What Benefits Can I Expect?

When someone is injured at work, they have two questions: Do I qualify for workers’ compensation? And, what benefits can I expect to receive?

At times, it seems the answers to each of those questions generate a half dozen more questions. That’s why, if you have suffered an injury on the job, it’s a smart decision to enlist the services of Erwin, McCane & Daly. The Albany, New York, firm’s partners have many years of experience representing injured workers and disabled individuals in New York workers’ compensation and federal Social Security Disability Insurance (SSDI).

You Can Get Answers from An Albany Disability Benefits Attorney

As part of a typical workers’ compensation claim you are entitled to four different kinds of benefits:

  • Weekly compensation
  • Permanent impairment benefits
  • Payment of medical bills
  • Death benefits

It’s important to note that there are no benefits for pain and suffering. In exchange for a no-fault system, Workers’ Compensation laws do not provide benefits for pain and suffering.

Medical Treatment

You’re entitled to receive payment for medical bills, medications, and even transportation to and from doctors’ appointments. However, if the insurer believes that your treatment has gone on too long, or that the treatment is too unconventional, the insurer may refuse to pay for the treatment on the grounds that it is no longer necessary or reasonable. If this happens to you, get in touch with us immediately. We will be able to file a claim with the New York Workers’ Compensation board and justify your treatment.

Death Benefits

If you were to die as a result of your work-related injury, your spouse, children, or other dependents may receive death benefits in the form of weekly cash payments. Death benefits are determined according to a formula based on the number of surviving children. Workers’ Compensation in New York will also pay for reasonable funeral expenses, up to a maximum that depends on the county. For all deaths on and after June 8, 2016, the maximum amount for funeral expenses was increased from $6,000 to $12,500 in Metropolitan New York counties, and from $5,000 to $10,500 in all other counties.

If there are no surviving children, spouse, grandchildren, grandparents, brothers or sisters, parents of grandparents entitled to compensation, the surviving parents or the estate of the deceased worker may be entitled to a sum of $50,000.

Determining Benefits

The amount you receive in compensation benefits is limited to two-thirds of your average weekly wage up to the maximum amount set by law. This amount is payable if you are totally disabled from any and all work. If you are capable of performing some type of work, even if it is not the type of work that you were doing when you became injured, you will be considered partially disabled and will be entitled to an amount less than two-thirds of your average weekly wage.

If you return to work at a job that pays less than your regular job because your on-the-job injury prevents you from returning to your regular job, the amount that you receive is determined by comparing the amount that you earned before you got injured to the amount you earn after your return to work. In such a situation, you are entitled to receive two-thirds of the loss of earnings.

Your average weekly wage is determined by looking back over the year prior to the date you became injured. The law provides a number of formulas to be used under particular circumstances. If you have not worked for the employer for at least one year at the time of your injury, the law specifies that the payroll of a similar worker should be used to determine average weekly wage.

The following formula is used most often to determine a persons benefits:
2/3 x average weekly wage x % of disability = weekly benefit

How Long You Can Receive Benefits

In 2007, the state of New York became a capped state. Before 2007 many workers who were permanently disabled were eligible to receive benefits for the length of their injuries, which was ultimately forever. Now there are caps on the amount of time injured workers can receive benefits, based on the body part that is permanently disabled. This is called a Scheduled Loss of Use award.

For example, an injured worker with a permanently disabled arm is eligible for up to 312 weeks of compensation. A Leg is eligible for 288 weeks and a hand up to 244 weeks. For a full schedule, visit the New York Workers’ Compensation Board website.

Using this schedule, your award is calculated based on the following:

  • The body part you injured
  • The percentage of loss of function or Schedule Loss of Use percentage as decided by the Judge.
  • Your average weekly wage

Schedule A Free Initial Consultation to Discuss the Unique Aspects Of Your Case

You’ll find answers to many other questions about filing for and receiving workers’ compensation benefits on our frequently asked questions page. There is also a list of frequently asked SSDI questions.

The best idea, however, is to take advantage of our free initial consultation, which allows us to review the unique aspects of your case. Call 518-449-2245 or request a free consultation below.

Workers’ compensation and SSD/SSI cases are taken on a contingency fee basis. If we accept your case, there is no fee unless we recover benefits for you.