When you are injured on the job and go out on NYS Workers’ Compensation you are entitled to receive both medical care and lost wages, to be paid by the carrier. But why, you might ask, is there a difference between your weekly rate of pay and what you receive while out on Workers’ Compensation?
First, it is important to understand that your Average Weekly Wage (AWW) will be determined using your own payroll for the 52 weeks leading up to the accident date. If you haven’t worked for a full year with the same employer leading up to the date of accident, a payroll for a similar worker will be produced. Once set, your AWW remains the same and is not subject to cost-of-living increases. Your wage replacement benefits are computed using your AWW and commencement of benefits begins after a seven (7) day waiting period has expired. Your wage replacement benefits are directly tied to your degree of disability, which is why it is so important for you to treat immediately and often. You must treat with a doctor or chiropractor every 60-90 days to keep you disability documentation current. It is ok to treat with a Nurse Practitioner or Physician’s Assistant but it is important to make sure that a doctor is co-authoring or co-signing the report. Otherwise the documentation will not be considered.
Your rate of pay based upon your percentage of disability is calculated as follows:
(2/3 x AWW) x % of disability
NOTE: At MOST all you are entitled to, even temporarily totally disabled, is two-thirds of your AWW. This amount is further curtailed by minimum and maximum caps under the Workers’ Compensation system.
What rate of pay you may be entitled to is further muddied by conflicting medical reports between your own treating physicians as well as the opinions of Independent Medical Examiners hired by the insurance carrier. Because of the murky and often confusing issues that develop with respect to your ongoing benefits, you deserve trained and competent legal professionals in your corner to help you understand all!