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A workplace injury can create serious physical, emotional, and financial challenges. Understanding New York workers’ compensation benefits is essential if you’ve been hurt on the job. This system provides medical treatment, wage replacement, and other benefits—regardless of fault—to help you recover and maintain financial stability during your time away from work. Knowing how the process works is the first step in safeguarding your health, livelihood, and future.

The workers’ compensation lawyers at Friedman, Levy, Goldfarb, Green & Bagley, P.C. utilize the firm’s 50 years of collective knowledge and experience for our clients. We assist and advocate for injured individuals to recover the largest benefits that they are entitled to receive.  We represent individuals in Manhattan, the Bronx, Long Island, Brooklyn, and the New York City metropolitan area.

What Is Workers’ Compensation in New York?

Workers’ compensation is a no-fault insurance system established by New York law to provide benefits to employees who suffer job-related injuries. Under this system, eligible workers can receive medical treatment, rehabilitation services, and partial wage replacement without proving their employer was at fault.

In exchange for these guaranteed benefits, employees generally waive the right to sue their employer for negligence, making workers’ compensation the exclusive remedy in most cases.

Covered Employees in New York

Most employees in New York are eligible for workers’ compensation benefits, including:

• Full-time and part-time employees
• Seasonal and temporary workers
• Public employees, such as municipal or school district workers
• Domestic workers employed 40 or more hours per week by the same employer
• Certain farm and agricultural workers
• Undocumented workers

If your employment status is unclear, you may still qualify. An attorney can help determine your eligibility and protect your rights after a serious job-related injury.

What Benefits Are Available Under New York Workers’ Compensation?

As noted, New York workers’ compensation provides a range of benefits designed to support injured employees during their recovery. These benefits help address both the immediate and long-term effects of a workplace injury, which may include the following:

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Medical Benefits

In New York, injured workers are entitled to all necessary and reasonable medical care related to their work-related injury or illness. This includes doctor visits, diagnostic tests, surgeries, prescriptions, and medical devices. Except in emergencies, treatment must be provided by a healthcare provider authorized by the New York State Workers’ Compensation Board (WCB).

Wage Replacement

In New York, if a work-related injury or illness prevents you from working for more than seven calendar days, you may be eligible to receive wage replacement benefits. These benefits are typically two-thirds of your average weekly wage, up to a maximum set by the state, and are calculated based on the degree of your disability (total or partial, temporary or permanent).

Disability Payments

Under New York’s workers’ compensation system, disability payments are available to employees who suffer a work-related injury or illness that results in a loss of earning capacity. These benefits are classified into four categories, depending on the nature and extent of the disability:

• Temporary Total Disability (TTD) – For workers who cannot work for a limited period.
• Temporary Partial Disability (TPD) – For workers who can return to work but only in a limited capacity or reduced hours.
• Permanent Total Disability (PTD) – For injuries that permanently prevent any gainful employment.
• Permanent Partial Disability (PPD) – For lasting impairments that do not completely prevent employment.

The amount you receive is generally two-thirds of your average weekly wage, multiplied by your percentage of disability, and subject to maximum and minimum limits set by the Workers’ Compensation Board.

Death Benefits

If a worker dies due to a job-related injury or illness, their surviving dependents may be entitled to weekly cash benefits. These benefits are typically calculated as two-thirds of the deceased worker’s average weekly wage, subject to a maximum amount set by the state. Eligible dependents include the surviving spouse, minor children, and other family members who were financially dependent on the worker at the time of death.

Filing a Workers’ Compensation Claim in NY

Filing a workers’ compensation claim in New York involves several steps to receive benefits. Timely and accurate action at each stage can significantly impact the outcome of your claim.

• Seek medical attention. Your health comes first. Tell your approved healthcare provider your condition is work-related. Be sure to keep all medical records, which will be critical for your claim.

• Notify your employer. You must provide written notice within 30 days of the incident. Include as many details as possible, such as the date, time, and nature of the injury, and notify your employees if witnesses were present.

• File Form C-3: Submit the Employee Claim Form directly to the New York State Workers’ Compensation Board within two years of the date of injury—or from the date you became aware that your condition is work-related. Prompt filing is crucial to avoid delays in processing your claim and receiving benefits.

• Provide documentation. Additional forms and records, such as Form C-4 (Doctor’s Report), wage statements, and medical records, support your claim. Always keep copies of all submitted documents for your records.

Claims are reviewed by both the WCB and the employer’s insurance carrier. If approved, benefits will begin shortly. Forms and filing tools are available on their website.

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What if My Workers’ Comp Claim Is Denied or Delayed?

