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New York is home to numerous industries and job sites. Office employees can suffer falls or injuries from equipment, leaving them facing time away from work. Construction sites carry the risk of exposure to hazardous substances and malfunctioning heavy equipment. Regardless of where someone is hurt, they have a right to seek financial relief through workers’ compensation insurance in New York City.
At O’Connor Law PLLC, our team of passionate New York workers’ compensation lawyers is here to fight for your rights. We understand how devastating a workplace injury or illness can be, not only for you, but also for your family. We are here to help you, from navigating paperwork to dealing with insurance companies. Contact us to schedule a consultation with a dedicated advocate who is not afraid to take on big New York corporations and insurance companies on your behalf.
Every year, over 125,000 workers across the five boroughs face the harsh reality of workplace accidents, injuries, and illnesses, leading to prolonged medical treatments, physical therapy, rehabilitation, or disability, along with significant financial hardship. New York workers’ compensation insurance is available to aid employees in paying these bills until they can return to work.
There are several key steps that sick or injured workers can take to begin their workers’ compensation claims.
In New York, mostly every employer is required to carry workers’ compensation insurance to cover illnesses and injuries that happen on the job. Establishing a direct connection between your condition as a result of an occurrence while working is the foundation of filing a successful claim. Therefore, timely notification to your employer about your injury is crucial.
You must inform your employer of the injury or illness in writing within 30 days of the incident. Failing to do so, or delaying the notification, can jeopardize your eligibility for Workers’ Comp benefits.
Sometimes, the workers’ compensation insurance representatives might not properly investigate your claim, take too long to process it, or reject it without looking at all the evidence. They do this mainly to protect the financial interests of the insurance company. By denying or delaying claims, they can minimize payouts and save the company money. Some reps might also be pressured to meet certain performance targets or quotas, which can lead to cutting corners in claim investigations or unfairly rejecting claims to keep the payout numbers low.
Trying to keep an eye on their actions and stand up for your rights can be stressful when you need to focus on recovering from your illness or injury. This is where an experienced New York workers’ compensation lawyer from O’Connor Law PLLC can help because they know how to deal with insurers and protect the rights of injured workers under all circumstances.
In addition to reporting your claim quickly, it is essential that you have a clear record of what happened and that you communicate this with your employer. Ensure you both share the same accurate details about your accident with the insurance company. Discrepancies between your accounts could trigger a delay and hurt your claim.
An injury associated with workers’ compensation is only compensable when the facts show that the injury arose out of the course of the injured employee’s employment. Therefore, employees must communicate directly with their employer as quickly and accurately as possible because the employer and/or their insurance carrier may argue later that the injury could have been caused by any number of reasons unrelated to their employment.
After being injured at work, see a doctor soon after the incident and keep up with regular appointments. If you wait too long between treatments, insurance providers might doubt your injury’s severity and deny your claim.
In New York, you may receive treatment from a medical provider already approved by the Workers’ Compensation Board. Selecting an authorized doctor may help you avoid issues with your claim. However, it is unnecessary, especially if it is an emergency situation that requires prompt medical treatment.
You strengthen your workers ‘ compensation claim when you report your incident and seek medical care quickly. Your doctor can clearly record every aspect of your work-related injury, including how it occurred and why it stopped you from working. This robust documentation helps insurance companies understand your situation and confirm that your claim is genuine.
When you are in pain and receiving treatment, the process of filing a workers’ compensation claim and securing the benefits can seem complex and overwhelming. If you or a loved one has sustained an injury on the job, here are the steps to take to ensure your workers’ compensation claim is successful:
Get medical treatment immediately, even if your injuries do not seem severe. Some conditions might not be apparent immediately and could worsen over time. Prioritize your health and document your injuries from the start.
Your doctor should submit a preliminary medical report with a detailed narrative of your condition about your condition using Form CMS-1500 to the New York Workers’ Compensation Board (WCB). You and your employer (or the insurance company) will also receive a copy. This report serves as crucial evidence for your claim.
You should notify your employer in writing about the accident as soon as possible, but within 30 days from when you knew or should have known about the incident. Timely communication helps avoid delays and complications in the claim process.
Complete Form C-3 online and submit it to the Worker’s Compensation Board (WCB) within two years of the accident. Acting quickly helps ensure your claim does not get denied due to missed deadlines. C-3 is a complicated form – we highly recommend that you contact an attorney from our firm to help walk you through the process.
In the unfortunate event of a worker’s death, the family or dependents should file Form C-62 (Claim for Compensation in Death Case) with the WCB within two years of the death. This form is necessary to claim death benefits and funeral expenses on behalf of the deceased individual.
