requires legal assistance to navigate.
What Are The Requirements For An Occupational Illness Claim?
Illnesses which occur directly because of work conditions qualify as occupational diseases under workers’ compensation. You must prove that workplace factor directly caused your condition, such as asthma caused by exposure to respiratory irritants like chlorine gas, sulfur dioxide, or smoke.
You also must make sure to file your claim within two years from the date your disability occurred, or two years from the time you knew or should have known that the disease was caused by your work environment.
Do Mental Health Problems Qualify For Workers’ Comp?
If you’ve developed a mental illness because something traumatic you experienced at work, you could be eligible for workers’ compensation. However, your experience must have involved an unreasonable level of stress for your job position. Examples of valid workers’ compensation claims for mental health may include:
- Psychological trauma you experienced after being injured in a workplace accident
- Suffering psychological trauma after you witnessed a serious injury in a workplace accident
- Developing a mental illness over time due to accumulated work-related stress
Can I See My Own Doctor?
Yes, as long as they’ve been approved by the Workers’ Compensation Board to treat workers’ comp patients. You can find a list of approved healthcare providers here.
Can You Ever Sue Your Employer For A Work Injury?
Workers’ compensation is no-fault insurance – this means that you’re covered even when your injury was caused by your own negligence, and your employer is usually protected from lawsuits, even if their negligence caused a work injury.
However, there are exceptions to this rule in cases of extreme negligence. For example, a construction project manager who ignored a serious safety hazard which caused an injury could potentially be held liable in a personal injury lawsuit.
Are Personal Injury Lawsuits Available For Work Injuries?
While employers are usually protected from lawsuits, you could have grounds for a personal injury claim against a negligent third party (someone other than your co-workers or employer) who caused your injury to occur.
Common examples of negligent third parties in work injury cases include:
- Negligent motorists who cause car accidents with occupational drivers
- Construction site accidents caused by third parties, such as independent contractors, an employee of a different subcontractor, project managers, etc.
- Property owners who fail to keep their property safe from hazards (such as a snow-covered sidewalk) which causes a worker to be injured on the property.
Are Preexisting Conditions Covered By Workers’ Compensation?
Preexisting conditions are covered by workers’ compensation if they’re made worse by your work environment.
For example, if you have asthma, you could be eligible for a claim if your symptoms have become more severe because of something in your work environment. But if your condition has not changed since you’ve been at your current job, you would likely not have a case for workers’ compensation?
Should I Hire A Lawyer To Help Me Get Benefits?
Yes. While you’re permitted to represent yourself, having an experienced lawyer to help you through the process is the best way to make sure you get the financial compensation you need.
The claims process is much more complicated than most people realize. A workers’ compensation lawyer can help guide you through this process by helping you submit paperwork on time, provide adequate medical evidence, and negotiate with difficult insurance companies.
If your claim has already been denied, it’s usually necessary to have a lawyer’s help in order to file a successful appeal.
Additionally, a work injury lawyer can help you seek other forms of compensation, such as Social Security Disability benefits and personal injury lawsuits, if applicable.
What If I Can’t Afford A Lawyer?
This is a common concern for injured workers, but you don’t need to worry about lawyer’s fees. At Banville Law, we offer free consultations where we can assess your case and help you determine if you need a lawyer.
You won’t pay a fee unless we help you secure your benefits, and this fee is determined by a Workers’ Compensation Law Judge and deducted from your benefits.
When Should I Speak With A Lawyer?
It would be best to speak with a lawyer as soon as you’ve reported your injury and received medical treatment. Many injured workers wait until their claim has been denied or until they’ve faced other difficulties before they hire a lawyer. But having a lawyer to guide you from the beginning is the best way to ensure you get through the process and secure your benefits quickly.
Can Families Recover Workers’ Comp After The Death Of A Loved One?
In the event of a fatal workplace accident, families often suffer financial stress in addition to the grief of losing a loved one. Workers’ compensation is available to provide financial relief for families in this situation, so they don’t have to worry about paying their bills.
What If I Caused My Own Accident?
