Sustaining an injury while working can be a stressful and challenging experience. Fortunately, workers’ compensation benefits can help those injured in the course and scope of their employment. In New York, the workers’ compensation system is designed to protect workers and ensure they receive the benefits they deserve. If you were injured on the job in New York, this guide will provide step-by-step instructions and tips for filing your claim.
Introduction to New York Workers’ Compensation Benefits
In New York, workers’ compensation benefits provide financial support and medical care to employees who have suffered work-related injuries or illnesses. The main benefits offered under the workers’ compensation system include the following:
- Medical care. Workers’ compensation can cover all related and necessary medical treatment for your work injury. Benefits can include reimbursement for doctor visits, surgeries, medications, and physical therapy.
- Lost wages. If you cannot work due to a work-related injury, you may be eligible for temporary disability benefits. Temporary disability benefits can replace a portion of your lost wages.
- Permanent disability benefits. If your work-related injury results in a permanent injury, you could be eligible for permanent disability benefits.
- Vocational rehabilitation. If you cannot return to your previous job because of work-related injuries, workers’ compensation may cover vocational rehabilitation services to help you find new employment or train for a new occupation.
- Death benefits. If workers die from work-related injuries, their dependents may be eligible for death benefits.
If you have questions about benefits under the workers’ compensation program, please contact a New York workers’ compensation lawyer.
Who Is Eligible for NY Workers’ Compensation Benefits?
In New York, most employees are eligible for workers’ compensation benefits, regardless of the employer’s company size or the nature of their work. This inclusion extends to full-time, part-time, and temporary workers. However, certain categories of workers may be exempt from coverage. Examples include:
- Independent contractors,
- Domestic workers employed in a private home for less than 40 hours per week,
- Volunteers and unpaid interns,
- Sole proprietors or partners in a business, and
- Certain religious and nonprofit workers.
When unsure whether you qualify for workers’ compensation benefits, consult a knowledgeable attorney or contact the New York State Workers’ Compensation Board for guidance.
Process of Reporting and Filing a Workers’ Compensation Claim in New York
Understandably, you likely don’t know how to report and file a workers’ compensation claim. Read on to learn everything you need to know about the claims process for workers’ compensation benefits.
Reporting Your Injury
Start by notifying your employer in writing as soon as possible. Include details about the date, time, location, and nature of your injury. New York law requires you to report your injury to your employer within 30 days. Failing to report within this timeframe could jeopardize your workers’ compensation benefits.
Next, be sure to document the incident. Keep a record of the incident and any relevant details, including witness information, photographs, and surveillance footage. This documentation may be helpful when filing your claim and providing evidence of your injury.
Seeking Medical Treatment
Seek immediate medical attention after the accident. Once you report your injury to your employer, seek medical treatment immediately. Explain to your healthcare provider that your injury is work-related, and provide them with your employer’s information.
Follow your doctor’s recommendations. It’s crucial to follow the treatment plan provided by your doctor. Failing to comply with medical advice can negatively impact your claim and may lead to a denial of benefits.
Keep records of your medical treatment. Maintain thorough records of your medical treatment, including doctor’s notes, prescriptions, medical bills, and any related expenses. These records will be essential when filing your claim and calculating your benefits.
Filing Your New York Workers’ Compensation Claim
When you’re ready to file your workers’ compensation claim, here’s a step-by-step guide.
Step 1: Obtain and complete Form C-3. You must complete Form C-3, “Employee’s Claim for Compensation.” This form is available on the New York State Workers’ Compensation Board website, or you can request it from your employer.
Step 2: Submit Form C-3 to the Workers’ Compensation Board. Once you complete the form, mail the original to the appropriate Workers’ Compensation Board office in New York. Make sure to keep a copy for your records. You must file your claim within two years from the date of your injury, or you may lose your right to benefits.
Step 3: Notify your health care provider. Inform your healthcare provider that you have filed a workers’ compensation claim. Your health care provider must submit medical reports to the Workers’ Compensation Board and your employer’s insurance carrier to support your claim. Ensure that the doctor you’re treating with is authorized by the New York State Workers’ Compensation Board to treat work-related injuries.
Attend the Independent Medical Examination (IME)
Your employer’s insurance carrier may require you to attend an independent medical examination (IME) with a doctor of their choosing. This examination will assess your injury and determine the extent of your disability. Attending this appointment is crucial, as failing to do so can result in suspending your benefits.
Be honest and accurate during the IME. You must provide accurate and truthful information about your injury and its impact on your daily life. Do not exaggerate or minimize your symptoms, as this can harm your credibility and affect your claim.
Obtain a copy of the IME report from the insurance carrier. Please review it carefully for any inaccuracies or discrepancies and address them promptly.
Receiving and Responding to the Workers’ Compensation Board Decision
Once the Workers’ Compensation Board and the insurance carrier review your claim, they will issue a decision regarding your eligibility for benefits. Reviewing the decision carefully is important so you understand the benefits you were awarded and any potential limitations.
