One accident at work can turn your life into something unrecognizable. Instead of steady pay, you face missed checks. Instead of normal routines, you juggle medical appointments and worry about bills.
Insurance companies fight back. They argue that a form was late, that medical treatment isn’t necessary, or that the injury didn’t come from your job duties. Those tactics keep injured employees from benefits when they need them most.
At O’Connor Law, we stand with workers across the state. When you need a Workers’ Compensation lawyer in New York, we explain your rights in plain language. Our woman-owned firm also provides a client app with real-time updates so you always know where your case stands. Call our team today.
Common Workplace Injuries in New York
Workplace injuries take many forms. A fall from scaffolding in Manhattan, a strain from lifting boxes in Queens, or chemical exposure on Staten Island all count as accidents covered by Workers’ Compensation. These reflect some of the most common work-related injuries in New York, and each story shows how quickly job duties can turn painful.
Our lawyers have represented city employees hurt while breaking up fights, nurses who tore muscles lifting patients, and sanitation workers left with lasting back pain. Every injured employee faces the same fears about missed paychecks and mounting bills after an accident.
Workers’ Compensation also applies to occupational illnesses, repetitive stress injuries, and permanent loss of function from years on the job. When the condition connects to your work, you have the right to benefits. Your Worker’s Compensation lawyer will help you figure out what benefits apply to your situation.
Filing a Workers’ Compensation Claim in New York
The claim process starts with notice. By law, you must report the workplace injury to your employer in writing within 30 days. A verbal report doesn’t protect you later. Keep a copy of the notice for your own records.
The next step is filing a claim with the New York Workers’ Compensation Board. Injured employees use Form C–3 to open the case. This form describes how the injury happened, what job duties you were doing, and what medical care you’ve received so far.
From there, the insurance company receives notice. They can accept, delay, or deny the claim. Their decision shapes what happens next, but a denial is not the end of the process.
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Medical Treatment After a Workplace Injury
Medical care is one of the most important benefits under Workers’ Compensation. It covers doctor visits, physical therapy, prescriptions, diagnostic tests, surgeries, and treatment for complications that can arise during recovery. You should not pay out of pocket for approved treatment.
Doctors authorized by the Workers’ Compensation Board must submit reports about your condition every 90 days. These updates keep benefits flowing. Without them, payments may stop even while you’re still recovering after your accident. This ongoing medical documentation also helps support your continued eligibility for benefits.
Insurance companies sometimes dispute treatment requests. They argue that a procedure isn’t necessary, your illness isn’t that serious, or that your rehabilitation is complete. When this happens, the fight centers on whether the judge accepts your doctor’s opinion or the insurance company’s independent medical examination (IME) report.
Independent Medical Examinations (IMEs) in New York
An Independent Medical Examination (IME) happens when the insurance company asks a doctor of their choosing to evaluate your injury or illness. These exams often lead to reports that minimize symptoms or suggest an injured employee can return to job duties sooner than expected.
During an IME, the doctor may ask about your medical history, current pain, and any work restrictions. Keep your answers honest and brief. If possible, bring someone with you and write down what happens during the visit.
When an IME conflicts with your treating doctor’s opinion, the judge decides which report to accept. These disputes often shape how hearings before the Board move forward, and a Workers’ Compensation attorney can step in to make sure your medical records and testimony are fully considered.
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Hearings Before a Workers’ Compensation Law Judge
When disputes cannot be resolved, the case goes to a hearing. This stage can feel intimidating for an injured employee. The insurance company arrives prepared with attorneys and medical reports.
You can testify about the circumstances of the injury and the medical treatment you’ve received. Your doctor’s records and any witness statements also become part of the record. The insurance company presents its own version, often relying heavily on IME findings.
At the end of the hearing, the judge issues a written decision. That decision may approve your claim for compensation benefits, deny it, or schedule another hearing to review more evidence.
Filing Form RFA-1 for a Hearing
If your claim stalls or gets denied, you may need to file Form RFA–1. This form requests a hearing before a Workers’ Compensation Law Judge. Without it, your case may sit unresolved for months.
The form asks for details about the injury, any related medical conditions, what benefits are disputed, and why you believe the case should move forward. Filing correctly is important because it sets the agenda for the hearing.
Once submitted, the Board places the case on the calendar. This step often brings the insurance company back to the table, since they know the judge will now review the dispute. A Workers’ Compensation lawyer can explain what this stage means for you and prepare you for the next steps, so you don’t feel left in the dark.
Appealing a Denied Workers’ Compensation Claim in New York
If a judge denies benefits, you can appeal to the Appeal Board. This step must be taken within 30 days. Deadlines matter in Workers’ Comp, and missing one can shut down your chance at benefits.
The Appeal Board reviews the hearing record and the judge’s reasoning. They do not consider new evidence. Their role is to decide whether the decision applied New York law correctly.
The Role of the Appellate New York State Supreme Court
The Appellate New York State Supreme Court reviews only legal issues. They examine whether the Board followed the law, not whether the injury is real. The Court does not accept new testimony or medical records.
Both sides submit written briefs, and sometimes the Court hears oral arguments. The process often takes months, but it may reset the case if the Court finds errors.
For injured workers, this stage often feels like a last resort. A favorable decision can send the case back to the Board with instructions to grant compensation benefits.