In New York, injured workers may encounter challenges such as denied or delayed claims. However, the law provides avenues to address these issues. If this has happened to you, understanding common reasons and the steps to appeal can be crucial.

Common Reasons for Claim Denials or Delays

• Missed Deadlines or Lack of Notice: Failing to report the injury to your employer within 30 days or not filing a claim with the Workers’ Compensation Board (WCB) within two years can lead to denial.
• Insufficient Medical Evidence: Claims may be denied if medical records do not adequately link the injury to your job or lack detailed documentation.
• Disputes About Work-Related Cause: Employers or insurers might argue that the incident did not occur during work hours or was unrelated to job duties.
• Pre-existing Condition Allegations: Insurers may claim the injury resulted from a prior condition rather than current work activities.

Why a Workers’ Compensation Lawyer in NYC Matters to Your Claim

Navigating a denied workers’ compensation claim in New York is often stressful and time-consuming. A skilled workers’ compensation lawyer can make all the difference in securing the benefits you deserve.

An attorney can do the following:

• Identify the Reason for Denial: An experienced attorney can review your claim and the denial letter to pinpoint the exact reasons for denial. They will explain the legal and procedural issues involved, empowering you to make informed decisions about your case.
• Compile Medical Evidence: Lawyers are adept at gathering and presenting persuasive medical evidence. They can work with your healthcare providers to obtain accurate, detailed documentation that supports the connection between your injury and your employment.
• Representation at Hearings and Appeals: Workers’ compensation disputes in New York often proceed to hearings before a Workers’ Compensation Law Judge. An attorney will represent you throughout the hearing and appeals process, advocating on your behalf and ensuring procedural rules are followed.
• Negotiate with Insurance Carriers: Insurance companies may attempt to reduce or deny benefits. A lawyer can negotiate directly with them, seeking the full extent of benefits to which you are legally entitled.
• Provide Legal Guidance Throughout the Process: From filing the initial claim to pursuing appeals, a workers’ compensation attorney can guide you through every stage, ensuring compliance with legal deadlines and procedural requirements.

Navigating the workers’ compensation system can be overwhelming, especially when coping with a serious injury.

Can I Sue My Employer or a Third Party?

In most cases, you cannot sue your employer for a work-related injury because workers’ compensation is your exclusive remedy. However, you may sue your employer if they intentionally caused your injury, failed to carry workers’ compensation insurance, or engaged in egregious misconduct beyond normal negligence.

Third-Party Liability Claims

In New York, if someone other than your employer—like a contractor, property owner, or equipment manufacturer—caused your workplace injury through negligence, you may file a third-party personal injury claim to seek additional compensation beyond workers’ comp.

Additional compensation from a third-party claim may include full lost wages, pain and suffering, and other damages not covered by workers’ compensation.

Can You Receive Workers’ Compensation and File a Lawsuit?

Yes, in New York, you can receive workers’ compensation benefits and also pursue a third-party personal injury lawsuit if another party (not your employer) was responsible for your injury. However, any recovery from the lawsuit may be subject to a lien or offset to reimburse the workers’ compensation insurer. Consulting a knowledgeable attorney is essential to understanding how these claims interact and to protect your full rights.

Get Answers About Your Work Injury at No Cost

When you suffer a workplace injury in Manhattan, the Bronx, Long Island, Brooklyn, or elsewhere in the general NYC metropolitan region, please contact us. You can speak directly with one of our experienced construction accident lawyers to improve your chances of reimbursement for your medical bills. We can also help recover the largest available workers’ compensation payments to replace your lost wages and other expenses.

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In 2020, New York City recorded more than 500 construction accident-related injuries and 8 fatalities. Many injured construction workers will recoup at least a portion of their lost wages and medical costs from the Workers’ Compensation that their employers carry. For many of those accidents, workers’ comp will be the injured employee’s only remedy.

In other cases, the circumstances of the accident might allow the injured employee to sue for additional damages even if they have already received workers’ comp benefits.

If you have questions about your opportunity to sue for additional damages, contact a New York construction accident lawyer from Friedman, Levy, Goldfarb, Green & Bagley, P.C.

When can an injured construction worker file a lawsuit after recovering workers’ comp benefits?

An injured construction worker’s right to sue will always be a function of the specific facts and circumstances surrounding the accident. A personal injury lawyer will always need to study them before a determination is made.

Here are some of the facts that the attorney will consider:

• Whether the owner and general contractor can be held liable
• Whether a negligent party other than the injured worker’s employer caused the accident– for example, if an individual suffers injuries due to defective construction equipment or as a result of an unsafe condition on the construction site property. Workers may have a right to sue the equipment manufacturer or the property owner.

