Workers Comp

Earning a living in New York is becoming increasingly dangerous. Injuries and illnesses in the New York workforce are higher than the nationwide average for US private-sector jobs. These concerning rates of injury and illness highlight the importance of understanding your rights under New York workers’ compensation laws.

No one should put their health in jeopardy simply by clocking into a shift. When you are injured on the job, there are benefits available to you that your employer must provide. These workers’ compensation payments can help cover medical bills and a portion of your living expenses while you recover.

If you are having trouble recovering workers’ compensation, if your employer has told you that you do not qualify, or if you need help with your claim, contact Pitta & Baione LLP today. Our experienced workers’ comp lawyers in New York have a proven track record of helping New Yorkers get the help they need.

What Is Workers’ Compensation?

Workers’ compensation is mandatory insurance that an employer must carry to provide benefits to their employees. It covers the cost of care for employees when they are injured or fall sick on the job. New York State workers’ compensation pays for covered medical bills required to treat the injury or illness, as well as a percentage of an employee’s salary for a temporary period while they recover.

Workers’ comp can also pay compensation for injuries that have permanent effects, like the loss of sight, hearing, or mobility. It also provides death benefits to surviving family members should an employee suffer a fatal injury while in the course of work. Workers’ compensation is unquestionably one of the most important rights that employees have under US law today.

While the payment of benefits and coverage of medical care for workers has been documented as far back as the Code of Hammurabi, U.S. workers lacked federal workers’ compensation protections until the early 1900s. Workers’ compensation is designed to be a temporary safety net that provides a realistic structure for employees in which to take time to recover when they are sidelined due to illness and injury. It also incentivizes businesses to provide safer working conditions and protects owners against legal liability in the event of a covered accident or injury.

Benefits Available Under New York Workers’ Compensation

New York state workers’ compensation is required for all businesses with more than one employee. New York workers’ compensation coverage can be provided through a private insurer, the State Insurance Fund, or self-insurance for qualifying employers. New York workers’ comp rates are adjusted based on the date of the injury and have steadily increased since 1985.

Under New York law, you are also entitled to payment of a portion of your lost wages if you must miss work due to an accident or injury for more than 7 days. These benefits will be paid after 14 days but will include the period of time that you were first unable to work. You can also qualify if your work schedule or income changes because of the illness or injury.

Rate of Disability

New York workers’ compensation benefits also provide payments for ongoing disability based on the degree of disability from an accident or injury. These payments range from total disability (100%) to partial disability levels, categorized as marked (75%), moderate (50%), or mild (25%).

Your rate of disability will be assigned by an independent medical examiner or by certification from your own doctor. Should the two medical experts disagree, you may be able to request a hearing instead of simply accepting a compromise offer from the insurer.

Who Is Entitled to These Benefits?

New York workers’ comp insurance is for all employees, regardless of immigration status. It is important to note that while most workers are covered from the first day of employment, certain aspects of filing for compensation may differ if you have been employed for less than 52 weeks. For workers’ compensation in New York, those who are covered by for-profit businesses include:

• Part-time workers
• Full-time workers
• Seasonal employees
• Casual or day laborers
• Family members and unpaid volunteers
• Certain independent contractors

Exceptions include independent contractors who meet a two-part test in the construction industry, sole proprietors, or partnerships without additional employees, as well as some volunteers or teachers for non-profit institutions like educational and religious institutions.

How Does the Workers’ Compensation Claims Process Work in New York?

New York’s workers’ compensation statutory limits must be followed in order to receive appropriate levels of compensation. If you do not notify your employer of your injury within 30 days of the accident or event, you may lose your right to workers’ compensation.

In addition to notifying your employer, you will need to file New York state workers’ compensation forms like Employee Claim (Form C-3) with the New York Workers’ Comp Board. You will need the following information on hand in order to file:

• Your employer’s name
• Your employer’s address
• The dollar amount of gross wages (pre-tax) you receive per pay period
• The names and addresses of any additional employers you worked for during the accident or injury period (so as to accurately calculate your AWW)
• The name and address of the doctor or hospital who provided your initial treatment

Maximum benefit rates vary, depending on the date of your injury. The maximum weekly rate is adjusted on July 1 of each year. Benefits are calibrated based on your Average Weekly Wage (AWW), which is based on your gross earnings plus any overtime during the period of 52 weeks prior to your injury.

