After an on-the-job injury, you need to make certain that you get all the compensation you are entitled to for your medical care and lost wages. Maximize your benefits by working with an NYC workers comp lawyer.
Few situations are as stressful as getting injured on the job. While New York state law protects you and entitles you to workers compensation benefits, you might feel pressured by your employer not to file a claim. Maybe you didn’t immediately realize how severe your injury was and didn’t report it right away. You might even have benefits available that you weren’t aware of.
The simple truth is that when you suffer a workplace injury, you have rights that cannot be denied, and this includes the right to workers comp benefits. Even when you do get offered a settlement by your employer’s work comp insurer, it can be difficult to know if what they’re offering you is fair and everything you’re entitled to.
By working with an experienced NYC workers comp lawyer from Finkelstein, Meirowitz & Eidlisz, LLP, you can rest easy knowing that you’ll get all of the benefits you are due—including the ones you might not have realized you should be receiving.
What Is Workers Compensation in NYC?
Workers compensation is a type of insurance that nearly every employer in NYC must obtain to provide financially for workers who are injured because of their employment.
The workers comp law came about as a solution that both provides financially for injured workers and protects employers from constantly being sued by hurt employees.
What’s great about workers compensation?
- It’s there when workers are injured.
- It doesn’t matter who was responsible for the injury. (Negligence doesn’t play a role, except in extreme cases.)
- It’s usually an adequate financial solution when a worker is out of work for a while.
What’s not so great about it?
- Filing a claim can be difficult, and there are filing deadlines to meet.
- The insurance companies that provide the monetary compensation are for-profit businesses, meaning they aren’t always looking out for injured workers.
- Mistakes made during the claims process can mean the worker doesn’t receive the benefits he or she should otherwise be entitled to.
There is a lot of red tape when filing a claim for workers compensation. The benefits can be a great help to the injured worker and his or her family, but getting to those benefits can be a long, frustrating process. Once you obtain your benefits, you will need to follow your doctor’s orders so you can return to work as soon as you’re able.
Does My Injury Qualify for Workers Compensation?
Most employers are required to carry workers compensation insurance. It doesn’t matter whether you’re a nurse working for a busy hospital, a corrections officer at a prison, or a mass transit worker operating a bus or subway—if you were hurt while performing your job duties, you could qualify for workers comp benefits.
Even if you were 100 percent at fault for what happened, your claim must be honored as long as you were working within the parameters of your job.
Not every injury will automatically qualify, however, and even if yours does, there’s a procedure you need to follow to ensure that your right to these benefits is protected:
- The company or business you work for must be required to carry workers compensation insurance under New York state law.
- Your injury or illness must have been suffered while performing your regular job duties.
- Within thirty days of the injury, you must give written notice to your employer detailing what happened. This notice is commonly called an “accident report” or “incident report.”
- You must have a medical report from a physician that says your injury happened at work due to an accident, exposure to a substance, or because of the nature of your job.
Because there are criteria that your injury and accident must meet, it unfortunately gives your employer or their insurer the opportunity to potentially deny your claim. If you meet resistance with any of the above points, it’s a good time to get in touch with an NYC workers comp lawyer from our firm.
Are Occupational Diseases Covered by NYC Work Comp Laws?
An occupational disease or illness is when you contract an illness at work or in the course of your employment. For example, if you’re a construction worker or home renovator and you’ve been exposed to dangerous mold while working on an old house, any resulting health problem is a work-obtained illness.
Even though your injury didn’t occur at an office, it occurred because of your working conditions. That illness would qualify for workers compensation benefits. What kinds of illnesses qualify as occupational diseases? Any disease that you’ve obtained at work or because of your job is considered an occupational disease.
A few common illnesses that have been known to occur because of working environments are listed below:
- Lung diseases like mesothelioma
- Hearing loss
- Carpal tunnel
- Skin diseases
Common reasons for work-related illnesses are exposure to dangerous fumes, chemicals or other substances, exposure to loud noises or extreme temperatures, exposure to bright light, and long amounts of time spent in extreme darkness.
What Benefits Does Work Comp Provide?
In an ideal world, you’d get the maximum benefits possible whenever you have to file a workers comp claim. Unfortunately, insurance companies are in business to make a profit, which means minimizing their expenses—and you can bet that they view paying out on claims as an expense to be limited.
There are several benefits you are entitled to under the law, and it’s not always easy to know if you’re getting everything you should be. By working with an NYC workers comp lawyer from our firm, you can ensure that you maximize the value of your benefits and get everything that the law mandates:
- Full coverage for medically necessary healthcare and chiropractic care
- Two-thirds of your average weekly wages or salary
- Reduced earning compensation if you’ve been disabled and can’t work in the same capacity
- Travel expenses required by your medical appointments
- Compensation for damage done to your limbs and extremities and any facial scarring, even if these don’t interfere with your ability to work
- Any other out-of-pocket expenses caused by your injury and medical care
Even if you think you’ve received an adequate settlement from the work comp insurer, it’s best to let us review your case during a free consultation. Insurers generally aren’t eager to disclose everything you might be entitled to, so there’s a good chance you could be getting undercompensated without realizing it.
What’s the Work Comp Claim Process like in NYC?
Work comp insurance is designed to protect workers like you when they’ve been injured during the course of their employment, but even though filing a claim should be easy, that’s not always the case. Some injuries or diseases can be difficult to prove, and the insurance companies deny claims for many reasons.
