If you are injured at work in New York, workers’ compensation can affect your medical treatment, lost wages, ability to return to work and long-term financial security. The answers below cover common questions injured workers ask about filing a claim, hiring a lawyer, medical treatment, hearings, disability benefits and workers’ compensation settlements.
For advice about your specific circumstances, speak with a New York workers’ compensation attorney.
Hiring a Workers’ Compensation Lawyer
When should I get a workers’ comp lawyer in New York?
You should consider speaking with a workers’ compensation lawyer when a problem could affect your medical treatment, lost-wage benefits or long-term rights. Common reasons include a denied claim, reduced or stopped benefits, an Independent Medical Examination, a hearing, a permanent disability determination or a proposed Section 32 settlement.
A straightforward claim may not always require representation, but the value of legal advice generally increases as the claim becomes disputed or permanent benefits are involved.
Do I need a workers’ compensation lawyer in New York?
You are not required to have a lawyer to file or pursue a New York workers’ compensation claim. However, representation can become particularly useful when the insurance carrier disputes the claim, your benefits change, medical evidence conflicts, a hearing is scheduled or you are considering a settlement.
The question is usually not whether a lawyer is legally required, but whether legal representation could protect benefits or rights that are now in dispute.
How much do workers’ comp lawyers charge in New York?
Workers’ compensation attorney fees in New York are regulated through the Workers’ Compensation Board. An injured worker should not pay a workers’ compensation attorney directly out of pocket. When a legal fee is awarded, it is approved by the Board and deducted from compensation awarded to the worker.
The amount depends on the type of award and work performed in the case.
What’s the most a workers’ comp lawyer can charge in New York?
New York does not use one flat maximum dollar fee for every workers’ compensation case. Attorney fees are governed by Workers’ Compensation Law and must be approved by the Workers’ Compensation Board.
For some awards, including approved Section 32 settlements, statutory percentage-based fee rules apply. The exact fee therefore depends on the type and amount of compensation being awarded.
Can you recommend a workers’ comp lawyer in Albany, NY?
When comparing workers’ compensation lawyers in Albany, look for a firm that regularly handles New York workers’ compensation claims rather than treating them as a small part of a broader personal injury practice.
Ask about experience with denied claims, benefit disputes, hearings, medical issues, permanent disability and Section 32 settlements. You should also understand which attorney will handle your case and how communication will work.
Erwin, McCane & Daly represents injured workers in Albany and the Capital Region in New York workers’ compensation matters.
What should I ask a workers’ comp lawyer during my first consultation?
Ask what issues the attorney sees in your claim, whether any deadlines are approaching, what medical or employment evidence may be important, what happens next and how legal fees work.
You should also ask who will personally handle the case, how hearings and insurer disputes are managed, and whether there are actions you should take or avoid taking immediately.
Starting a New York Workers’ Compensation Claim
What should I do immediately after being injured at work in New York?
Report the injury to your employer as soon as possible, obtain appropriate medical treatment and make sure your injury is accurately documented as work-related.
New York generally requires an injured worker to notify the employer within 30 days of an accident. You should also file an Employee Claim, Form C-3, with the Workers’ Compensation Board rather than assuming your employer or insurance carrier has handled everything for you.
How do I file a workers’ compensation claim in New York?
A New York injured worker generally files Form C-3, the Employee Claim, with the Workers’ Compensation Board. The form asks for information about your employer, wages, accident or occupational illness and initial medical treatment.
Filing the C-3 creates your claim with the Board. Your employer has separate reporting obligations, but its report does not replace your responsibility to protect your own claim.
How long do I have to file a workers’ comp claim in New York?
A Form C-3 generally must be filed with the New York Workers’ Compensation Board within two years of the accident.
For occupational diseases, the deadline generally runs from when the worker knew or should have known the condition was related to employment. Separate notice rules apply to telling your employer about the injury, which should normally happen within 30 days of a workplace accident.
What are the main requirements for getting workers’ compensation in New York?
A compensable workers’ compensation claim generally requires an employment relationship covered by the workers’ compensation system and an injury or illness sufficiently connected to the worker’s employment.
The claim must also be properly reported and supported. Medical evidence is especially important because it connects the diagnosis, disability and need for treatment to the work-related accident or occupational exposure.
What does workers’ compensation cover in New York?
New York workers’ compensation can cover reasonable and necessary medical care for an accepted work-related injury or illness and lost-wage benefits when the injury reduces or prevents earnings.
Depending on the case, additional benefits may be available for permanent disability, Schedule Loss of Use, reduced earning capacity or death. Workers’ compensation benefits are different from damages available in a personal injury lawsuit.
How long can you stay on workers’ comp in New York?
There is no single time limit that applies to every New York workers’ compensation claim.
Temporary benefits depend on the worker’s continuing disability and eligibility. Permanent partial disability benefits may be limited to a statutory number of weeks, while permanent total disability benefits can continue without a fixed maximum number of weeks. Medical care for an established work-related injury can also continue separately from lost-wage payments.
