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New York Workers' Compensation

Workman’s compensation is an insurance program that was designed to provide benefits for employees who suffer work-related injuries. Benefits are available for injuries that occur in a single accident such as when an employee falls at work or is burned by a chemical splash. They are also available in cases where the worker suffers an illness or injury that occurs over time, such as a repetitive action injury or an injury related to long-term exposure to lead paint. While the New York’s workers’ compensation law gives injured employees the right to benefits, receipt of such benefits are frequently delayed or denied. If you were injured while working, it is important that you immediately contact an experienced New York workman’s compensation lawyer who will ensure that your legal rights under the workers’ compensation law are protected.

New York workers' benefits

Under New York workers’ compensation law all New York employers must carry workers’ compensation insurance in order to ensure that injured workers receive necessary medical care and to ensure that while recovering, injured employees continue to have income. Benefits are generally available to any injured worker even if the injured worker’s own negligence caused the injury.

To be covered by New York’s workers’ compensation rules, you must work for a company that is mandated to have workers' compensation coverage under New York law, and you must hold a covered position. The injury or illness that you suffered at work must have occurred because of your employment and while you were performing the duties involved in your job. Another prerequisite of receiving workers’ compensation benefits is that you must give your employer a written notice of the incident that caused your injury or illness within 30 days of when it happened. Furthermore, you must provide a medical report that states that your injury or illness was caused by conditions at work.

Sadly, as a New York workman’s compensation lawyer will explain, even if you meet all of the requirements for workers’ compensation benefits, your claim may still be denied or delayed.

Causes of workplace accidents and injuries

Practically every imaginable accident can occur in any type of workplace. Some of the most common type so accidents that result in workers’ compensation claim include:

  • Construction accidents: Because construction sites are inherently dangerous, if proper safety precautions are not followed a variety of types of accidents can occur including falls, burns, and being injured by heavy equipment. In New York, construction accidents involving workers falling from unstable scaffolding are not unheard of. The consequences of such accidents can be serious head injuries, back injuries, spinal cord injuries, and broken bones.
  • Repetitive stress injuries: Muscle, nerves, ligaments, and tendons can be damaged from performing the same activity over and over. This type of injury is common with workers whose jobs require them to constantly work on computers as well as employees in manufacturing plants who perform the same task repeatedly.
  • Work-related car accidents: Car accidents impact workers such as truck drivers who drive as a regular part of their duties, as well as workers who occasionally drive to get to meetings or visit client sites.
  • Electrocution accidents: Electrocution accidents typically occur on construction sites. Electrocution can occur from contact with power lines, contact with exposed wires, and improper extension cord usage. Both overhead and underground power lines carry a high voltage and care must be taken when working around them in order to avoid a potentially deadly injury.
  • Machinery accidents: Machinery accidents can occur as a result of defective equipment, poor training, or failure to follow OSHA safety procedures. Machinery accidents can cause workers to break bones, suffer amputations, and other serious injuries.
  • Heavy lifting injuries: Injuries that result from heaving lifting can occur at construction jobs, retail jobs, or office jobs where proper safety precautions are not taken prior to a worker attempting to lift a heavy object.
  • Hearing and vision loss: OSHA requires that workers wear eye and ear protection and take other safety precautions to protect their vision and hearing. However, hearing and vision loss happens frequently, particularly in construction, manufacturing, and farm worksites.
Pursuing a workers’ compensation claim

Generally, when someone gets injured in an accident that was caused by another person the law allows that injured person to file a personal injury lawsuit to demand compensation for medical bills and other losses. However, in the case of workplace injuries, New York’s workers’ compensation law applies and includes a provision making it the "exclusive remedy" for an employee injured in the course of working. This means that generally injured employees are legally not allowed to file a personal injury claim against an employer, even if the employer’s negligence was the reason of the employee’s injury. The employee must instead pursue a workers’ compensation claim. Benefits provided by workers’ compensation include:

  • Medical care: Workers’ compensation will pay for medical and chiropractic treatment to treat the workplace injury. Treatment must be received by a medical professional or facility that is authorized by the New York Workers' Compensation Board. The only exception to this requirement is when emergency treatment is required. Prescription medications are also covered by workers’ compensation insurance. However, if there may be restrictions on where you must get your prescriptions filled.
  • Wage replacement: Workers’ compensation provides injured workers a percentage of his or her weekly wages. This is referred to as a “cash benefit.” The weekly benefit is equal to 2/3 x average weekly wage x % of disability. Percentage of disability refers to the severity of the injury and how it impacts the worker’s ability to work. When determining whether an injured worker’s workplace injury is permanent, the doctor will first treat the worker until his (or her) condition reaches the point where it will not improve any more, even with additional treatment. In other words, the worker’s condition has reached its “maximum medical improvement.” The doctor will then evaluate the workers to determine if the injury has left the worker with permanent limitations. If the doctor concludes that the worker is 100% disabled, the worker will receive 2/3 of your average weekly wage as long as he continues to be disabled. Generally, permanent total disability means that you cannot work at all because of your limitations. However, there are some cases where even those with permanent disabilities can be retrained and able to work. There is a maximum benefit and it is set every July.
  • Vocational rehabilitation: If as a result of a workplace injury you are unable to return to your former job, you may be eligible for a vocational rehabilitation program or job placement services.
  • Social security benefits. If the injured worker’s injuries are expected to prevent him (or her) from working for 12 months or more, the worker may be entitled to monthly Social Security benefits.
  • Death benefits: For workers who die from a compensable injury, certain family members are eligible to receive workers’ compensation death benefits. Eligible family members include the surviving spouse, children under the age of 18 or under the age of 23 if in school full-time, and any child who was dependent on the worker and is permanently physically disabled. In the absence of a spouse or children, the decedent’s dependent grandchild, sibling, parent, or grandparent would be eligible for death benefits.