If you disagree with the decision or believe there are mistakes, you must address them immediately.
Appealing the Decision
If you’re unsatisfied with the decision, you can appeal. To appeal, you must file an Application for Review (Form RB-89) within 30 days of the decision. You can find this form on the New York State Workers’ Compensation Board website. An appeal will usually result in a hearing before a Workers’ Compensation Law Judge. You will be able to present evidence and testimony to support your claim. The judge will review the case and issue a decision.
As noted in this article, you must complete several time-sensitive steps in the workers’ compensation process to avoid jeopardizing your claim. To recap, these steps are:
- Reporting your injury. You must notify your employer in writing within 30 days of the incident.
- Filing your claim. You must file Form C-3, “Employee’s Claim for Compensation,” with the New York State Workers’ Compensation Board within two years from the date of your injury.
- Attending medical appointments and IME. You must attend all scheduled medical appointments and any independent medical examination (IME) requested by the insurance carrier.
Failing to follow all deadlines could result in a denial of workers’ compensation benefits.
When Do You Have a Third-Party Claim in Addition to Workers’ Compensation Benefits?
Sometimes, you may have a third-party claim besides your workers’ compensation benefits. A third-party claim arises when someone other than your employer or a co-worker is responsible for your injury. Examples of third-party claims include:
- Defective products. If a defective piece of equipment or machinery caused your injuries, you might have a claim against the manufacturer or distributor of the product.
- Motor vehicle accidents. If your work-related injury occurred in a motor vehicle accident caused by another driver, you might have a claim against the at-fault driver.
- Premises liability. If your injury occurred on someone else’s property due to their negligence (e.g., a slip and fall at a client’s office), you might have a claim against the property owner.
Filing a third-party claim is a separate legal action from your workers’ compensation claim. This claim could allow you to recover additional fault-based damages, such as pain and suffering. Workers’ compensation does not cover these damages. It’s essential to consult with an experienced attorney if you believe you have a third-party claim to ensure you receive the total compensation you’re entitled to receive.
New York’s Special Labor Laws
New York State has enacted special labor laws that provide additional protections for workers in the construction industry. Sections 200, 240(1), and 241(6) of the New York Labor Law outline these protections and allow injured workers to pursue third-party lawsuits in specific situations. Here’s a brief introduction to each one of these labor laws:
- Section 200: This section establishes a general duty for employers and property owners to provide a safe work environment for employees. If an employer or property owner fails to adhere to this requirement and an employee is injured, the worker may have grounds for a third-party claim.
- Section 240 (Scaffolding Law): This section protects construction workers who work at elevated heights, such as on scaffolds, ladders, or other similar devices. The law imposes strict liability on property owners and contractors for injuries sustained by workers due to a fall from an elevated height or being struck by a falling object. If an injured worker can prove that their accident occurred due to a New York scaffold law violation, the worker may be entitled to bring a third-party lawsuit against the responsible party.
- Section 241: This section requires property owners, contractors, and their agents to comply with specific safety regulations set forth by the Industrial Code when performing construction, demolition, or excavation work. If a worker is injured on the job because these regulations are violated, the worker might have a valid third-party claim against the responsible party.
These special labor laws offer additional protections to certain workers and allow injured employees to seek compensation beyond the scope of workers’ compensation benefits. If you believe your injury falls under one of these labor law provisions, consult with an experienced attorney who can help you navigate the complexities of these laws and pursue any available third-party claims.
Seeking Legal Assistance
Although navigating the workers’ compensation process independently is possible, having an experienced New York workers’ compensation attorney can significantly improve your chances of success. They can help you understand your rights, gather evidence, and advocate for the benefits you deserve. If you’re struggling with your claim or facing a denial, consider consulting with a workers’ compensation attorney for guidance and support.
Tips for a Successful New York Workers’ Compensation Claim
Workers’ compensation claims can be complicated, especially ones involving third-party liability claims. Keep these tips in mind to help streamline your workers’ compensation claim:
- Keep organized records of all documents related to your injury, including medical reports, communications with your employer, and expenses incurred.
- Communicate openly and honestly with your healthcare provider, employer, and the Workers’ Compensation Board.
- Follow your doctor’s treatment plan and attend all medical appointments.
One of the best ways to streamline your case is to hire an experienced workers’ compensation lawyer. A lawyer can help you identify all potential sources of recovery after a work-related injury.
Contact Attorney Anthony A. Ferrante
Don’t risk your workers’ compensation benefits and potential third-party compensation by trying to handle your claim alone. Anthony A. Ferrante has nearly two decades of experience representing injured victims. When you need assistance after a work-related injury in New York, the legal team at Ferrante & Koenig, PLLC, stands ready to help. Contact our office today to learn more about how we can assist you.