Your employer’s insurer should provide you with a written statement outlining your rights under New York’s workers’ compensation laws within 14 days of receiving your accident report. This document helps you understand the process, the benefits you are entitled to, and any responsibilities you have during the claim process.
Expect to start receiving your workers’ compensation benefits within 18 days of the insurance company receiving your report. If your claim is disputed, the insurer must inform you and the Workers’ Compensation Board of the reasons for the dispute.
While receiving benefits, your doctor must update Form CMS-1500 regarding your case to the Workers’ Compensation Board every 90 days. These progress reports monitor your recovery and determine ongoing eligibility for benefits.
After your illness or injury has been diagnosed by a healthcare professional, you may be asked to undergo an Independent Medical Examination (IME). This is typically done by the employer and insurance carrier for one of the following reasons:
The insurance carriers could use the results of the IME to their advantage, interpreting the doctor’s findings in a way that limits or denies payouts to injured workers. This can leave employees feeling powerless and unsure of what to do next.
In addition to paying for your medical care, worker’s compensation benefits compensate you for lost wages. The amount you are eligible for depends on the severity of your injuries and how much they affect your ability to work. Your doctor will examine you and issue a disability rating.
In New York, there are four disability classifications for workers’ compensation benefits, rated according to whether the disability is temporary or permanent, and then according to whether there the disability is partial or total. You can better estimate your eligible benefits by understanding these classifications and working closely with your healthcare provider and a New York workers’ compensation lawyer.
This classification is given when your wage-earning capacity is partially reduced, but only temporarily. For instance, suppose you dislocated your shoulder at work and can still do some tasks but cannot lift heavy objects or reach high shelves. As your shoulder heals, you can return to your full job duties.
If you break your leg in a workplace accident and cannot work while you recover, then you completely lose your ability to earn wages, but only for a limited time. Once your leg heals, you can return to your regular work duties.
When you suffer a permanent partial disability, you will have a permanent loss of some of your wage-earning capacity. If you injured your arm at work and permanently lost some movement and strength, you may need to switch to a job that requires less physicality on your part.
These benefits can be broken down into two categories based on the type of injury and affected body part:
Paralysis or another catastrophic injury after a workplace accident can lead to a complete and permanent loss of your wage-earning capacity. You will not only be unable to return to your job but have lost the ability to work in any capacity for the remainder of your life.
The permanent vs. temporary and partial vs. total classifications will be used to determine the amount of weekly benefits you receive to compensate for your lost wages. New York State Workers’ Compensation Board uses the following formula to calculate weekly workers’ compensation payments:
Weekly benefit = (2/3 x average weekly wage) x % of disability
The amount of weekly benefits is adjusted each year by the Commissioner of Labor to the Superintendent of Insurance and is based on the New York State Average Weekly Wage for the previous calendar year. The benefit payout from July 1, 2023, to June 30, 2024, is $1,145.43 per week for both partial and total disability.
You will not receive cash benefits for the first seven days of your injury, but if your work-related disability lasts longer than 14 days, your payments will include benefits starting from the first day of your disability. Your medical coverage will last as long as the disability lasts, starting from the day you were injured.
Your prescription medications for your injuries or illness are included, although you might need to use specific pharmacies chosen by your employer’s workers’ compensation insurer. Transportation costs, such as mileage for medical appointments, may also be covered in some situations.
When workers are injured due to their employer’s negligence, they usually cannot sue their employer directly. New York Workers’ Compensation Law Section 29(6) states that workers’ compensation benefits are the “exclusive remedy” for injured workers.
There are a some caveats to this rule, including:
Under Section 11 of the New York Workers’ Compensation Law, third parties are prohibited from pursuing contribution or contractual indemnification claims against the injured worker’s employer, except in cases where the employee has experienced a “grave injury” (such as amputation) as outlined by the law. Proving a “grave injury” can be vital for maximizing the available insurance coverage in your case, potentially making the difference between partial and maximum compensation.
If you were injured at work due to the negligence of a coworker, you are generally unable to sue them for damages since exclusive remedy under Section 29(6) also applies to coworkers. However, the same exceptions listed above that limit an employer’s liability under this rule also apply to coworkers.
When you get injured at work through the fault of a third party, you may be able to file a personal injury claim against that party. In these cases, you can collect workers’ compensation benefits from your employer’s insurance company and pursue a personal injury lawsuit against the liable third party.
Third-party personal injury claims can result from various situations, such as:
To determine the best course of action for your specific case, consult an experienced workers’ compensation lawyer from our firm to evaluate your situation and guide you through the best legal options.
If you are an independent contractor and get injured due to negligence, your ability to sue for damages depends on specific factors. Just because you were hired independently does not mean you do not have the right to file a claim. We can help assess your situation and determine your eligibility.
