Workers’ compensation is a no-fault benefits program that provides workers who suffer a work-related injury or work-related illness compensation for certain losses. Workers’ compensation, also known as workers’ comp or WC, is an insurance policy that is managed by a private company. However, it is overseen and payments are process by a state agency known as the Workers’ Compensation Board. The rules and regulations that companies must follow is also promulgated by the Workers’ Compensation Board, and if there is a dispute between the claimant and the carrier, the Workers’ Compensation Board has certain steps to review and settle the disagreement.
Being a no-fault program, a worker who partially or completely causes his or her work injury or work-related illness is not denied benefits. The purpose is to afford workers a quick and non-adversarial avenue to obtain compensation for benefits that they need, such as for medical bills and lost wages. In return for this benefit, workers’ are generally prohibited from suing an employer for negligence – making workers’ compensation benefits the “exclusive remedy” for most workers hurt or ill from work-related conditions.
Nearly all employers are required to obtain workers’ compensation insurance in New York. There are fines and penalties for failing to carry workers’ compensation insurance when it is required. In addition, the “exclusive remedy” shield provided to employers is waived when an employer fails to carry workers’ compensation insurance when it is supposed to. Thus, an injured worker may be able to file a negligence lawsuit against an employer in that situation.
Virtually all workers are entitled to workers’ compensation benefits under New York law. There are no blackout periods or waiting periods, meaning a worker is covered whether it is the first day or the last day on the job. This includes the following:
However, individuals who are working as independent contractors or freelancers are not considered to be an employee and are not entitled to an employer’s workers’ comp benefits.
When it comes to workers’ compensation benefits, the three most common and notable ones include the following:
Employees who are injured on the job or who suffer a work-related illness are entitled to up to two-thirds (2/3s) of lost wages. This is the main type of compensation that most people consider when they think of WC benefits.
Reimbursement for medical bills or complete coverage for medical bills is another very common and important aspect of WC. The carrier will reimburse you for certain out-of-pocket expenses that you have already paid before benefits started (or if there was a dispute and appeal). In addition, certain future expenses could be paid directly from the carrier once the paperwork at the physician’s office is completed and the carrier assumes responsibility for them.
If an injury has reached maximum medical improvement (MMI), meaning that it is not healing or improving after a certain period of recovery time, a worker is considered to have a permanent injury or disability. There is a chart set by the Workers’ Compensation Board with the maximum number of weeks of pay that a worker can obtain per body part. A physician will opine as to the total percentage of loss of usage (i.e., 30%), and find the corresponding body part of the chart, and then multiple the total weeks allowed by 30% to arrive at a number of weeks of pay that a worker may obtain.
We hope this FAQ was helpful. We have more FAQ questions and answers available here
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 NYC to learn more about how we can help you. You can reach us by dialing (844) 692-6671 or by sending us a private message through our “Contact Us” box available here.