New York State Workers' Compensation
Introduction
to the Worker's Compensation System in New York
New York State Law requires employers to
carry insurance, known as Workers’ Compensation (or Worker's Comp or
Workmans Comp), to cover employees injured in the course of their
job.
The NYS Workers’ Compensation Law offers benefits (quick
payments for medical expenses and compensation for injuries) and
restrictions (strictly limiting lawsuits against employers).
If you are hurt on the job or at a work
site, even with
Workers’
Compensation, you may be eligible for additional compensation
for your injuries. If you were injured in a workplace accident or
developed an occupational disease, you should contact an attorney to
help ensure that you receive all benefits to which you are entitled.
If you have questions about a New York
work-related injury or illness, or if you think you may have a
lawsuit, please feel free to contact me at 1-800-660-1466 or send me
an email at
Carol@SchlittLaw.com. There is never a charge for
this consultation.
This document provides an overview of the
New York Workers’ Compensation program and offers guidelines for you
to follow if you are hurt on the job or at a work site. This
document does not provide legal advice, which you can only receive
by consulting an attorney.
Overview of the NY Worker's Compensation Program
While companies and employees may have
all the best intentions, workers still get hurt on the job. If you
suffer a work-related injury, New York State established the
NY Workers’ Compensation system to help you. NY Workers’ Comp
will pay your medical bills and partly replace lost income when your
injury prevents you from returning to work full time or from
regaining your original salary.
You do not have to prove that anyone was
at fault to receive Workers’ Compensation benefits. In fact, you
could have made a mistake that led to your injury. As long as the
injury occurred while on the job, you are entitled to
NY Workers’ Compensation benefits. You do not have to sue anyone
to receive these benefits and that both reduces the costs of the
program and speeds up benefits.
Note: You may be entitled to
Workers’ Compensation benefits even if you work “off the books”
or if you are in this country illegally. You may be entitled
to Workers’ Compensation benefits even if your employer does not
carry the required insurance coverage.
In exchange for giving employees these
benefits, the
NY Workers’ Compensation law limits the ability to seek
additional damages from an employer. In short, if you are hurt on
the job, you collect Workers’ Compensation benefits, but you
generally cannot sue your employer for compensation for your
injuries.
There are important exceptions to the
restriction on suing for additional compensation. You may be
entitled to additional compensation if you fit any of the following
categories:
-
You are a uniformed employee or teacher in New York City or other municipality who is exempt from Workers’ Compensation by contract.
-
Your injury occurs while working on a ladder, a scaffold or at any elevation.
-
Your injury results from an object falling on you from a ladder, scaffold or construction site.
-
Your injury occurs due to a defective product.
-
Your injury occurs due to the negligence of someone or some entity other than your employer. This category would include injuries resulting from a motor vehicle accident with a driver not employed by your employer or an injury resulting from the negligence of a property owner when you are working off-site.
-
Your injury occurred due to gross negligence of your employer or fellow employee.
Filing a Workers’
Compensation Claim
If you are injured while working, it is
important to file your claim as soon as possible so that you can
receive the benefits to which you are entitled. Most companies
designate an office or person who handles NY Workers’ Comp claims
and that is whom you should contact. When in doubt, you can contact
your human resources department or union rep or supervisor.
If you have not received a Workers’
Compensation claim form (a
C-3 form) from your employer, you can
file it yourself. You must also notify your
employer of your injury in writing within 30 days of your injury.
Workers’ Compensation Benefits: Medical Benefits
If you suffer a work-related injury or
illness, you should seek immediate and appropriate medical care.
You can seek treatment from any
doctor or
medical provider authorized by the New York State Workers’
Compensation program. You can ask the doctor of your choice if he or
she participates. You can also call the New York State Workers’
Compensation Board at 1-800-781-2362 to find a provider or check
their
web site by clicking here.
Workers’ Compensation insurance in New
York will pay for all treatment directly related to the on the job
injury or illness. Unlike many insurance policies, you do not pay a
deductible or co-payment.
The Workers’ Compensation fee paid to the doctor or health
provider is the total fee. The health care provider may not collect
a fee from the patient.
To learn more about the medical benefits
and your provider options, you should check the
New York
Workers’ Compensation Board web site.
Workers’ Compensation Benefits: Cash Benefits
If you must miss more than seven days of
work due to a work-related injury or illness, Workers’ Compensation
will partially reimburse your lost wages. The amount you receive
will depend upon your average weekly wage for the previous year.
The maximum amount paid cannot exceed $500 per week.
The NYS Workers’ Compensation Board uses the following formula
to calculate the weekly cash benefit:
2/3 X average weekly wage
x % of disability = weekly benefit
To give an example of a cash benefit, if
an employee averaged $600 pay per week in the previous year and is
totally disabled (100 percent) then the weekly benefit would be
$400.
2/3 X $600 X 100%
disability = $400
According to the Workers’ Compensation
Board, if you can return to work but your injury prevents you from
earning the same wages you once did, you may be entitled to a
benefit that will make up two-thirds of the difference in the wages
you lost.
If you are permanently disabled or
partially permanently disabled, your claim entitles you to the cash
benefit for the duration of your disability. The insurance company
providing the Workers’ Compensation coverage may offer to make a
lump sum payment to settle your claim. You are under no obligation
to accept such a settlement offer.
To learn more about the cash benefits,
you can consult the Workers’ Compensation web site or consult with
an attorney well versed in Workers’ Compensation.
Workers’ Compensation Benefits: Death Benefits
Here is the official explanation of the
death benefits from the Workers’ Compensation Board:
“If
the worker dies from a compensable injury, the surviving spouse
and/or minor children, and lacking such, other dependents as defined
by law, are entitled to weekly cash benefits. The amount is equal to
two-thirds of the deceased Workers’ average weekly wage for the year
before the accident. The weekly compensation may not exceed the
weekly maximum, despite the number of dependents.
If
there are no surviving children, spouse, grandchildren,
grandparents, brothers or sisters, parents or grandparents entitled
to compensation, the surviving parents or the estate of the deceased
worker may be entitled to payment of a sum of $50,000. Funeral
expenses may also be paid, up to $6,000 in Metropolitan New York
counties; up to $5,000 in all others.”
Seeking
Compensation beyond NY Workers’ Compensation
All injury sustained while in the course
of work-related duties entitle you to Workers’ Compensation
benefits. Some injuries entitle you to compensation beyond what the
Workers Compensation coverage will pay.
You may be entitled to additional
compensation if you fit any of the following categories:
-
You are a uniformed employee or teacher in New York City or other municipality who is exempt from Workers’ Compensation by contract.
-
Your injury occurs while working on a ladder, a scaffold or at any elevation.
-
Your injury results from an object falling on you from a ladder, scaffold or construction site.
-
Your injury occurs due to a defective product.
-
Your injury occurs due to the negligence of someone or some entity other than your employer. This category would include injuries resulting from a motor vehicle accident with a driver not employed by your employer or an injury resulting from the negligence of a property owner when you are working off-site.
-
Your injury occurred due to gross negligence of your employer or fellow employee.
I have handled
numerous cases involving work-related injuries and illnesses
and I am well-versed in New York's Workers' Compensation program. I would be glad to assist you if you have a case or think you
might have a case. There is never a charge for the consultation.
Feel free to call me at 1-800-660-1466 or send me an e-mail at
Carol@SchlittLaw.com.
I hope you have found this information
helpful.
Carol L. Schlitt
New York Personal Injury Attorney
1-800-660-1466
Carol@SchlittLaw.com.