Even when you diligently file your paperwork, and your injury or illness is serious, your claim may be denied. In these situations, you can request a hearing before judges to determine if you are eligible for compensation, following these recommendations:
Before you start your request for a hearing, you must understand why your claim was denied. Common reasons include incomplete or inaccurate information, missed deadlines, and disputes about the extent or cause of the injury. When you know why you were denied, you can prepare your case with the necessary documentation needed to support your request.
Just because a claim has been denied or an issue arises regarding a workers’ compensation claim does not prevent the employee from seeking recourse. The claimant (injured employee) has several options to address their claim denial or issues, including seeking an administrative review of the decision by the Board. To commence this process, the claimant or their legal counsel must file FORM RFA 1-W, a formal request for a hearing in front of the Board.
After filing the notice, you must gather evidence, such as medical records, witness statements, and any other documentation establishing the nature and extent of your injury. You should hire an expert workers’ compensation attorney to help you build a stronger case.
The WCB will schedule a hearing to evaluate your case, presided over by workers’ compensation judges. They will listen to both parties and render a decision based on the available materials. At the hearing, you can present your arguments and submit any evidence you have collected. You can also question witnesses presented by the insurance company.
Following the hearing, the judges will provide a written decision. If the decision is in your favor, you will receive the benefits you have been pursuing. However, if the ruling denies your claim, you can request a review by the WCB’s Appeal Board.
You have the right to request an appeal in writing from the WCB’s Appeal Board within 30 days of the decision. The Appeal Board will then review the evidence presented during the hearing and render a decision.
If the Appeal Board rules in your favor, your benefits will be granted. However, if the Appeal Board upholds the judges’ decision, you can file an appeal to the New York State 3rd Department.
If the WCB Appeal Board denies your appeal, you can file a petition with the Appellate New York State Supreme Court within 30 days of the decision. The Court will review the evidence presented at the hearing and issue a decision. If the Appellate Court agrees with you, you will receive the benefits you deserve.
At O’Connor Law PLLC, our New York workers’ compensation attorneys understand that an injury or health condition caused by your job duties can instantly change your life. With over 85 years of experience, we have helped more than 10,000 New Yorkers successfully navigate the complex workers’ compensation process with excellent outcomes.
Our tenacious legal team can help you with everything from filing your claim to dealing with the insurance company. We negotiate on your behalf and, if necessary, fight it out in court.
Don’t let an insurance company take advantage of you while battling the physical tolls of a workplace injury. We will be your advocate, and help you get the compensation you are entitled to. Contact us at (914) 595-4502 or fill out this form to schedule your free case review today.
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Our legal team has a detailed knowledge of New York workers’ compensation and Social Security disability law, including a unique perspective gained from our founder’s past experience serving as defense counsel for dozens of workers’ compensation insurance firms. You can rest easy knowing that we have the skills necessary to handle your claim.
Our firm’s reputation is unparalleled throughout the Big Apple. When you choose to work with us, you’re getting the benefit of respected representation from one of the leading workers’ compensation and Social Security disability firms in the state.
At O’Connor Law, we understand how vital our work is to your future. We’re committed to fighting for your right to benefits while providing you with the support you need to navigate this difficult time in your life. You will always feel like you are our top priority.
We’re compassionate and empathetic, but far from being a pushover. We’re an iron fist in a velvet glove and will aggressively advocate for your interests—even if that means litigation is necessary to protect your right to benefits.
Mary Ellen O’Connor took my case because she cares about those who need professional attorneys to help with Workman’s Comp. As a retired Broadway performer, I struggled with many injuries that still hinder my quality of life. She and her team are fabulous to ...
Omg, the best experience I have had with a firm. From the first time I called, very friendly staff. Vanessa Noel was the best… Always called me to remind me what I had to do, always seemed, and seems; truly concerned about me, and my case. Kept me prepared and ...
The legal services of O'Connor Law PLLC exceeded my expectations. Vanessa Noel and John Talbot were very professional and kept in daily contact with me while my court appearance approached. There were no surprises or delays, and I highly recommended them ...
I have had a ridiculous amount of questions regarding my case, and EVERY time I have been met with professionalism, courtesy, and kindness. My previous law firm stopped responding and did not return my calls or emails for months at a time, so I found ...
My experience with the O'Connor Law Firm has been excellent. All the attorneys I have worked with have been very helpful. They also have the best paralegals who are also very professional and helpful. I would definitely highly recommend this firm. Any issues I may have ...
The legal services of O'Connor Law PLLC exceeded my expectations. Vanessa Noel and John Talbot were very professional and kept in daily contact with me while my court appearance approached. There were no surprises or delays, and I highly recommended them ...
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