What damages can an injured construction worker recover in a lawsuit?

Negligence law governs construction site fall accidents and other mishaps. If an injured worker has an opportunity to sue for injuries, they can claim damages that would be recoverable in different kinds of negligence cases. These include:

• lost wages and compensation for reduced future earnings if injuries cause permanent disabilities
• reimbursement for out-of-pocket expenses related to the injuries
• costs and expenses for physical, rehabilitative, and occupational therapy
• medical and hospital costs and expenses
• compensation for pain and suffering

However, negligence law will not allow a worker to claim double recovery for the same injuries. If an injured party has received workers’ comp benefits, the aggregate value of those benefits will likely be credited against the damages that they can recover in a lawsuit. A lien is asserted and a portion of the benefits already paid are paid back only if a recovery is made.

How should a construction worker proceed after suffering an on-the-job injury?

An injured construction worker should provide written notice of the injury to their employer and start the process as soon as is possible. Worker’s compensation insurance will be the quickest source of recovery for reimbursement of lost wages and medical expenses. Prompt notice of injuries is generally a condition to receive it.

That worker should also write down all information about the accident and injuries and then contact a knowledgeable and experienced construction accident attorney. They can help determine if additional damages are recoverable in a lawsuit. Workers’ comp claims can be filed without a lawyer’s help, but any subsequent lawsuit will require a lawyer’s assistance.   

Call the NYC Construction Accident Lawyers at Friedman, Levy, Goldfarb & Green, P.C.

If you’ve been injured in a construction accident in New York City and have already filed for workers’ compensation benefits, you may be able to hold other parties accountable and recover further compensation for your injuries.

The personal injury and construction accident attorneys at Friedman, Levy, Goldfarb & Green in Manhattan represent injured New York construction workers in lawsuits. Please see our website and call us after you have suffered injuries to determine if you have a right to recover damages above and beyond your workers’ comp benefits. 

If you suffer a job-related injury– workers’ compensation insurance will replace up to two-thirds of your wages. Although you will not be able to replace the full amount, you might also be eligible to collect additional social security disability income (SSDI) payments.

Submitting and coordinating claims for both workers’ comp and SSDI payments is a complex process that could be simplified with assistance from a knowledgeable New York City personal injury lawyer. At Friedman, Levy, Goldfarb, Green & Bagley, P.C., we represent injured workers so that they receive their full amount of benefits.

Is there a limit to the amount that an injured worker can recover from both workers’ comp and SSDI?

Under New York law, the disability benefits that an injured worker is entitled to receive from all sources cannot be greater than 80% of what they were making. Workers’ comp will replace up to 66% of those earnings, and SSDI will replace the balance up to that 80% cap.

For example, a worker who earned an average of $1,500 per week in the year immediately before the accident might recover $1,000 per week from workers’ comp. This amount is 66% of their average weekly wages, which is the maximum allowable payment. Their weekly maximum SSDI benefits in this example would be $200. The injured worker would then receive a total weekly benefit of $1,200, which is 80% of their prior average weekly pay.

When should an injured worker apply for SSDI benefits?

An injured worker can and should apply for SSDI benefits as soon as an injury-related disability prevents that person from going to work. To qualify for those payments, however, the injured worker will need to demonstrate that they will not be able to return to work for at least a year.

The Social Security Administration will make its own determination of the injured person’s disability. It will be based on a physician’s diagnosis and other assessments. Under specific circumstances, in which a person’s condition is expected to improve, they might delay making a decision. A New York City construction accident lawyer who has expertise in processing applications for SSDI benefits– can help an injured worker to improve the likelihood of a favorable determination.  

Will SSDI Benefits Begin at the Same Time as Workers’ Comp Benefits?

If an employer approves a workers’ comp claim, that person might begin to receive payments fourteen days after notice of the injury. Unlike these payments, SSDI will not begin until five months after the onset of the disability, but the first check will be retroactive. If this has happened to you, you should consult with a personal injury lawyer for assistance in determining the earliest date for the start of SSDI payments.

Call Friedman, Levy, Goldfarb, Green & Bagley, P.C. For Assistance in Filing for Workers’ Comp and SSDI Benefits

You might readily conclude that workers’ comp and the SSDI rules have been written to prevent the average worker from receiving these benefits. Friedman, Levy, Goldfarb, Green & Bagley will help you to cut through the complexity and the red tape—so you can get the help you deserve.

