Frequently Asked Questions about Workers Compensation
What is workers' compensation?
Workers’ compensation is a comprehensive benefits package that provides income for lost wages and payment of medical bills for employees that have been injured as a result of an accidental incident arising out of or during the course of employment, or due to occupational disease.
What medical bills will be covered under workers' compensation?
Bills for hospitalization, doctor services, chiropractic treatment, dental care, pain management, physical therapy, diagnostic tests, laboratory tests, surgery, nursing services, prescription drugs, and durable medical goods.
How much money will I receive if I can't work due to my injuries?
You will receive two-thirds of the average weekly wages that you have earned in the 52 weeks prior to the accident up to a maximum of $739.83. However, compensation benefits will not be paid for the first 7 days that you are unable to work unless your disability lasts for more than 14 days.
Do I have to file a claim with my employer?
Yes. You should notify your employer when, where, and how you were injured as soon as possible, preferably within 30 days of the accident. Your employer will complete and file Form C-2, the Employer’s Report of Work Related Accident/Occupational Disease, and you are required to file Form C-3, Employee’s Claim for Compensation. The C-3 Form must be filed within 2 years from the date of the accident, or in the case of an occupational disease, from the date the medical condition is known, or should have been known.
Do I need to hire a workers' compensation attorney?
No. However, there are many complicated issues that must be resolved so an experienced workers’ compensation lawyer can help to establish your claim, get you the medical care that you need, get your lost wages repaid, negotiate a cash settlement, and represent your interests at all court proceedings.
How much does it cost to hire a workers' compensation attorney?
You do not have to pay the attorney anything out of your pocket. A Workers’ Compensation Law Judge may award attorney’s fees but these fees are paid directly from the insurance company and are deducted from the claimant’s award.
Do I need pre-approval for medical treatment?
Only for specialist consultations, surgical procedures, physiotherapeutic procedures, occupational therapy procedures, and diagnostic testing that costs more than $1,000.
What qualifies as an «on-the-job» injury?
While the intricacies are sometimes complex, an on-the-job injury must occur while on-the-job, and while performing a work-related task. Or, in the case of work-related diseases, must arise from workplace conditions. A workers’ compensation benefit attorney will be able to determine whether or not an injury was directly related to employment.
How long should I wait to hire an attorney?
Navigating legal terrain can be difficult. We feel it’s best to proceed with experienced counsel and, if you decide to, it’s best not to hesitate. Gathering evidence is a crucial step in the beginning stages and the farther removed from the time of the incident, the harder it will be for attorneys to accurately gather it. Trained attorneys can prove invaluable when dealing with insurance companies and in court.
What does settling a case entail?
When a case is settled, you are agreeing to a sum of compensation benefits in exchange for dismissing all future liabilities against the person or corporation responsible for your injury. A settlement can occur before, during, or after a trial, depending on when you and your counsel have decided that you’ve reached a just and maximal benefit amount.
What is the difference between NYS Workers' Compensation and NYS Disability?
NYS Workers’ Compensation is for workers who have been injured while on the job, whereas NYS Disability is for workers whose injuries occurred off the job, and preclude them from working. One cannot receive payments from both simultaneously.
What are punitive damages?
In some cases of heinous negligence or overt intent, punitive grievances can be paid to the claimant. If an employer is found to be guilty of providing an unduly hazardous workplace, or was particularly reckless, these payments can be awarded on top of the money received for lost wages, medical pay, etc.
If my employer asks me to submit to a medical examination, do I have to?
It is prudent to do so, yes. Failure to comply with such a request could have negative effects if the case goes to trial.
If an insurance adjuster asks me to give a recorded statement, do I have to give one?
Remember, anything you say can be used against you. If your insurance provider includes a cooperation clause, however, you may be obligated to give a recorded statement.
What if I am cleared to go back to work, but my injury prevents me from making as much money as I previously was?
You may have a reduced-earnings claim. As you are entitled to receive two-thirds of your lost earnings while on disability, you are also entitled to two-thirds the difference between your original and reduced earnings.
What do I do if I don't stop receiving medical bills?
This may be a miscommunication between the hospital and the Workers’ Compensation case, as claimants are not supposed to be billed directly for work-related injuries. Attorneys can alert hospitals, healthcare organizations and the like to this rule. If you are receiving billing directly, it is sometimes necessary to update the hospital with the Workers’ Compensation carrier’s information.
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