Problems With a Workers’ Compensation Claim
What happens when a workers’ compensation claim is denied?
A denied claim can be challenged through the New York Workers’ Compensation Board process. The first step is identifying exactly why the insurer is disputing the claim.
Disputes may involve whether the accident occurred at work, whether proper notice was given, whether medical evidence establishes a work-related injury or another legal or factual issue. Evidence can then be presented to the Board, and disputed claims may require hearings before a Workers’ Compensation Law Judge.
Why would workers’ comp suddenly stop paying?
Workers’ compensation payments can change because of new medical evidence, an Independent Medical Examination, a return to work, a change in disability classification, a Board decision or a dispute raised by the insurance carrier.
Do not assume a stopped check means the claim itself has ended. Find out what action or decision caused the interruption and whether the carrier had authority to change the payments.
Can workers’ comp stop paying without notice in New York?
An insurance carrier cannot simply disregard the Workers’ Compensation Board’s rules when changing established benefits. Whether payments can be reduced or suspended depends on the status of the case, existing Board decisions and the reason the carrier is seeking the change.
If checks unexpectedly stop, review any notices, Board decisions or medical reports immediately. A benefit interruption can become financially significant very quickly.
Can workers’ comp reduce my weekly benefits?
Yes, workers’ compensation benefits can change when the evidence supports a different degree of disability, the injured worker returns to work or earnings change, among other reasons.
Temporary partial disability benefits are tied to the degree of disability and wage loss. A reduction should therefore be examined against the medical evidence, earnings information and any Workers’ Compensation Board decision governing the claim.
What should I avoid doing while on workers’ comp?
Avoid ignoring medical appointments, missing required examinations, working outside medical restrictions without discussing it with your provider, giving inconsistent accounts of the injury or failing to respond to Workers’ Compensation Board notices.
You should also avoid exaggerating or minimizing symptoms. Workers’ compensation cases rely heavily on consistent medical, employment and factual evidence, so accuracy matters more than trying to say what you think someone wants to hear.
Can you be terminated while on workers’ comp in New York?
An employer cannot lawfully fire or otherwise discriminate against an employee because the employee filed or planned to file a workers’ compensation claim.
However, workers’ compensation law does not automatically require an employer to hold a position indefinitely while an injured worker cannot work. A termination for a legitimate, non-discriminatory business reason is different from retaliation for filing a claim.
Medical Treatment and Workers’ Compensation Doctors
Does workers’ comp cover doctor visits?
Yes. For an accepted New York workers’ compensation claim, the insurance carrier generally pays for medically necessary treatment related to the work injury.
Covered care can include physician visits, diagnostic testing, physical therapy, medication and other authorized treatment. Certain procedures or treatments may require prior authorization under the Workers’ Compensation Board’s medical treatment system.
Can I choose my own workers’ comp doctor in New York?
In many New York workers’ compensation cases, an injured worker can choose a health care provider who is authorized by the Workers’ Compensation Board to treat workers’ compensation patients.
There are exceptions. For example, an employer participating in certain approved provider or alternative dispute resolution programs may affect the initial provider options. Always verify that the provider is authorized to treat workers’ compensation injuries.
How do I find a doctor who accepts workers’ comp in New York?
Use the New York Workers’ Compensation Board’s authorized health care provider search or ask a provider directly whether they are Board-authorized and currently accepting workers’ compensation patients.
Finding a provider familiar with workers’ compensation is useful because medical reports do more than document treatment. They can also affect findings about disability, ability to work, causal relationship and permanency.
What should I avoid saying to a workers’ comp doctor or adjuster?
Do not lie, exaggerate, minimize symptoms or guess when you do not know the answer.
Give an accurate account of how the accident occurred, your symptoms, prior relevant medical history, work restrictions and recovery. Inconsistencies between medical records, statements and later testimony can create unnecessary disputes. Accuracy and consistency are considerably more useful than trying to find a supposedly “perfect” answer.
Hearings, Disability and Permanent Impairment
What happens at a workers’ comp hearing in New York?
A workers’ compensation hearing is a proceeding before a Workers’ Compensation Law Judge. The judge may address disputed issues such as whether the claim is compensable, the worker’s degree of disability, lost-wage benefits, medical evidence, treatment disputes or permanent disability.
Some hearings resolve relatively narrow issues, while contested cases may require testimony, medical depositions or additional hearings before a final decision is issued.
What happens at a workers’ comp permanency hearing?
A permanency hearing addresses whether a work-related injury has resulted in a permanent disability after the worker reaches maximum medical improvement.
The Workers’ Compensation Law Judge can consider medical opinions about permanent impairment and other relevant evidence. Depending on the injury, the resulting award may involve a Schedule Loss of Use or a non-schedule permanent partial disability based on loss of wage-earning capacity.
What are the four disability classifications in New York workers’ compensation?