We represent injured workers in Manhattan, the Bronx, Long Island, Brooklyn, and elsewhere in the NYC metropolitan area. Please see our website or call us for assistance in recovering the full amount of the benefits you deserve from workers’ comp, SSDI, and any third party sources following an accidental job-related injury.

 Additional Resources:

1. www.dol.gov: Workers’ Compensation. https://www.dol.gov/general/topic/workcomp
2. www.ny.gov: Workers’ Compensation (On the Job Injury or Illness). https://www.wcb.ny.gov/content/main/Workers/Discrimination.jsp
3. www.ssa.gov: Disability Benefits. https://www.ssa.gov/benefits/disability/

The way that workers’ compensation treats pre-existing conditions reflects the difficulties that an employee might face when applying for benefits. Specifically, those benefits that are available for medical expenses and disabilities associated with a worsening of a pre-existing condition. However, a workers’ comp insurance carrier might deny coverage, for example, with an argument that the condition, and not the accident, caused the injury.

Employees in New York who have pre-existing medical conditions will have a better opportunity to receive benefits when they enlist the help of a New York City personal injury lawyer who understands this process. The attorneys at Friedman, Levy, Goldfarb, Green & Bagley, P.C. have developed a deep understanding of this through more than 50 years of representing injured workers. We advocate for our clients so that they get the full amount they are entitled to receive. 

How Might an Employer and Workers’ Compensation Insurance Carrier Use a Pre-Existing Condition to Deny Benefits?

These claims are always a function of the facts of each specific situation. Employers and insurance companies might use facts in an employee’s personnel file in a variety of ways to deny or limit benefits. This is especially true if the employee has a pre-existing medical condition:

• Employment records might show that the worker was already unable to perform certain tasks due to a pre-existing condition;
• An insurer might argue that exacerbation of a pre-existing injury might have nothing to do with the specific accident that caused a different injury (e.g. a hand injury has no relation to the further deterioration of a previous leg injury);
• Claims for compensation due to pain can be denied if the pain is related more to the pre-existing injury than the on-the-job accident;
• An employee who goes to work before receiving medical clearance for a pre-existing condition might be challenged for not following a physician’s recommendations.

What Should a Worker with a Pre-Existing Condition Do When Seeking Workers’ Compensation Benefits?

An individual in New York State that who a pre-existing medical condition can take steps to improve their opportunity to receive benefits for a new injury. They can do this by paying very close attention to the procedures and details that are inherent in every claim. Specifically, the individual should promptly notify their employer of the accident and injuries.

Next, they should also file for workers’ compensation benefits as soon as is possible. Filing the claim quickly will prevent the employer and insurance carrier from arguing that delays in seeking treatment and benefits were the primary cause of the injuries or disability.

Further, the worker should always inform medical personnel that they will be filing a claim for workers’ compensation. They should also disclose pre-existing conditions to every physician who is consulted for treatment. Finally, they should strictly follow all instructions from a treating physician, including recommendations for therapy and follow-up appointments.

How Are Claims for Pre-existing Conditions and Workplace Injuries Apportioned in New York State?

Employees can be injured multiple times in separate workplace accidents, each of which might generate a legitimate claim. An individual, for example, might already be receiving benefits for a prior injury that would be categorized as a pre-existing condition. Then they suffer another injury in a subsequent accident. In New York State, the benefits must be allocated proportionately between the separate injuries. A knowledgeable New York City construction accident attorney who has experience in apportioning claims and benefits under these circumstances– is a worker’s best resource.

Contact Friedman, Levy, Goldfarb, Green & Bagley, P.C. for Representation in Filing Workers’ Compensation Claims

The workers’ compensation lawyers at Friedman, Levy, Goldfarb, Green & Bagley, P.C. utilize the firm’s 50 years of collective knowledge and experience for our clients. We assist and advocate for injured individuals to recover the largest benefits that they are entitled to receive. These would include benefits for injuries that occur when a worker is already suffering from a pre-existing medical condition. We represent individuals in Manhattan, the Bronx, Long Island, Brooklyn, and elsewhere in the New York City metropolitan area.

Please see our website or call us when you have questions about filing applications for workers’ compensation benefits when you have a pre-existing condition– regardless of whether your new injuries have made it worse. We will review your case to verify that your employer and its workers’ compensation insurer are not using your prior medical problems as an excuse to deny your benefits claims. Contact us today for a free case evaluation.

