A work-related illness or injury can contribute to a cascade of problems. In addition to your condition and the mounting medical bills associated with it, you may be unable to perform your regular work duties, leading to a loss of income. This is precisely the situation New York State Workers’ Compensation insurance is designed to assist with.
Regardless of residency, employees who work in New York are covered by workers’ comp. This program pays for medical care and provides partial wage replacement while you are out of work because of a work-related injury or illness. Employers cover the entire cost of this insurance benefit and cannot pass any of its expenses on to employees.
What Does Workers’ Comp Cover?
New York’s workers’ compensation program provides a comprehensive package of benefits for employees who are injured on the job. It is important to note that to receive benefits, your injury must have occurred while performing work duties. If you file a claim for an illness, it must be directly related to work activities, such as carpal tunnel syndrome resulting from repetitive use of your hands.
Some highlights of the program include:
- Medical care for your illness or injury
- Rehabilitation services
- Survivors benefits
- Return to work assistance
- Partial wage replacement
- One-time payments for partial disability
These benefits are designed to ensure that all workers have access to appropriate medical care after an injury. Income replacement also allows you to take time off from work so you can heal properly. Return-to-work programs act as a stepping stone when you cannot perform previous duties but can return to a modified position at your company.
Who Is Covered By Workers’ Comp in New York?
Most workers are covered by the New York State workers’ compensation program. Generally, all for-profit and most non-profit companies must provide coverage to all employees. This coverage must be provided free of charge to employees, and there are no co-payments for care provided under it. Additionally, employers cannot penalize employees filing workers’ comp claims.
The rise in gig workers and independent contractors has led to some confusion about workers’ comp benefits. Independent contractors are generally considered self-employed and, as a result, are not eligible for company-provided benefits. Contact your HR department for clarification if you are unsure about your status.
How Do I File a Claim?
Filing a workers’ comp claim is relatively simple. It requires notifying your employer of the accident, seeking medical care, and submitting a completed C-3 form with the state Workers’ Compensation Board. You can complete and submit the form entirely online.
While filing the official form is simple, post-accident procedures may vary at individual businesses. For example, most employers require you to complete an accident report to document the situation. Additionally, you may be subjected to a drug or alcohol screening.
That is why it is a good idea to seek advice from a supervisor or the human resources department immediately if you are injured at work. They can provide you with the correct forms to file with your employer.
Seek Medical Care
Your employer will refer you to the workers’ comp-approved medical provider for care. In New York, you must use an approved provider except for injuries that require immediate emergency medical attention. If the provider does not provide adequate care, you may appear to visit a different one.
If your accident involves a severe injury that requires immediate medical care, you may need to complete this process once you are released from the hospital or urgent care center. Remember that you should neither pay directly for services related to the accident nor use your private health insurance.
It’s a good idea to consult with an attorney if you are unsure about any forms your employer asks you to complete. Cellino Law attorneys can help you navigate the workers’ comp claim filing process.
Timeline for Filing a Claim
All claims must be filed before the time limit expires. In New York, you have two years from when you are injured to file a claim. In the case of a work-related illness, you have two years from when symptoms first appear. There are some exceptions to these time limits, such as in the case of hearing loss. You can also reopen your case if your injury gets worse over time. The attorneys at Cellino Law can help you determine if you are eligible to file for workers’ compensation in New York.
What If My Claim Is Denied?
In most cases, claims are processed by your employer and its insurance carrier with no problems. However, a workers’ compensation claim can be denied in New York. Luckily, there is an established procedure for this situation.
If your employer finds inconsistencies with your claim or disputes that an injury is work-related, the claim may be referred to an administrative review board. Complicated cases may also be presented to a Workers’ Compensation Law Judge.
Filing an Appeal
You may file an appeal if the Board or a Law Judge denies your claim. You have 30 days from when the decision is made to file an appeal. Your employer or its insurance company will have an additional 30 days to file a rebuttal. A three-member panel then reviews these filings, and a decision is handed down. You or your employer may appeal the panel’s decision for a full Board review.
Having an attorney present during any hearings that might impact your case is advisable. Experienced personal injury attorneys can help you compile and present evidence connecting your injury to your work. They will also review all documents and paperwork to ensure it is correctly filed on time.
Your Rights After FIling a Workers’ Comp Claim
Many people hesitate to file a claim, fearing it will count against them. However, you should never avoid treatment for a work-related injury because you are concerned about retaliation. Employees who file for workers’ comp benefits have certain rights that protect them from aggressive, retaliatory, or intimidating behavior.
As an employee filing a workers’ comp claim, you have the right to:
- Return to work when cleared by your doctor
- Receive appropriate medical care for your injury or illness
- File a claim without fear of retaliation
- Disability compensation if your injury warrants it
Can I Sue My Employer After Receiving Workers’ Comp Benefits?
You can often sue your employer even if you have received workers’ compensation benefits. However, there are some exceptions. For example, you may have inadvertently waived your right to sue when accepting a settlement through the workers’ comp system.
The best way to maintain your legal rights to sue is to have an injury attorney carefully review every document involved in a workers’ comp case. This will help ensure you do not waive rights or give up benefits to which you would otherwise be entitled.
Find Out if You Are Eligible for Workers’ Comp Benefits
If you were injured at work in New York, there is a good chance you are eligible for workers’ comp benefits. Talk to one of the work injury attorneys at Celino Law today. In addition to helping to determine eligibility for workers’ comp benefits, we can also look into other potential forms of compensation to which you may be entitled. Contact us at (800) 555-5555 to find your local office and schedule your free evaluation.
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