Proving Your Claim: What to Show to Obtain Workers’ Compensation Benefits in New York?
QUESTION: What do I need to show to obtain workers’ compensation benefits in New York?
ANSWER: You will need to show several documents and proof that establishes your status as an employee, your injuries, and other information as requested by the carrier, the Workers’ Compensation Board, or your employer. These documents are what you need to show to obtain workers’ compensation benefits in New York. Our workers’ compensation attorneys in the Bronx break down more specifics of what you will need to demonstrate.
First, you will need to establish that you are an employee. That includes a full-time or part-time worker, but also seasonal or temporary workers. The only real exception would be if you are an independent contractor or a freelancer. Another exception could be that you were outside the scope of your employment when the injury occurred, or that your illness was not work-related. In most instances, you will be able to demonstrate that you were an employee by stating that on the form and your employer not challenging it or affirming it.
Next, you will need to establish your work-related injury or illness. That will require you to provide your medical records. This includes from the actual accident or first intake, such as to an emergency department, primary care doctor, or specialists. You will need to turn these records over or provide a HIPAA authorization form so the WC carrier can request and obtain your records.
Relating to this, you will also need to present for an independent medical examination or IME doctor. This physician is hired by the workers’ compensation carrier and will evaluate your injuries or illness, render an opinion as to how it occurred, and assign a percentage loss of use. An IME doctor may also consider what further treatment is medically necessary and estimate a time out of work.
You will also need to establish your lost wages. This is usually easy to establish if you are salaried, as your employer will issue a paycheck with your total salary. However, if you are not salaried, you may need to provide several past payment stubs or provide a tax return demonstrating your wages. This is necessary to calculate your average weekly wages, especially if you have a permanent injury resulting in a disability.
Further, you may also have to submit information regarding collateral sources of income. That includes Social Security Disability or other sources of income that you may have received as it relates to this claim. That is because workers’ compensation has a lien that must be paid back if you make a recovery, such as in a third-party lawsuit.
Finally, you will be required to cooperate with the workers’ compensation adjuster and the Workers’ Compensation Board. That means answering any of their requests for information, even if it is seemingly unrelated to your work or injuries. You will also need to be truthful with your statements and not provide any willingly false or material misrepresentations – even if it not about your work or injury. This means you may also need to go to a hearing or be questioned over your claim and injuries.
Having Trouble Completing Your WC Paperwork? Ask Our Workers’ Compensation Lawyers in the Bronx for Help With Your Claim
We hope this FAQ was helpful. We have more FAQ questions and answers available here.
It is important to realize that this list is not exhaustive but is a good indication of what you will need to submit as part of your workers’ compensation claim in New York. The only way you can guarantee to having your claim fully and properly submitted is to have an experienced workers’ compensation lawyer handle it for you.
But if you still have questions about what is workers’ compensation in New York, call to schedule a FREE consultation with our experienced workers’ compensation lawyers in the Bronx to learn more about how we can help you. You can reach O’Connor Law by dialing (914) 595-4502 or by sending us a private message through our “Contact Us” box available here.
