Workers' Compensation Attorney in New York
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New York State Workers’ Compensation Law
In New York State, your employer’s workers' compensation insurance pays for medical and vocational rehabilitative costs plus provides wage benefits to employees who sustain on-the-job injuries regardless of fault. In almost all circumstances, this is the employee's only legal remedy because of how workers' compensation law works. Employers pay for the insurance, and it's generally considered a perk because employees pay absolutely nothing toward it, even though it's a legal requirement for nearly all employers to carry this insurance.
New York state workers' compensation law has been evolving since the early 20th century. Before the law was in place, workers could sue their employer for injuries sustained on the job. However, obtaining a favorable outcome was a strenuous and costly task, with the burden on the employee to prove negligence on behalf of the employer as the cause. Meanwhile, an injured worker may have been out of work with no pay and no access to medical care. It's been called "the great trade-off," but while workers gave up the right to sue, they gained dependable and predictable access to valuable benefits for on-the-job injuries.
Still, even though we live in relatively progressive times concerning the rights of workers, one thing persists, and that's the greed of businesses that use power and intimidation to evade accountability. Morgan and Morgan Law Firm is here to stand up for your rights if you're having trouble getting the full benefits you deserve or are experiencing backlash for making a claim. One of our many qualified workers' compensation lawyers can advise you on the best strategy to secure the maximum benefits available to you.
Contact us today for a free, no-obligation case evaluation to get started.
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Am I Eligible to Get Workers’ Compensation?
New York State law is clear. Employers must carry workers' compensation insurance to cover medical care and provide wage benefits for injured employees. This means employees are covered on their first day of work, whether employed, full or part-time. When a worker is not considered an employee and therefore ineligible for workers' comp benefits is determined by the New York State Workers' Compensation Board. Generally, only authentic independent contractors, uniformed fire, police, and sanitation workers, teachers, and federal, maritime, and longshore workers are not covered by New York state workers' compensation law.
What Kind of Injuries Are Covered by Workers' Compensation?
Typically, any injury you sustain or occupational illness you develop is covered by workers' compensation as long as the condition is linked to the work you perform. Here are some common examples:
- Sprains and strains
- Carpal Tunnel Syndrome
- Bone fractures
- Injuries caused by equipment
- Back injuries
- Spinal injuries
- Head injuries
- Knee, ankle, wrist, hand, shoulder, elbow, and foot injuries
- Bulging, slipped, and herniated discs
- Vision or hearing loss
Almost any work-related injury qualifies for workers' compensation coverage, including injuries that develop over time (from repetitive motions, for example.) However, there are some exceptions for psychological injury, which has a higher bar. You must demonstrate that you faced an above-average amount of stress than other workers typically face due to a traumatic event at work, you've suffered mental trauma because of extremely negative work conditions, or the physiological issue is directly linked to a physical injury sustained while on the job.
Suppose you've suffered an injury that is excluded from workers' compensation coverage. In that case, a workers' compensation lawyer might be able to acquire the medical documentation and testimony needed to win your claim.
When Should I File a Workers' Compensation Claim in New York State?
You can file a workers' compensation claim anytime you're injured or become ill as a direct result of your work. However, you are responsible for notifying your employer as quickly as possible after the accident, or you become aware that an illness is linked to your job. In fact, if 30 days pass without providing your employer notification, you may lose access to benefits. Still, you have a deadline of two years after the injury or becoming aware of an occupational illness.
When you delay, it makes it easier for your employer's insurance company to argue that your injuries aren't all that serious. Otherwise, you would have sought medical care sooner. It also makes sense to start the process quickly, so you can begin treatment and start receiving other benefits you're entitled to have.
How Do I File a Workers' Compensation Claim in New York State?
Upon notification, your employer will alert their insurance carrier of the claim. You are responsible for filing a claim with the Workers' Compensation Board. If you're uneasy about the process or have questions, one of our attorneys can provide guidance. You can file online, in person, or send the required forms through the mail. If a family member died from a work-related injury or illness, you must file a Claim for Compensation in Death Case within two years of their death.
How Much Are Workers' Compensation Wage Benefits?
Money is always a worry when you're unable to work or can only work in a limited capacity. The way the system works, injured workers are only able to receive wage benefits after missing more than seven days of work. If your disability lasts for a full 14 days, you'll be able to recoup payment for the first seven days as well and beyond during the disability period. For example, if you miss five days because of a sprain, no benefits will be allocated, but your medical care will be covered.