Workers’ compensation benefits are no-fault, which means that you’re eligible to file a claim even if you got injured through your own mistake or negligence.
Can I Collect Social Security & Workers’ Comp At The Same Time?
If your injury qualifies for both workers’ compensation and Social Security Disability benefits, then you may receive both at the same time. Your total benefit payments cannot exceed 80% of your average weekly wage, so your workers’ compensation payments may be reduced.
What Happens If My Employer Doesn’t Have Insurance?
It’s illegal for any New York employer not to carry workers’ compensation insurance. If you were recently injured and have discovered that your employer violated this law, you could have grounds for a personal injury lawsuit against your employer.
Are Independent Contractors Covered?
Since independent contractors have no employer, they are not covered by any employer-provided insurance plan. Independent contractors have the option to purchase their own workers’ compensation coverage. But even if you were injured while working uninsured, you could potentially have grounds for a personal injury lawsuit if someone else caused your injury through negligence.
Why Are So Many Workers’ Comp Claims Denied?
In every workers’ compensation claim, there are two sides: the injured employee, and their employer & the insurance carrier. While workers’ compensation is supposed to protect employees with work-related injuries and illnesses, the insurance system makes this process more complicated than it needs to be.
Paying out claims means less profits for the insurance company, which goes against their business model. Additionally, employers have a financial interest in disputing claims in order to keep their premiums low.
The process of compiling evidence and documents is also complicated, and many claims are denied for small errors or inaccuracies.
Should I Speak With An Insurance Representative?
No. Insurance representatives may act like they’re looking out for your best interests, but don’t be fooled. Speaking with them almost never helps your case, and will most likely make it more difficult to receive your benefits. Some insurance policies have a clause which may require you to give a statement, but we recommend speaking with a workers’ compensation lawyer before any correspondence with the insurance company.
Can I Trust The Insurance Company?
No. Insurance is a business, and approving claims means less revenue for that business. These companies put their profits above all else, even though they may claim to represent the interests of injured workers. Your employer’s insurance carrier will have skilled lawyers working to deny your claim. It’s important you realize that these companies are not on your side, and it’s often necessary to have your own skilled lawyer who can stand up to them.
What Benefits Are Available For Public Employees?
Public employees (such as NYPD officers, FDNY firefighters, or NYC Sanitation workers) may not qualify for workers’ compensation, but they have their own work injury compensation systems.
To find out more about seeking benefits as a public worker, see these resources:
Can I Be Fired For Reporting An Injury?
No. It’s illegal for your employer to retaliate against you in any way for reporting a work injury. This includes firing, demotions, changing job duties, or cutting hours. If you’ve faced disciplinary actions which you believe could be retaliation for reporting a work injury, a knowledgeable work injury lawyer could help protect your workers’ rights.
What Are My Options After A Construction Work Injury?
Construction site injuries involve different circumstances than most other workplace injuries. These sites are usually made up of workers from a variety of different parties, including various subcontractors, independent contractors, project managers, property owners, and others. When one of these third parties causes an injury, a personal injury lawsuit may be an option in addition to your employer-provided workers’ compensation benefits.
If you were injured while working on a construction site, there is a good chance the person who caused your injury is not a co-worker or employer. For example, perhaps you suffered serious injuries after construction materials fell through a roof and trapped you underneath debris. If a third-party crane operator made a mistake by putting too much weight on the roof, you could potentially hold that operator or his employer liable for damages in a personal injury lawsuit.
Construction site accidents are extremely complex. In order to fully examine all possible options for compensation, it’s often necessary to have the circumstances of your accident and injuries reviewed by an experienced construction injury lawyer.
What Should I Do Following A Work Injury?
In order to give yourself the best chance of receiving your workers’ compensation benefits, it’s best to follow three first steps:
- Report the injury to your employer and file a claim with the Workers’ Compensation Board
- Seek medical treatment for your injuries
- Contact a workers’ compensation lawyer to schedule a consultation
Seeking compensation for a work injury can be difficult, but following these three initial steps will likely make the process much easier.