It’s imperative that you follow the claims process perfectly or you could receive a denial and suffer financially from it. See below for how the claims process works for NYC workers comp claims:
- The first thing you should do following your work-related injury is seek medical attention immediately. Your doctor will need to keep careful records of your injury; you should ensure that your doctor documents your injury, linking it to your workplace.
- Next, you need to inform your employer of the injury. You should do this whether you decide to file a claim right away or not. Some injuries may not seem serious until months later. If you failed to inform your employer, you could ruin your chance to file a claim down the road. You have thirty days to inform your employer of your injury, or your right to workers comp benefits could be lost.
- You have to file the claim paperwork within two years of your work-related injury. Filing claim paperwork can be complicated and confusing, and any errors with the paperwork and supporting documentation could lead to a denial. An attorney can help you file your claim paperwork.
- If your claim is denied, you have thirty days to file an appeal. You should supply as much evidence as possible during the hearing to prove your case. You will want to demonstrate the extent of your injury and provide proof that your injury occurred because of your employment.
Remember—you don’t have to file your workers comp claim on your own. Hiring a work comp attorney in NYC can make filing your case much easier, and it will likely decrease your chances of a denial. Your attorney will walk you through each step in the process, help you determine what evidence to gather, and assist you with hearings.
When a Workers Comp Claim Gets Denied
It’s not uncommon for workers compensation claims to get denied, even if you have a legitimate injury that should qualify. This is especially likely if you suffered a repetitive stress injury, carpal tunnel syndrome, or a delayed injury that wasn’t immediately reported, as is common with concussions and some back injuries. In these circumstances, your employer or the insurance company might claim that the injury happened while you were off duty.
It might also be that your claim has been accepted, but the work comp insurer is disputing whether a treatment is medically necessary and refusing to pay for it. This can put you in a terrible situation, as your health insurance won’t be willing to pay for something that should be covered under work comp, and you certainly shouldn’t have to pay for the treatment out of your own pocket.
Whether your work comp claim has been denied outright or you’re having difficulty accessing all of your benefits, an NYC workers comp lawyer from our office can help you overcome the difficulty. We can help you reconstruct the accident and prove where it happened, and we can help you prove the severity of your injury and why you need the care prescribed by your doctor.
Hearings and Appeals for Your NYC Work Comp Case
The insurance companies can deny your claim for a number of reasons, and they will do so if they think they can get away with it. In some cases, they will deny the entire claim, suggesting your injury didn’t occur at your workplace at all.
For example, if you were injured in a work-related vehicle collision, the insurer may suggest that you were on your lunch break and therefore do not qualify for benefits.
In other cases, they will deny part of your claim, such as a certain medical procedure they don’t believe was necessary.
The way to fight a work comp denial is to take your case to the New York State Workers’ Compensation Board.
Initially, the board will attempt to resolve any disputes. If it still can’t make a decision, it will schedule a hearing with a workers compensation law judge. That’s when you and your attorney can present evidence to prove your work comp case.
It’s imperative that you have the evidence to back up your case. Evidence could include the following:
- All medical documentation of your injury, as well as the medical treatment provided
- Witness statements from those who witnessed the accident or can corroborate your version of events
- Documentation of how the injury has affected your life
If the judge rules against you, an appeal can be filed within thirty days of the ruling.
Retaliation Against Injured Workers
Sometimes, injured workers don’t file a claim because they’re worried about being retaliated against by their employer. It might even be that your employer is pressuring you not to file a claim because they’re worried that their insurance rate will go up or that it will damage their reputation.
Whatever the circumstances, you should be aware that your employer cannot punish you for seeking the benefits you are legally entitled to. If you feel uncomfortable about filing a claim for any reason, your NYC workers comp lawyer will help you resolve the situation so your job is protected and you get the medical care and compensation you deserve.
NYC Workers Comp FAQ
Trying to get the most out of your workers compensation benefits can make for a confusing and frustrating experience. It’s not always easy to get answers, and with that in mind, we’ve addressed a few common questions here.
If you’d like further information as it pertains to your case, please contact our office so you can speak with an NYC workers comp lawyer at length.
Can I collect both workers compensation and Social Security Disability benefits?
If you meet the criteria for both the New York workers compensation program and the federal Social Security Disability Insurance program, yes. It’s important to note that the criteria do differ significantly, so it’s entirely possible to receive benefits from one program but not be eligible for the other.
What is a Section 32 waiver agreement?
A Section 32 waiver agreement is reached when you accept a lump sum to cover your injury-related medical care and lost wages. By accepting a lump sum, you waive your right to future and ongoing benefits, so it’s imperative to make certain that this agreement is as favorable for you as possible.
What happens if I settle my claim but get re-injured at work in the same way later?
You can file a new workers comp claim for the re-injury, but the judge hearing your case might attribute the re-injury to the original injury. This will reduce the amount of compensation you’ll receive in benefits, so it will be important to make certain your case is presented as persuasively as possible.
Contact a New York City Workers Compensation Lawyer
At Finkelstein, Meirowitz & Eidlisz, LLP, we’ve been helping injured workers get the compensation they’re entitled to for over forty years. Our firm has recovered millions of dollars for our clients, and we can help you get the workers compensation benefits you’re entitled to, as well.
Find out how we can help you by scheduling a free consultation to discuss your case with an experienced NYC workers comp lawyer. Just complete the contact form on this page or give us a call at 212-385-9190.