If you miss three weeks, you can collect for all missed days because the income loss extends beyond 14 days. If you miss 13 days, you will be able to collect for six days of missed work because you're past the seven-day threshold but not quite at 14 days.
Workers' compensation wage benefits are based on the last 52 weeks of your average weekly wage prior to your injury and are further determined by the level of your disability, typically calculated as a percentage. You're entitled to two-thirds of your average weekly wage multiplied by the percentage of disability assigned through medical evidence. As of 2023, the maximum available is $1,125,46, whether your disability is total or partial. However, your wage benefits rate is determined by your injury's date and will not increase if new maximums are established.
For example, if your average weekly wage is $700 and your disability rating is 100%, you would get $466.66 (or 100% of two-thirds of your average weekly wage). If you use the same average weekly pay scenario above and your doctor's medical opinion is that you're 50% disabled, you will get half of that amount.
How Do Workers' Compensation Disability Ratings Work in New York?
Your disability rating matters a great deal because it determines how much your cash benefits will pay. There are different classifications as well, such as:
Temporary total disability - You aren't able to work and earn pay, but only temporarily. With this classification, you can collect the full allowable wage benefit until you return to work.
Temporary partial disability - You have temporarily lost the ability to work at full capacity and earn the total amount of your pre-injury wages. This classification entitled you to collect 2/3rds of your average weekly wage at the percentage of disability determined by your doctor. So, using the example above, if your average weekly wage is $700, and you're determined to have 50% disability, you would get 50% of 2/3rds of $700.
Permanent total disability - You have lost the capacity to earn wages permanently and completely. You may collect wage benefits with no time limit.
Permanent partial disability - You've permanently lost the ability to work at total capacity but retain some capability. This classification is further determined by the body part affected and the type of disability.
What Happens if My Workers' Compensation Claim Is Denied in New York?
It's not unusual for workers' compensation claims to get denied. What is remarkable is the number of people that just accept this decision. You have a right to appeal a denied claim, and all it takes is a request for a Workers' comp hearing. Once processed, you'll be scheduled for a hearing. At this point, we strongly recommend having a workers' compensation lawyer help you prepare by gathering evidence concerning your medical issue and coaching you on how to articulate details about your inability to work.
When you dispute a denied claim, the opposing party (your employer's insurance carrier) will have lawyers prepared to challenge your right to workers' compensation benefits. If you're again denied, you have another option to appeal to the Workers' Compensation Board panel.
What Should I Do If I Were Asked to Go for an Independent Medical Exam?
Many times, whether you're trying to get a workers' comp claim approved or need to continue claiming workers' comp benefits after an extended period, the insurance carrier will request an Independent Medical Exam (IME).
This exam is just as it sounds, and an independent doctor will examine you concerning your workplace injury and deliver an independent decision based on their professional opinion. However, these doctors are chosen by the insurance company, so there's a concern they might make a decision that favors the insurance company.
These exams are often the precursor to denying or reducing your benefits. Unfortunately, you'll almost certainly lose access to benefits by refusing this exam. If the IME doctor's opinion hurts your case, Morgan and Morgan will fight to have a favorable doctor's opinion supersede the IME doctor's or challenge it in other ways.
Should I Sign a Medical Release or Give Recorded Statements to My Employer's Insurance Adjuster?
Just like any insurance claim you’re involved with, the other party's insurance adjuster wants to minimize liability for their client so that the insurance company doesn't have to pay as much. While refusing to cooperate with the insurance company will almost certainly result in the denial of your claim, your Morgan and Morgan workers' compensation lawyer can review the release to ensure they're only asking for relevant medical history and advise you on how to answer questions for a recorded statement.
Contact Morgan and Morgan
You deserve to get the help you're entitled to after an on-the-job injury, and we're here to make sure you get it. Our workers' compensation lawyers are experienced in New York state workers' compensation law and are committed to protecting your rights to obtain the benefits you deserve. While not every workers' compensation claim requires the help of an attorney, some cases are more complicated than others, and legal counsel can make a substantial and meaningful difference. If we accept your case, you will only owe us for services once your claim is resolved successfully.
Contact us today for a free and confidential case evaluation.