 Additional Resources:

1. www.dol.gov: Workers’ Compensation. https://www.dol.gov/general/topic/workcomp
2. www.ny.gov: Workers’ Compensation (On the Job Injury or Illness). https://www.wcb.ny.gov/content/main/Workers/Discrimination.jsp
3. www.ssa.gov: Disability Benefits. https://www.ssa.gov/benefits/disability/

The Bureau of Labor Statistics reports that construction has more work-related injuries and deaths than any other industry in New York City. Over the past five years, construction site injuries in NYC have increased by 221 percent. Every day workers put their lives on the line, facing the prospect of faulty equipment, inadequate safety gear, electrocution, scaffolding collapses– to name just a few occupational hazards.

Workers’ compensation insurance is designed to financially assist people who are hurt on the job. These benefits are paid to those who are partially or fully disabled because of a workplace injury or illness.

No matter the circumstances of your construction site accident or illness, insurance companies may be reluctant to pay out for lost wages, medical expenses, and other losses.

Get the benefits you rightfully deserve after a workplace accident by seeking legal representation from an experienced New York personal injury attorney.

Benefits provided by Workers’ Compensation

In New York, employees who develop an illness or injury on the job are entitled to worker’s compensation benefits to pay for medical care costs with an authorized provider, a portion of lost earnings, and reimbursements for transportation to medical appointments.

• Medical care benefits – You are eligible for medical care directly related to the injury or illness and the recovery from your disability. Your doctor or health care provider must be authorized by the New York Workers’ Compensation Board, except in emergencies. This coverage is extensive and includes doctor’s visits, diagnostic tests, prescription medications, emergency services, medical equipment, and transport to and from your appointments, with no co-pays or deductibles.
• Lost income – Workers’ compensation will pay a portion of your income during your recovery while you are disabled. This is a weekly benefit of 2/3 of your average weekly pay. The following formula is used: 2/3 of average weekly wage x % of disability = weekly benefit. If you were making $600 a week and are diagnosed as 100% disabled, your weekly benefit would be $400. If you were 50 percent disabled, your benefit would be $200 per week. If the accident occurred between July 1, 2019 – June 30, 2020, the weekly maximum benefit paid is $934.11
• Cash awards for permanent disability – Supplemental benefits may be available if you suffered any kind of permanent or total disability.  The amount of the award will be 2/3 of the difference between your previous average weekly pay and your current earning capacity. The length of time you’ll receive these benefits depends on the calculation of your lost earning capacity.
• Vocational rehabilitation – benefits will cover the cost of retraining for a new position or job
• Death benefits – in the event of death, the surviving dependents and spouse are entitled to weekly cash benefits equivalent to 2/3 of the deceased worker’s average weekly wage for the year before the accident.

Get the compensation you deserve

Workers’ compensation insurance is useful in that it is generally paid out quickly and without the need for proving which party – if any– was responsible. However, claimants may find themselves taken advantage of without proper legal counsel.

At Friedman, Levy, Goldfarb & Green, we can protect your rights and help make sure that your worker’s comp claim is properly evaluated and paid out. If you feel that your claim is being rushed, or your benefits were terminated prematurely, you should speak with a New York construction accident attorney at our firm.

The benefits under worker’s compensation will depend on:

• The nature of your injuries
• Medical diagnosis
• Whether you can return to work in some capacity
• Total recovery time
• If the injury is permanent
• Your level or percentage of disability
• If vocational training is needed

Legal guidance in New York City Contact Friedman, Levy, Goldfarb & Green for a free consultation today. Our dedicated attorneys have been serving New York for over 50 years and can help you secure the cash benefits you deserve. There is no risk to exploring your options, as we offer our legal services on a contingency basis.

In a perfect world, workers’ compensation payments would begin as soon as an injured worker stops receiving their regular paycheck. In part, workers’ compensation is intended to reimburse medical costs and to replace lost wages. An injured employee can suffer severe financial hardships if a source of income abruptly ends.

If construction-related injuries are keeping you from working and earning your regular wages, call Friedman, Levy, Goldfarb, Green & Bagley, P.C. to speak with a New York City personal injury lawyer about expediting your claim.

What can an injured worker do to expedite payments of workers’ compensation benefits?

Injured workers in New York can improve their chances of approval of their workers’ compensation claims if they seek immediate medical treatment. They must also notify their employer of the injury in writing no later than thirty days after it happens. Many claims are delayed or denied because an employee failed to see a doctor, or only filed a claim with the New York Workers’ Compensation Board– without alerting the employer of the injury. 

Employers and workers’ compensation insurance companies will point to the employee’s delays and notification failures to argue that an intervening non-work related accident caused the injuries.

What medical services should an injured worker seek?

An injured worker should seek emergency room treatment after experiencing an industrial accident or another job-related injury. For less severe injuries, an employee in New York can schedule a visit with their doctor– if they are on the list of registered New York physicians who provide workers’ compensation care.

