Worker’s Compensation

Worker’s Compensation

If you are injured while working, you may be entitled to wage and medical payments by coverage paid for by employers. This is known as basic workers compensation coverage. The idea is that you will not be able to bring a legal action against your employer for their negligence in the occurrence of your injuries. However, you will be able to collect for your medical care, lost wages and related expenses. You may even be entitled to a scheduled loss of use of a body organ or part and this may result in compensation to you.

On-the-job injuries may result from a fall from scaffolding, falls from ladders, machinery accidents, rollovers, bulldozer accidents, forklift claims, site work, heavy equipment claims, trench work, burn injuries, disfigurement, fractures, and injuries during construction work. Workers compensation injuries may also include operation of buses, trucks and autos, if you were in the scope of your employment, that is, on the job at the time of your injury.

Of course, any person who is considering workers compensation benefits should hire an attorney. The reason here is that insurance companies who provide workers compensation coverage all have attorneys or representatives working for them at hearings before the Workers Compensation Board. If you do not have an attorney or representative, you may not get all of the benefits you are entitled to or may find yourself cut off from benefits. Besides, attorneys representing injured clients before the Workers Compensation Board are paid from the award made, not from the injured worker. So, bottom line is that you should have an attorney.

Even though cannot make a legal claim in Court against your employer for the injuries you sustained, you can make a legal claim against other parties or companies who may be responsible for your injuries, other than your employer. Many clients to not understand this. So, if you are hurt on the job, you should consult with a workers compensation attorney and also an attorney who may consider taking what is known as a “third party claim” against firms, companies or others, not your employer, who may be responsible for your injuries.

As to NYS Workers Compensation, here is a summary and outline of benefits and requirements:

  • Filing Claims:

    You must first report your injury to your employer. If you have lost time from work, you can file claim for compensation [Form C-3].

  • Monetary Benefits:

    Unless disability extends beyond 14 days, cash benefits are not paid for the first 7 days of disability. If the injury resulted in death, the surviving spouse and children may be entitled to weekly cash benefits. Weekly benefits are calculated at 2/3 of the claimant’s average weekly wage multiplied by the percentage of disability. You may also be entitled to supplemental benefits and/or social security benefits.

  • Medical Care:

    Compensation coverage usually pays for medical and hospital care including surgery and testing. Sometimes, prior authorization from the carrier or employer is required. No fees can be collected from the patient by the health care provider.

  • Classifications of Disability:

    Cash benefits are paid in relationship to the following classifications: [a] temporary total disability; [b] temporary partial disability; [c] permanent total disability; [d] permanent partial disability and [e] disfigurement.

  • Occupational Disease& Hearing Loss:

    Claims for diseases produced by the natural incident of a certain occupation must be made: 2 years from the date of disability or 2 years from the date the worker knew or should have known that the disease was from employment. There is a time limit here as well: 3 months from the date the worker is removed from the harmful noise on the job or 3 months after leaving employment where the damages were caused.

  • Rehabilitation:

    You may be asked to participate in different types of rehab including: [a] vocational; [b] selective placement; [c] medical rehabilitation and [d] social services.

  • Volunteer Firefighters & Ambulance Workers:

    There are similar coverages for these types of volunteers injured in line of duty.

  • Timelines for Claims:

    The claimant must report the injury and then file a C-3 form with the Board. The treating doctor then submits a C-4 from and mails to the district office [within 48 hours]; the employer within 10 days files a C-2 form. Within 18 days of the receipt of the C-2 form, the insurer should begin payment of benefits.

  • Hearings & Appeals:

    Hearings are held before Administrative Judges who may take testimony and review records. Appeals can be made by either side within 30 days of the decision of the Judge.

  • District Offices:

    You may contact the District Administrator at the Albany Dist. Office, at 100 Broadway-Menands, Albany, NY 12241 for further information. Tel: [518] 474-6674.