How Compensation Benefits Are Calculated
Workers’ Compensation covers both medical treatment and lost wages after an accident. Lost wage benefits depend on how the average weekly wage is calculated under New York law. The Board looks back at your earnings during the 52 weeks before the accident, including overtime or second jobs when applicable. That number forms the base for your benefits.
The formula for wage replacement is straightforward: Weekly benefit = (⅔ × average weekly wage) × % of disability.
For example, if your average weekly wage is $900 and your disability rating is 50%, the weekly benefit is $300, subject to state maximums. Payments usually begin within 18 days of the employer’s report reaching the insurance company.
Disability Classifications in New York
Workers’ Compensation classifies disabilities by type and duration. These categories determine both the length and amount of benefits.
- Temporary Partial Disability: You can do some work, but not full job duties.
- Temporary Total Disability: You cannot work at all for a period of time.
- Permanent Partial Disability: Lasting loss of function reduces earning capacity. This includes Schedule Loss of Use awards and non-schedule awards.
- Permanent Total Disability: Severe injuries result in a permanent loss of wage-earning ability.
A Workers’ Compensation attorney can walk you through these categories so you know which benefits apply to your situation.
Schedule Loss of Use Awards
When a workplace injury leaves permanent loss of function in a limb or other body part, the law addresses it through a Schedule Loss of Use award. Understanding how a Schedule Loss of Use Award is calculated begins with a medical exam. Your doctor measures your range of motion and compares it to the normal function of a healthy joint or limb.
The Workers’ Compensation Board then takes that percentage of permanent loss and applies it to a set number of weeks assigned to that body part. For example, the schedule lists 312 weeks for an arm. A 20% loss equals 62.4 weeks of pay.
Any wage replacement benefits already received are deducted from the final award on a claim. Many workers feel caught off guard by this rule, but it comes straight from New York law. Understanding the formula early helps set clear expectations before the decision arrives.
Exclusive Remedy in New York Workers’ Compensation
Workers’ Compensation is considered the exclusive remedy for most workplace injuries. That means you cannot sue your employer directly, even if negligence caused the accident.
Exceptions include situations where the employer had no Workers’ Compensation insurance, where harm was intentional, or where you work for certain city agencies with different coverage systems.
You may also pursue claims against third parties. For example, a subcontractor, driver, or product manufacturer who caused the injury can still be held responsible.
Independent Contractors and Workers’ Compensation
Independent contractors do not automatically fall outside of Workers’ Compensation. New York law looks at the reality of the work relationship, not only the tax form.
If a company directs your schedule, supervises your tasks, and treats you like an employee, you may still qualify for benefits with a 1099. Courts consider factors such as economic dependence and how closely your role ties into the business.
Eligibility depends on the actual conditions of the job. An injury that happens under an employer’s control can still lead to a claim, even for someone labeled as a contractor. Workers with that status sometimes qualify for the same protections as employees when the facts support coverage.
Permanent Loss and Long-Term Impact
Some injuries don’t go away. Maybe your arm won’t lift the way it used to, or your grip feels weaker no matter how much you try. Those changes spill into everyday life—doing your job, playing with your kids, even simple chores. Workers’ Compensation looks at those lasting damages through impairment ratings and long-term benefits.
Doctors evaluate whether you’ve reached maximum medical improvement and then assign a percentage of permanent loss. This rating reflects the lasting impact on your health and becomes the foundation for benefits moving forward.
Even if you return to work, a permanent injury and its loss remain recognized. Awards reflect lasting changes to your body, not just your current employment status.
Standing Up to the Insurance Company
Insurance companies manage claims with one priority: reducing payouts. The tactics insurance companies use to delay the Workers’ Compensation claim include leaning on IME reports, enforcing procedural deadlines, and raising technical arguments to cut benefits. Injured workers often feel the system works against them.
The claim process requires persistence. Hearings, appeals, and sometimes the Appellate New York State Supreme Court form part of the path to benefits. Each stage depends on strong records and timely filings.
At O’Connor Law, we believe every injured employee deserves to understand their claim. Our mobile app and advanced case management system provide real-time updates, so clients always know where their case stands with the insurance company and their employer.
Protecting Your Rights
Working with a Workers’ Compensation attorney helps balance the scales. Insurance companies have their own lawyers and medical experts. Without guidance, injured employees often struggle to keep up.
An attorney can explain your rights in plain language, prepare you for hearings, and file appeals when necessary. An attorney can also track deadlines, including Form RFA-1 filings and Appeal Board requests, so that you can focus on your recovery.
Our role is to make the claim process understandable after a work injury. We speak in everyday language, not legal jargon, and we stand beside you at each stage, from the moment the job leaves you hurt to the final decision on benefits.
Talk to O’Connor Law
For 15 years, O’Connor Law has represented injured workers across New York, guiding each claim with care and experience. We are a woman-owned, multicultural firm with bilingual staff fluent in Spanish, Haitian-Creole, Tagalog, and Cebuano, and we are ready to advocate for you.
Every year, our team secures more than $25 million in non-medical compensation benefits for injured workers. After an accident, we lay out your options and take action to protect your rights and your family’s stability.
If you need a Workers’ Compensation lawyer in New York, call us today. We only receive money if you do, and we fight every day so workers can protect their paychecks and their families.