The employee should inform the doctor that the injury was work-related, and the doctor will then file the appropriate forms for reimbursement of invoices for services. The employer or its workers’ compensation insurer may require the employee to see a different doctor for subsequent evaluation and treatments.

How quickly will workers’ compensation benefits begin if an injured employee follows all notice and filing requirements?

The doctor who examines and evaluates the injured employee should complete a report within 48 hours, and the employer or its workers’ compensation insurer should provide a written statement of rights within 14 days after the employee submits written notice of the injury to the employer.

If everything is in order, the insurer should begin to make payments within 18 days after it receives the report. If there are any problems with the claim, the insurer will send a dispute notice to the Workers’ Compensation Board.

The benefits that an injured employee is eligible to receive

The statement of rights from the workers’ compensation insurer will provide details of the benefits that an injured employee is eligible to receive– including when those benefits will be paid. Those benefits might include reimbursement for approved medical bills and medications, disability payments, and lost wages replacement. The insurer might offer a single lump-sum payment or a structured settlement that pays benefits over time.

An injured employee has a right to dispute an insurer’s settlement offer, but that dispute will generally delay the payment. An experienced workers’ compensation and New York City construction accident lawyer can help an injured employee to negotiate a dispute and to manage the pressure that the employee will inevitably feel to settle a case and to start benefits payments.

Do Benefits Payments Stop When an Employee Can Return to Work?

Structured workers’ compensation benefits that are paid out over time can include reimbursement for the above-noted benefits. However, some of those components might be reduced or stopped when an employee is well enough to continue working. In certain circumstances, partial disability payments and reimbursements of medical expenses might continue.

If an employee has retained a workers’ compensation lawyer, they will work on negotiating the largest payments over the longest time to give the employee the best opportunity to recover from injuries with a minimal impact on their financial wellbeing.   

Call us For Legal Representation in Expediting Workers’ Compensation Claims

Call the Manhattan law offices of Friedman, Levy, Goldfarb, & Green to speak with a New York personal injury lawyer about filing for benefits and expediting the payments that you deserve.

Our attorneys represent New Yorkers injured in construction accidents in Manhattan, the Bronx, Long Island, Brooklyn, and elsewhere in the NYC metropolitan area. We understand the importance of rapid payments of compensation and we will fight tirelessly to get you the largest payments you are entitled to receive. 

 Additional Resources:

1. www.dol.gov: Workers’ Compensation. https://www.dol.gov/general/topic/workcomp
2. www.insureon.com: What Is the Workers’ Compensation Claims Process? https://www.insureon.com/small-business-insurance/workers-compensation/how-to-file-a-claim
3. www.ny.gov: Workers’ Compensation Coverage – What to Do When an Accident Happens. https://www.wcb.ny.gov/content/main/Workers/lp_claim-process.jsp

By law, workers’ compensation insurance in New York State will provide payments that (i) replace a portion of an employee’s lost wages when they are unable to work due to employment-related injuries; (ii) reimburse certain medical expenses incurred by the employee for treatment of those injuries; and (iii) provide death benefits if the employee dies as a result of his or her injuries.

Notwithstanding this coverage, an injured employee should not assume that these benefits will pay for all medical bills. Many workers’ compensation insurance companies will deny payments, for example, for services that are not deemed to be medically necessary.

 If you have been denied reimbursement for your medical bills after a work-related accident, call Friedman, Levy, Goldfarb, Green & Bagley, P.C. in Manhattan to consult with a personal injury lawyer about pursuing your claim and pressing an appeal from any denials of benefits to cover your medical bills.

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Medical Bills That Are Commonly Covered by Workers’ Compensation

In most cases, an employee that suffers on-the-job injuries will receive reimbursement under workers’ compensation for:

• emergency room services;
• diagnostic tests, including X-rays, MRI’s, blood tests, and other standard medical procedures;
• rehabilitation and physical therapy;
• transportation costs for doctor’s visits;
• certain types of medical equipment.

Medical bill payments will be subject to limits, particularly for physical therapy and other medical services that are provided over several weeks. A knowledgeable and experienced workers compensation lawyer will challenge these limits and pursue compensation for a longer stretch of therapeutic services.    

Medical Bills That Are Commonly Denied

Workers’ compensation benefits default to standard medical treatments over alternative therapies, such as acupuncture or experimental drugs. An injured employee should consult with their physician and should verify coverage with the workers’ compensation insurance carrier before pursuing any alternative therapies. This is to avoid surprise denials of coverage when medical bills are submitted for reimbursement.