New York workers’ compensation recognizes four main disability classifications:
- Temporary total disability
- Temporary partial disability
- Permanent total disability
- Permanent partial disability
Temporary means the condition has not yet become permanent. Total means the worker has lost all wage-earning capacity, while partial means some wage-earning capacity remains.
Permanent partial disability can be divided further into Schedule Loss of Use and non-schedule disability.
What does a 30% impairment rating mean?
A 30% impairment rating generally means a medical evaluator has found a measurable permanent loss of function, but the financial effect depends on the type of injury and the workers’ compensation classification involved.
For a Schedule Loss of Use injury, the percentage can be applied to the statutory number of weeks assigned to the affected body part. A 30% medical impairment does not automatically mean a worker receives 30% of a particular settlement value.
What is a Schedule Loss of Use award?
A Schedule Loss of Use, or SLU, award is a workers’ compensation benefit for permanent functional impairment of certain body parts, including the arms, hands, fingers, legs, feet, toes, eyesight and hearing.
The award is calculated using the affected body part, the percentage loss of function and the worker’s compensation rate. Prior temporary benefits may be deducted from the total SLU award.
Workers’ Compensation Settlements
Do you automatically get a settlement from workers’ comp?
No. A workers’ compensation claim does not automatically result in a settlement.
Some claims remain open with ongoing medical or lost-wage benefits. Others are resolved through a negotiated Section 32 Waiver Agreement. Whether settlement makes sense depends on the nature of the injury, future benefits, medical needs, permanency and the terms the insurance carrier is willing to offer.
What is the average workers’ comp settlement in New York?
There is no reliable “average” settlement that tells an individual injured worker what their New York workers’ compensation case is worth.
Settlement value depends on factors such as wages, disability classification, remaining indemnity exposure, permanent impairment, expected medical care, age, future treatment and the specific benefits being closed. Two workers with similar injuries can therefore receive substantially different settlement offers.
What determines the value of a workers’ comp settlement?
Workers’ compensation settlement value is driven primarily by the benefits the insurance carrier may otherwise be responsible for paying in the future.
Important factors can include the worker’s compensation rate, disability, remaining duration of benefits, permanent impairment, future medical treatment, medications, surgery, disputed issues and whether the settlement closes lost-wage benefits, medical benefits or both.
The value of the settlement should therefore be compared with the value of the rights being surrendered.
Does New York workers’ comp pay for pain and suffering?
No. New York workers’ compensation generally does not award damages for pain and suffering in the way a personal injury lawsuit can.
Workers’ compensation instead provides statutory benefits such as medical treatment, lost-wage compensation and certain permanent disability awards. In some workplace accidents, a separate claim against a negligent third party may be possible, and that type of case can involve different categories of damages.
Should I accept the first workers’ comp settlement offer?
Do not judge a workers’ compensation settlement solely by whether the lump sum looks large.
Before accepting an offer, consider what future wage benefits and medical rights would be closed, whether additional treatment may be necessary, whether permanency has been established and what the carrier’s remaining exposure may be. Once an approved Section 32 agreement closes particular benefits, those benefits generally cannot simply be reopened later because the money ran out.
What is a Section 32 workers’ compensation settlement?
A Section 32 Waiver Agreement is a negotiated agreement that settles some or all future workers’ compensation benefits in exchange for a lump-sum payment or annuity.
A Section 32 agreement may settle lost-wage benefits, medical benefits or both. The Workers’ Compensation Board must approve the agreement. Once approved, the benefits covered by the agreement are permanently closed.
How long does a workers’ comp settlement take in New York?
There is no single settlement timeline that applies to every claim.
The process can include negotiation, preparation and signing of the agreement, submission to the Workers’ Compensation Board, Board review or a settlement hearing, approval and then payment. Disputes over terms, medical issues, liens or other case-specific matters can extend the process.
How long does a Section 32 settlement take in New York?
A Section 32 settlement is not complete when the worker and insurance carrier merely agree on a dollar amount.
The written agreement must be completed and submitted to the Workers’ Compensation Board for approval. Depending on the type of agreement and circumstances, the Board may review it through a hearing or an eligible desk-review process. Timing therefore varies from case to case.
Do I have to pay workers’ comp back after a settlement?
Receiving a workers’ compensation settlement does not normally mean you simply repay all workers’ compensation benefits previously received.
However, deductions or repayment issues can arise in particular situations. For example, temporary benefits previously paid are deducted when calculating certain Schedule Loss of Use awards, and liens or other obligations can affect settlement proceeds. The settlement statement should identify deductions before the agreement is approved.
Speak With an Albany Workers’ Compensation Attorney
Workers’ compensation cases become more difficult when benefits stop, medical treatment is disputed, a hearing is scheduled or an insurance carrier proposes a settlement that may permanently close future rights.
Erwin, McCane & Daly represents injured workers in Albany and throughout New York’s Capital Region in workers’ compensation matters.
Contact the firm to discuss your workers’ compensation claim and the options available in your case.