A New York workers’ comp lawyer can help you with all of these details, as well as negotiate with the insurer should they deny or reduce your claim amount. We can help ensure your claim is filed correctly and on time, and that your employer upholds their end of the bargain.

When Should I Get a Lawyer for Workers’ Comp?

If your claim is challenged under New York state workers’ compensation requirements, you might see your benefit amounts reduced, be assigned an improper disability rate, or be forced to return to work prematurely because of difficulty affording your recovery period. Your employer might argue that your injury was self-imposed or aggravated by an existing condition, that it happened away from work, that you reported it incorrectly, or that you otherwise do not qualify for full benefits. In a worst-case scenario, you may also find yourself suddenly laid off while injured in an effort from your employer to avoid increasing its own insurance rates.

Not every workers’ comp claim requires legal representation. It is perfectly possible to self-represent in the event that your injury was minor or straightforward and if your claim is approved right away for the correct amount. However, if your employer or their workers’ comp insurance company argues that any of the following apply to your situation, you might need a workers comp lawyer in New York:

• The accident involved horseplay or inappropriate behavior.
• You were not following safety regulations at the time of the accident.
• You were allegedly under the influence of drugs or alcohol.
• You did not notify your employer right away.
• Another employee disputes the details of your claim.
• A treatment your doctor recommends is determined to be optional or not medically necessary.
• There is a comorbidity or other aggravating effect on your health that your employer argues has exacerbated the injury.
• Your employer does not cooperate with New York workers’ comp law.
• Your employer threatens to report you or replace you, particularly in high-risk fields like construction, warehouses, hospitals, and nursing homes.

None of these scenarios should ever happen to an injured worker. Pitta & Baione LLP are trained and authoritative negotiators who are experienced with all of the ways that insurance companies attempt to protect their bottom line. We can build up your claim with support from eyewitnesses and medical experts, as well as powerful precedents under New York State and local case law. We know what amounts are standard and when to refuse a low-ball offer.

How to Choose the Right Workers’ Comp Lawyer in New York

A skilled New York workers’ comp attorney can protect you from efforts to reject or reduce your claim. At Pitta & Baione LLP, we offer a personalized focus for our clients’ claims, bringing minute attention to detail, as well as years of experience fighting for injured New Yorkers. We offer flexible fee structures to be able to advocate for the maximum number of New Yorkers.

New York Workers’ Compensation Laws

By New York state law, if your claim is accepted by the workers’ comp insurer, payments must begin within 18 days from the date of your injury, or within 10 days after your employer became aware that you were injured – whichever is later. Workers’ compensation in New York State also provides wage replacement benefits to employees once you have an accident report on file from your employer, as well as a medical report from your physician that affirms your permanent or temporary disability is due to a work-related injury or illness. Your employer must also file the New York Employer’s Statement of Wage Earnings Preceding Date of Accident (Form C-240), which will calculate your total gross pay as well as paid time off and overtime for the 52 weeks prior to your injury.

Claims submitted without these required forms and medical certifications can be denied or delayed for an indeterminate period of time. If you have concerns about your employer’s compliance or any other questions about your claim, contact Pitta & Baione LLP for a free case evaluation.

Most Common Workplace Injuries

Some of the most common fatal workplace injuries include:

• Falls and slips
• Exposure to toxic chemicals and harmful substances like lead, asbestos, pesticides, cleaning products, and more
• Equipment-based injuries
• Car crashes

In New York, the most common ER visits due to workplace injuries are caused by:

• Falls
• Overexertion
• Burns
• Cuts and lacerations
• Motor vehicle accidents
• Machinery issues

Across New York State, nursing homes, warehouses, hospitals, food manufacturing, and hotels have the highest incidence of workplace injuries. Immigrants and Latinx workers suffer higher than average injury rates across New York State. Immigrants hold over a third of all jobs in low-wage, high-injury-prone industries according to the New York Committee on Occupational Safety and Health.

Have More Questions? Contact Pitta & Baione for Help Today

Pitta & Baione LLP has been by New Yorkers’ side for years. We protect our clients at every step of the way, strategizing for your interests and defending you against insurance companies and corporate interests that seek to take advantage of you. Our New York workers’ comp lawyers are skilled advocates who bring their legal training, education, and experience to serve our clients’ best interests.