Qualifying for Medical Bill Payments

The most direct way to start the benefits is to notify your employer’s insurance carrier that you intend to ask for them. You also intend to inform the first treating physician that you see that you were injured in a workplace accident. The insurance carrier will likely require you to procure pre-approval before you schedule an appointment with a physician. They may also refer you to a health care center within their provider network.

You might find yourself in a conflict between a workers’ compensation insurer that is not approving medical treatments, and your health insurance that is denying coverage because your injuries or illness are work-related. An experienced attorney is your best resource to resolve this conflict in your favor.

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The Benefits of Retaining a Workers’ Compensation Lawyer

A workers’ compensation lawyer will do more for an injured employee than just resolve conflicts between insurance carriers.  For example, an attorney will:

• negotiate cash settlements for injuries incurred in the workplace in an amount that is greater than any voluntary settlement offers that an insurance carrier might offer;
• verify that an injured worker is receiving the full amount of benefits for lost wages, including any overtime wages that the worker would expect to receive;
• push to get coverage for all of the medical treatments that an employee needs to recuperate fully from injuries, and to argue for treatment by an employee’s regular medical team over an insurance carrier’s designated physicians;
• verify that all claims are filed within statutory deadlines, and extend those deadlines when necessary to increase benefits that may be payable to an injured worker;
• fight back against insurance company claims that an employee’s injuries are not severe or are only an exacerbation of an existing condition.

Contact Us for Legal Representation in Workers’ Compensation Claims 

When you suffer a workplace injury in Manhattan, the Bronx, Long Island, Brooklyn, or elsewhere in the general NYC metropolitan region, please contact us. You can speak directly with one of our experienced construction accident lawyers to improve your chances of reimbursement for your medical bills. We can also help recover the largest available workers’ compensation payments to replace your lost wages and other expenses.

Additional Resources:

1. www.ny.gov: Workers Compensation Benefits. https://www.wcb.ny.gov/content/main/Workers/lp_benefits.jsp
2. www.thehartford.com: Workers’ Compensation NY. https://www.thehartford.com/workers-compensation/new-york
3. www.ny.gov: Workers’ Compensation Coverage – Understanding Workers’ Compensation Insurance.  https://www.wcb.ny.gov/content/main/Employers/workers-compensation-insurance.jsp

After receiving a workers’ compensation claim, employers and their insurance companies sometimes investigate claims to weed out cases of fraud. Though it may make you a bit uncomfortable, they are allowed to investigate you after you file a claim so long as they follow certain rules.

Workers’ compensation claims are complex. At Friedman, Levy, Goldfarb, Green & Bagley, a New York personal injury lawyer will counsel clients through the claim process, appeals, and even the unexpected issues like surveillance.

How workers’ compensation benefits work

New Yorkers who are disabled on the job have the right to receive workers’ compensation benefits. A disability for the purposes of this discussion includes both acute and slowly developing injuries, as well as contracted illnesses.

Workers’ Comp provides valuable benefits that cover necessary medical care and lost wages. This allows workers to get the treatment they need and return to work as soon as possible. However, as a trade-off, they lose their right to sue the employer for negligence.

Investigation by workers’ compensation companies

Workers’ compensation wants to see you back to work– and no longer collecting money under their policy– as soon as possible. One of the ways they limit how much they pay out in claims is to hire investigators. They attempt to verify that the extent of injuries is consistent with what has been reported by you.

No one wants to feel spied on, but as long as they follow certain rules, the investigators are allowed to perform their review. If you have reason to believe they are not following the rules, discuss this with your attorney.

What is permitted in a workers’ compensation investigation?

Legally, private investigators have wide latitude in how they may obtain information about you. They can observe you throughout the day, and often choose to do so when you are going to or from medical appointments. They can also speak with family, friends, neighbors, and even people who provide services to your home. They may ask about the activities you can perform throughout the day or record videos of you while you are in public.

What they cannot do is trespass or lie about who they are. If they impersonate someone else to gain access to you, your friends, or your home, then they may be outside their rights.

Why might someone watch you after a workers’ compensation claim?

Fraudulent claims can drive up the price of insurance while providing an incentive to employees to stay out of work longer than necessary. In addition, knowingly defrauding the workers’ compensation system is a felony in New York.

Injured workers who file a claim must provide true and accurate statements and records to the Workers’ Compensation Board. Employers and workers’ compensation carriers often keep an eye on claimants to be sure that their physical capabilities match what they have reported.

If surveillance shows that a workers’ compensation claim could be fraudulent, the employer can report it to the Fraud Inspector General for further investigation. If the case warrants it, they may hand it off to local prosecutors to take criminal action.

