Understanding Workers’ Compensation in New York

You’ve been seriously injured on the job and it’s preventing you from returning to work. Now you have questions about Workers’ Compensation and Social Security Disability. You aren’t alone. Each year, thousands of hardworking New Yorkers are struggling to navigate this complicated process. Our legal team is here to help answer your questions.

What Is Workers’ Compensation?

Workers’ compensation is a type of insurance that was created to provide injured workers with wage replacement and medical benefits. Coverage is provided for acute injuries caused by an accident and those that occur over a long period of time, like repetitive motion injuries.

Specifically, workers’ compensation pays for:

  • All medical care that directly relates to the workplace injury
  • Travel expenses that directly relate to health care appointments
  • Wage replacement of up to two-thirds of an average weekly wage

The vast majority of employers in New York are required by law to provide worker’s compensation coverage to their employees. In exchange for this coverage, employees are unable to sue their employers for accidents that occur at work.

Are Illnesses Covered By Workers’ Compensation Insurance?

Yes. If it can be proven that an illness was caused by your employment, treatments can be covered by workers’ compensation.

Steps To Take After Being Hurt On The Job

Obtaining workers’ compensation coverage should be easy but unfortunately, insurance companies make the process overly difficult to deny claims and save money. There are simple steps any injured worker should take that can help to ensure a smooth claims process. These steps include:

  1. Obtain Immediate Medical Care. Don’t wait to go to the doctor. Get the care that you need as quickly as possible.
  2. Notify A Supervisor About The Injury. Be sure to provide a supervisor with written notification about the injury.
  3. File The Initial Claim (Form C-3).

Be sure to start a personal file with copies of all of the letters, forms, and medical records that pertain to the work injury. This information could be invaluable if the claim is contested or if a denial is issued.

If the injury or illness sustained prevents a return to work for a prolonged period of time, it may be possible to pursue additional coverage through a Social Security Disability Benefits claim.

What Are Social Security Disability Benefits?

Most New Yorkers are aware of Social Security Benefits for retirees but don’t realize that benefits can also be obtained for those who are unable to return to work.

Who Is Eligible For Social Security Disability Benefits?

In order to be eligible for these benefits, a worker must:

  1. Have actively worked for a set period of time. Typically this time period is twenty out of forty quarters or five of the past ten years.
  2. Have been diagnosed with a physical or mental disability that prevents continued employment.
  3. Provide clear medical evidence from a doctor showing the limitations created by the disability and proving the inability to work.

Sadly, the majority of initial social security claims are denied each year, typically for mistakes made on the claim forms or a lack of documentation to support the claim. An appeal is possible, however, there is a huge backlog and it can take more than a year to get a hearing.

How Can A Lawyer Help With Workers’ Compensation Or Social Security Disability Claims?

Navigating the Workers’ Compensation and Social Security Disability claims process can be incredibly confusing and stressful. An attorney can help by:

  • Identifying the necessary forms for each claim.
  • Assisting with correctly filling out and filing the forms.
  • Speaking with the insurance company on behalf of the client.
  • Collecting required documentation.
  • Handling an appeal.

In addition to this, an attorney can review the accident which caused an injury and determine if a personal injury lawsuit can be filed.

What Is A Personal Injury Lawsuit?

A personal injury lawsuit is a type of legal dispute that is filed when the actions of one party contribute to the injury of another.

For example, if an employee is required to drive for their job and they are involved in a car accident that is caused by another driver, they could file a lawsuit against the negligent driver.

These lawsuits provide another legal way to fight for the compensation that could help pay for medical expenses, lost wages, and even pain and suffering.

Carrothers & Clough, PLLC Can Help

If you’ve been hurt at work, contact our experienced team of attorneys and counselors for your free consultation. With more than 60 years of combined experience, you can rest easy knowing that your case will be handled with compassion. Together we will fight for the maximum benefits possible in your case.


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