What is Covered by NY Workers Compensation?

NYS Workers’ Compensation is a statutory benefit, paid for by your employer, either through an insurance carrier contracted by your employer or their own self-insurance.

What Benefits Am I Entitled To Under Workers’ Compensation Law? 

  • Full coverage of related medical care and hospital treatment for job-related illnesses and injuries;
  • Partial wage replacement for temporary or permanent loss of earnings;
  • Special compensation for loss or partial loss of the use of a limb;
  • Rehabilitation services;
  • A variety of death and survivor benefits.

Of special note: if eligible, you are entitled to medical benefits and possible cash compensation for a job-related injury or illness even if there is no loss of time from work.

Employers are required to provide this coverage for workers in the event of an occupational injury or illness, and CANNOT require employees to contribute to the cost of this benefit. Workers’ Compensation benefits provide urgently needed financial support to workers and their families. Payments are made when a worker is injured, made sick, or killed on the job. All Workers’ Compensation benefits are tax free.

The Workers’ Compensation Board (WCB) is a New York State agency that administers the Workers’ Compensation Law. The Workers’ Compensation Board receives and processes the workers’ claims for benefits, employers’ reports of injuries and medical reports from physicians and other healthcare providers.  Prior to the enactment of the Workers’ Compensation Law in 1914, when a worker was injured, the only remedy was to sue the employer for on-the-job injuries. While some workers received full compensation through jury award, many other deserving workers and their families got nothing, after years of court delays and personal expense.

When the new law was enacted, it was often referred to as an “Historic Compromise.” Both workers and employers gained and lost something as a result. Workers lost the right to sue their employers in exchange for medical care and payment for their injuries. Employers agreed to assume all liability, regardless of fault, for all job-related injuries. The law was amended in 1922 to include job-related illnesses and diseases.

Consequently, in a Workers’ Compensation claim, fault is not an issue. The amount that a claimant receives is not decreased by his/her carelessness, nor increased by an employer’s fault. However, a worker loses his/her right to Workers’ Compensation if the injury resulted solely from his/her intoxication from drugs or alcohol, or from intentional self-inflicted injury.

WHO IS COVERED BY NYS WORKERS’ COMPENSATION?

Most full-time and part-time workers in New York State are covered. This includes:

  • Workers in all employments conducted for profit.
  • Employees of counties and municipalities.
  • Public school teachers, excluding those employed by the New York City Board of Education.
  • Public school aids throughout New York State are covered.
  • Employees of the State of New York.
  • Nearly all organized volunteers, such as members of fire and ambulance corps.
  • Certain domestic workers, such as full-time sitters or companions, and live-in maids, employed forty or more hours per week by a single employer.
  • Farm workers paid more than $1200 for farm labor in the preceding year.
  • Any other worker determined by the Workers’ Compensation Board to be an employee.
  • Temporary workers are covered, and even some people who have been told they are “independent contractors” may be eligible for WC benefits.

SPECIAL NOTES:

  • U.S. citizenship is not required to be eligible for Workers’ Compensation benefits.
  • Benefits can often be available even if the employer has no insurance, goes out of business, or tells workers they are not eligible.

WHO IS NOT COVERED UNDER WORKERS’ COMPENSATION LAW?

  • New York City police, firefighters, uniformed sanitation workers and public school teachers who are covered by other compensation systems.
  • Seafarers, dock workers, interstate railway workers and federal workers, who are covered under the Federal Workers’ Compensation Law.
  • Clergy and members of religious orders.
  • Persons engaged in a teaching or non-manual training capacity in or for a religious, charitable, or educational institution.
  • Persons, including minors, doing yardwork or chores at a one-family owner-occupied residence.
  • Sole proprietors, partners and one/two person corporate officers with no employees are not covered, although insurance coverage may be obtained voluntarily.

STEPS TO OBTAIN COVERAGE AND FILE A CLAIM:

Following a work injury, it is important that you take the right steps to establish your Workers’ Compensation claim:

  • Obtain emergency medical treatment, if needed.
  • Note location of accident site, make sure to get names or witnesses. Do not be concerned if there are no witnesses. Having a witness is not essential to your right to file a claim or to establish it.
  • Notify your supervisors about the accident including how, and where it occurred. You should do so as soon as practical, but you have up to 30 days to notify your supervisor.
  • Although you have up to 2 years following the date of injury to file the C-3 with the Workers’ Compensation Board, the sooner you do so, the faster you will be able to establish your claim for benefits
  • Place yourself under the care of a physician who treats Workers’ Compensation patients. No claim can be established without proper medical documentation that the injury was work-related.
  • Contact Beck Law, P.C. so that our attorneys assist filing your claim and expediate your Workers’ Compensation benefits.

SPECIAL NOTE:

Failure to timely file a C-3 or give the employer timely notice may result in the loss of rights to Workers’ Compensation benefits. Remember: 30 days to give notice and up to 2 years to file the C-3. Both of these requirements are solely the responsibility of the injured worker.

Responsibilities of others:

  • The treating physician, using Workers’ Compensation Board form C-4, should complete medical report and mail it to the appropriate Workers’ Compensation Board District Office. Copies should also be sent to the employer or its insurance carrier, the injured worker, and his/her attorney. DO NOT pay the physician for work-related medical treatment.
  • The employer, using Workers’ Compensation Board form C-2, should report the accident to the Workers’ Compensation Board District Office and its insurance company within 10 days of notification of the accident/injury.
  • Do not be concerned if the employer fails to meet its obligation to file a C-2.

WHY SHOULD YOU FILE A CLAIM?

Workers’ Compensation is a major resource if you become sick or injured on the job. If you don’t file a claim, you could lose your rights to receive benefits. Here are some good reasons to file a claim if you have been injured or made sick on the job:

  • It costs you nothing to file.
  • Your health insurance will not pay medical costs for injuries that happen at work.
  • By law, Workers’ Compensation is your employer’s responsibility. The premiums for this insurance have already been paid by your employer.
  • Your employer may not require any employee contribution toward the cost of the Workers’ Compensation coverage.
  • Generally, you cannot sue your employer for work-related injuries/illnesses, therefore, Workers’ Compensation is your only remedy against the employer.
  • You don’t have to lose time from work in order to file a claim and be entitled to full Workers’ Compensation medical benefits, as well as cash payments for partial or full loss of motion or the use of a limb, vision or hearing. This is true for facial scars and marks as well.
  • Unlike health insurance, your Workers’ Compensation payments and medical care may continue even if you get a new job, retire or leave the state. Additionally, if you are not able to work because of your injuries, the benefits may continue for life.
  • If eligible, you’re entitled to Workers’ Compensation no matter who was responsible for the accident/injury. Fault is not an issue.
  • Your injury may reoccur (such as a back injury or carpal tunnel syndrome), and if your case wasn’t established to begin with, you may not be able to get Workers’ Compensation at that time.
  • Each new injury, even to parts of the body previously injured, should be filed as a new claim.
  • You owe no attorney fee unless you have received a cash award from a Workers’ Compensation Judge. The fees are reasonable and are set by the Judge.
  • An employer may not fire or otherwise discriminate against an employee because he/she files a Workers’ Compensation claim.

If you or a loved one were involved in a work accident, the Queens Workers’ Compensation attorneys at Beck Law, P.C. will navigate your claim so that you do not jeopardize your Workers’ Compensation benefits. Call Beck Law, P.C. today at (516) 388-7785 for a free consultation.  You do not pay us unless we win for you.

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