Workers’ compensation does pay for lost wages in situations where covered workers sustained a workplace injury that is work-related, but the amount will not be the full amount of your wages. The amount of wages that workers’ comp will pay is limited by certain factors and percentage formulas set out by law and by the type of injury or disability. We’ll get into those details below. You may also be entitled to additional coverage for expenses such as medical bills and for help getting back to work.
Workers’ comp rules are complex. The process of filing for benefits and gathering information to prove your claim can be difficult. Fortunately, there is help available to guard your rights. If you believe your situation qualifies you for more benefits than you were awarded, or if your claim has been denied or you are having trouble collecting benefits, Kaplan Law can help. It pays to consult with our experienced workers’ comp lawyer who can explain how the law applies to your situation, handle the application process, and fight any denials. Count on us to fight for the compensation you deserve.
Our Clients Ask: Does Workers’ Comp Pay for Lost Wages?
While workers’ comp does pay for lost wages and other expenses related to your injury, there are factors that influence whether and how much you will be paid. The first consideration is whether you can be covered at all. To be covered under New York workers’ compensation laws the following must exist:
- Your employer provides New York workers’ compensation.
- You are a covered worker under the law.
- Your accident, injury, or illness is directly connected to the job and happened while you were doing work-related duties.
- You gave your employer a written notice of what happened within 30 days from the date the injury, illness, or accident occurred.
- You provided a medical report from you treating physician stating that your disability was caused by an on-the-job accident or condition.
It Is Important to Know, Does Workers’ Comp Cover Lost Wages?
If you meet the above criteria, workers’ comp does cover lost wages, but not all of them. While you are entitled to medical coverage from day one, you may not receive cash benefits for the first seven days of the disability, unless it continues for more than fourteen days. If it does, you may receive cash benefits from the first day off the job.
The actual amount workers’ comp will give you to replace lost income depends upon how your disability is classified. New York has the following disability classifications for payment:
- Temporary total disability — You are completely unable to work, but only for a temporary period.
- Permanent total disability — You have a total and permanent loss of wage-earning ability.
- Temporary partial disability —Your ability to earn wages is partially lost, but temporarily.
- Permanent partial disability —You are partially disabled on a permanent basis, so part of your wage-earning capacity is lost. Depending on the injury and what part of the body is affected, you may receive one of two kinds of permanent partial disability benefits.
Types of Benefits for Permanent Partial Disability
Schedule loss of use
When your injury involves upper and lower extremities, eyesight and hearing, it falls under a “schedule loss of use” (SLU). A SLU award compensates you for permanent loss of earning power, as determined by the Workers’ Compensation Board, according to a schedule of the maximum number of weeks of benefits you can receive for the body part you have permanently injured. Your doctor will submit a report stating what percentage of functional use you have permanently lost in the injured body part, and that percentage will be used to calculate the number of weeks of benefits and the payment you will receive.
With this workers’ comp benefit, you will receive two-thirds of your average weekly wage (up to the legal maximum) for the number of weeks listed in the schedule, multiplied by the percentage of lost functional use of that body part.
When your injuries include other body parts, such as the brain, lungs and heart, your benefits are calculated as a “non-schedule loss.” The number of weeks you can receive these benefits depends on the percentage of your lost earning capacity, according to a formula.
Workers’ Compensation Calculation of Lost Wages
Whether you are totally or partially disabled, if you are unable to work for more than seven days, workers’ comp will pay for lost wages based on your average weekly wage for the previous year. The following formula is used to calculate benefits:
2/3 x average weekly wage x % of disability = weekly benefit
If you are classified as totally (100%) disabled, you would receive the full two-thirds of your weekly wage. If you were classified as 50 % partially disabled, you would receive half that amount. There are also maximum benefit amounts that you are not allowed to exceed that are adjusted every July 1 based on the New York State Average Weekly Wage for the previous calendar year.
If a medical condition reaches a point where it wouldn’t improve even with further treatment and you are 100% disabled, you can receive two-thirds of your average weekly wage as long as you are disabled. If you can return to work but are unable to earn the same wages you once did, you may be entitled to a benefit to make up two-thirds of the difference.
Workers’ Compensation and Lost Wages and Other Benefits
Workers’ compensation provides other benefits in addition to weekly benefits to cover lost wages. These include:
- Medical benefits for injury-related expenses, including doctor and rehabilitation bills and prescription costs, and costs of transportation to and from medical appointments.
You may have to use specific providers from your employer’s workers’ compensation insurer for medical services. The insurance carrier must notify you of the contact information for the network you must use.
- Supplemental benefits are possible for permanently and totally disabled claimants (or their widows or widowers) who were injured before January 1, 1979 and considered to be most affected by rising costs. If you are left with a permanent, serious disfigurement to your face, head, or neck that might limit your earning capacity, you may be able to receive an additional award up to $20,000.
- Vocational rehabilitation. If you cannot return to your former job, you may be eligible for vocational rehabilitation program or job placement services.
- Death and funeral benefits apply if death occurs due to a work-related injury.
Contact Us for Help with Workers’ Compensation and Lost Wages
If you have been injured on the job in New York, you do not have to navigate the complex workers’ compensation process alone. The experienced New York workers’ compensation lawyers at Kaplan Lawyers PC will help you understand and comply with the law and fight to make sure you receive the maximum benefits and best medical care available.
Also, because workers’ comp pays only a portion of your lost wages and does not reimburse for pain and suffering or award punitive damages, we may be able to sue outside of the workers’ comp system and obtain additional benefits.
We offer a free consultation, so call (516) 399-2364 today.