Workers’ compensation benefits are not automatic simply because a worker is injured while working. Injured workers must follow the established procedures. Failure to do may result in the claim being delayed or denied. The New York workman’s compensation lawyers at the Law Offices of Stephen Bilkis & Associates have the skill, resources, and experience to represent you as you pursue the benefits you deserve based on a variety of accidents including construction accidents, machinery accidents, tunnel worker silicosis, heavy lifting injuries, repetitive stress injuries, hearing and vision loss due to work conditions, work-related car accidents, hospital workplace injuries, electrocution accidents, workplace related diseases, utility worker asbestos, and exposure to chemicals or fumes.

Examples

Harriet work for ABC Co. ABC’s parking lot was under repair. Harriet had to walk back and forth from the building to the parking in order to unload supplies from a work vehicle. During one trip to the parking lot, Harriet tripped and fell on a portion of the parking lot that was still in disrepair. Harriet broke her arm. Harriet immediately followed required workers’ compensation procedure, informing her supervisor of her injury, seeking medical treatment, and filing a claim. She stated that she tripped on a portion of the pavement that was in poor condition and had not yet been fixed. She noted that walking across that portion of the pavement was the easiest way to get from the vehicle to the building. Harriet’s employer initially denied the claim, arguing that Harriet was not in the building working at the time and that Harriet should have walked around the damage pavement and not over it. However, with the help of an experienced workman’s compensation attorney in New York, Harriet’s appeal was granted and she received the full amount of benefits to which she was entitled.

Henry was an experienced bus driver. One afternoon he had picked up several passengers before he merged onto a highway. A truck struck the bus from behind. Henry tried to maintain control of the bus without success. The bus ended up hitting the guardrail and then flipped over it. Henry and several passengers were trapped inside the crushed bus. Ultimately Henry was airlifted to a hospital. He suffered serious injuries such that he was unable to return to work for several weeks. His claim was initially denied because his employer claimed that Henry was not wearing his seatbelt. However, after appealing his claim was approved and he received benefits.

Common reasons for benefit delays or denials

While the procedure for filing and workers compensation claims is well-established and fairly routine, it is also quite common for claims to be denied or delayed. As a result, injured workers in sore need of benefits must wait in uncertainty and with no income. The top reasons for delays in the victim receiving benefit payments include the doctor’s diagnosis being inaccurate of the doctor concluding that the injury is not disabling. A delay may also be caused because the doctor concluded that the injury was caused by a pre-existing injury or condition. It is important that claimants report their injuries promptly and file their claims right away. If the injury was not reported promptly, if the worker failed to seek timely medical care, or if the claim was not filed on time, then there may be a delay or denial of the claim. Finally, if there is not sufficient evidence that the injury occured at work or while in the course of working, then the claim will likely be denied.

Whatever the reason for the delay or denial, our team will review the circumstances surrounding your claim and determine the most appropriate course of action to ensure that your legal rights are protected and that you receive the benefits you deserve as quickly as possible.

Contact the Law Offices of Stephen Bilkis & Associates

Even though the law gives employees the right to receive workers’ compensation benefits if they are injured at work, there are rules and procedures that must be followed in order to receive such benefits. It is therefore critical for you to have experienced representation. The seasoned workman’s compensation attorneys serving New York at the Law Offices of Stephen Bilkis & Associates have extensive experience handling workplace injury cases and workers' compensation claims as well as helping clients pursue benefits and compensation from other sources such as Social Security disability benefits. We can help. Contact us at 800.NY.NY.LAW (800.696.9529) to schedule a free, no obligation consultation regarding your case. We represent clients in the following locations: Manhattan, Brooklyn, Long Island, Suffolk County, Queens, Staten Island, Nassau County, Bronx, and Westchester County.

Client Reviews
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When my mom, who is suffering from dementia, faced a slip and fall personal injury lawsuit, I contacted Stephen Bilkis of the Law Offices of Stephen Bilkis & Associates. Not only did he provide a strategy for defending the claim, he also advised me on steps to take to avoid future personal liability. Whether you are the defendant or plaintiff in an injury case, I highly recommend Mr. Bilkis. S.M.