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New Yorkers who have been injured on the job can help themselves through the complex workers’ compensation process by contacting an experienced Manhattan personal injury lawyer. We specialize in this practice area.  If you have been hurt at work, schedule a free consultation with a construction accident lawyer. Our attorneys proudly serve clients throughout New York City, including the Bronx, Long Island, and Brooklyn.

Regardless of whether you work on a shipyard, in a corporate office, or at a daycare center, if you are injured on the job, you likely have the right to seek compensation under the New York workers’ compensation system. In less common cases, you may be entitled to bring a personal injury lawsuit against your employer or another at-fault party. The rules, procedures, and deadlines can be complicated, but a New York workers compensation attorney at Friedman, Levy, Goldfarb & Green can help you through the process.

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Workers compensation laws

The New York workers’ compensation allows those who suffer work-related injuries or illnesses to recover certain benefits in a relatively quick and simple way. The procedure requires less time and money than a lawsuit, which is a win for both the employer and the employee. On the flip side, employers must pay even if they are not at fault and employees can only recover limited benefits while usually losing the right to sue an at-fault employer.

Under state law, employers are required to have workers compensation insurance, whether it is obtained through the state, a private insurer, or via self-insurance. Any type of workplace injury can be covered, regardless of what caused the injury. Covered injuries range from broken bones to carpal tunnel syndrome to mental health issues.

It is a good idea to discuss your injury with a worker’s compensation attorney and to be prepared to file a report with your employer in case you have a compensable claim.

Benefits available under NY workers compensation insurance

When your injury or illness is covered by workers’ compensation, the following benefits are available, if appropriate in your case:

• All reasonable and necessary medical care provided by an authorized healthcare professional
• Mileage reimbursement for travel to and from necessary and related medical appointments.
• Temporary disability benefits to replace a portion of your lost income if you are unable to work for more than seven days. Temporary disability can replace up to 2/3 your average weekly wage up to a maximum amount, though the payment is reduced if your disability is partial rather than total.
• Permanent total disability benefits of 2/3 your average weekly pay if you have reached “maximum medical improvement” and still cannot work.
• Permanent partial disability benefits for permanent injuries such as disfigurement or lost use of a body part; the amount of compensation may be based on a schedule according to the type of injury or based on a difference in earning capacity.
• Vocational rehabilitation services if you cannot return to your job and need to seek new employment.
• If the injury or illness was fatal, death benefits to a surviving spouse or dependents, including funeral expenses.

The benefits depend on the facts of the situation so it is a good idea to speak with a New York City attorney at Friedman, Levy, Goldfarb & Green to determine what benefits may be available to you.

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Injuries not covered by NY workers compensation laws

While most workplace injuries are eligible for workers’ compensation, some are not. Problems may arise in situations such as when:

• You are an independent contractor rather than an employee
• The injury fell outside the scope of your employment (for example, it occurred on your morning commute or while taking a lunch break)
• The injury was a pre-existing condition
• Your injury was caused by your own impairment due to drugs or alcohol or for your own intentional or reckless actions

In some cases, like when a third party is at fault, the injured employee can bring both a workers’ compensation claim against the employer and a personal injury lawsuit against the at-fault third party.

You may also sue your employer directly if the employer intentionally caused you harm or if your employer does not carry proper worker’s compensation insurance. The laws can limit how much you may recover from workers’ compensation in these situations, so be sure to discuss your options with an attorney.

New York workers compensation attorney

A work-related injury can set you on a seemingly unstoppable cycle. The injury can cause mounting medical bills as well as impair your ability to work, preventing you from climbing out of debt. Ideally, a worker’s compensation claim would prevent this, but it can take a fight – against insurance companies that do not offer full value or employers who do resist a claim – to obtain full compensation.

A New York City work accident lawyer makes the process less complicated from the very beginning, by guiding you through the required paperwork and deadlines and helping you to gather the evidence to support your case. Your attorney can take the pressure off of you while in improving your outcome by negotiating with the insurance company. The settlement will need to be memorialized in an agreement, and your attorney will ensure the agreement does not jeopardize your rights.

When you and the insurance company cannot reach a settlement, your attorney will make sure you are prepared for court, then present your strongest case at the hearing.

When a workplace accident has caused setbacks, do not wait to speak with a skilled attorney. The workers’ compensation lawyers at Friedman, Levy, Goldfarb & Green are here to help. We are dedicated to fighting for the rights of injured parties throughout NYC, including Manhattan, the Bronx, Brooklyn, and Long Island. Call today to schedule a free consultation to determine whether you have the right to file a worker’s compensation claim.