NYS workers compensation laws: understanding your rights

NYS workers compensation laws: understanding your rights

If you are injured on the job in New York State, you may be entitled to workers’ compensation benefits. Workers’ compensation is a system that provides medical care, wage replacement, and disability benefits to workers who suffer work-related injuries or illnesses. In this article, we will explain some of the key aspects of NYS workers compensation laws and how they affect your rights as an injured worker. 

What are the eligibility requirements for workers’ compensation in New York? 

To be eligible for workers’ compensation benefits in New York, you must meet three basic criteria: 

• You must be an employee of a covered employer. Most employers in New York are required by law to have workers’ compensation insurance for their employees, but some exceptions apply, such as domestic workers, independent contractors, volunteers, and certain agricultural workers. 
• You must have a work-related injury or illness. This means that your injury or illness must arise out of and in the course of your employment. For example, if you slip and fall at your workplace, you may have a work-related injury. However, if you get injured while commuting to or from work, you may not have a work-related injury. 
• You must report your injury or illness to your employer and file a claim with the Workers’ Compensation Board. You must notify your employer in writing within 30 days of your injury or illness, and file a claim form (C-3) with the Board within two years of your injury or illness. 

What are the benefits available under workers’ compensation in New York? 

If you are eligible for workers’ compensation benefits in New York, you may receive the following types of benefits: 

• Medical care: You may receive reasonable and necessary medical treatment for your work-related injury or illness, as long as it is authorized by the Board or your employer’s insurance carrier. You may choose your own doctor from a list of authorized providers, unless your employer has a preferred provider organization (PPO) or an alternative dispute resolution (ADR) program. 
• Wage replacement: You may receive cash benefits to replace a portion of your lost wages due to your work-related injury or illness. The amount of cash benefits depends on your average weekly wage and the degree of your disability. The maximum weekly benefit rate for 2023 is $1,056.75. 
• Disability benefits: You may receive disability benefits if you are unable to work or have reduced earning capacity due to your work-related injury or illness. There are four categories of disability: temporary total disability, temporary partial disability, permanent total disability, and permanent partial disability. The duration and amount of disability benefits vary depending on your category and degree of disability. 
• Death benefits: If you die as a result of your work-related injury or illness, your surviving spouse and/or dependents may receive death benefits. The amount of death benefits depends on your average weekly wage and the number of dependents. The maximum weekly benefit rate for 2023 is $1,056.75. Your survivors may also receive funeral expenses up to $12,500. 

What are your rights and responsibilities as an injured worker in New York? 

As an injured worker in New York, you have certain rights and responsibilities under NYS workers compensation laws: 

• You have the right to file a claim for workers’ compensation benefits if you are injured or ill because of your job. 
• You have the right to receive medical care for your work-related injury or illness from a provider of your choice (unless your employer has a PPO or an ADR program). 
• You have the right to receive timely and accurate payments of cash and disability benefits according to the law. 
• You have the right to appeal any decision made by your employer’s insurance carrier or the Board regarding your claim. 
• You have the right to be represented by an attorney or a licensed representative at any stage of your claim. 
• You have the responsibility to report your injury or illness to your employer within 30 days and file a claim with the Board within two years. 
• You have the responsibility to follow the medical advice and treatment plan prescribed by your authorized provider. 
• You have the responsibility to attend any independent medical examinations (IMEs) requested by your employer’s insurance carrier or the Board. 
• You have the responsibility to cooperate with any investigations conducted by your employer’s insurance carrier or the Board regarding your claim. 
• You have the responsibility to notify your employer’s insurance carrier or the Board of any changes in your medical condition, employment status, or income. 

What is a work-related injury or illness? 

A work-related injury or illness is any physical or mental harm that occurs as a result of your work activities or conditions. This can include injuries caused by accidents, repetitive stress, exposure to hazardous substances, violence, or stress. It can also include occupational diseases that develop over time due to your work environment, such as lung cancer, hearing loss, or carpal tunnel syndrome. 

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How do I file a claim for workers’ compensation? 

If you suffer a work-related injury or illness, you should notify your employer as soon as possible, preferably in writing. You should also seek medical attention from a doctor who is authorized by the Workers’ Compensation Board (WCB) to treat injured workers. You will need to fill out a form called C-3 (Employee Claim) and submit it to the WCB within two years of your injury or illness. Your employer and your doctor will also need to file reports with the WCB. 

Common Injuries Covered by Workers’ Compensation 

Workers’ compensation covers a wide range of injuries and illnesses that are related to your job duties. Some of the most common injuries include: 

• Falls 
• Repetitive motion injuries 
• Carpal tunnel syndrome 
• Back injuries 
• Exposure to toxic chemicals 
• Hearing loss 
• Vision loss 
• Broken bones 

Workers’ Compensation and Pre-Existing Conditions 

If you have a pre-existing condition that is aggravated by your job duties, you may be entitled to workers’ compensation benefits. However, you must be able to show that your pre-existing condition was worsened by your job duties. If you have a pre-existing condition that is not related to your job duties, you may not be entitled to workers’ compensation benefits. 

NYS Workers’ Compensation Dispute Resolution Process 

If you are involved in a dispute related to your workers’ compensation claim, there are several steps you can take to resolve the issue. These include: 

• Contacting your employer to discuss the issue 
• Filing a dispute resolution request with the Workers’ Compensation Board 
• Requesting a hearing before a Workers’ Compensation Law Judge 
• Appealing a decision by the Workers’ Compensation Board 

How long does the process take? 

The processing time for a workers’ compensation claim in the state of New York is not predetermined and can fluctuate based on several factors. In the event that the claim is not approved or denied within a week, the insurance provider will commence disbursing benefits within eighteen days of receiving the Employer’s Report. After approval of the claim, the insurer will issue payments bi-weekly. Additionally, your doctor will be required to submit a progress report to the Board every 45 days. 

Conclusion 

The NYS Workers’ Compensation Law is designed to protect employees who are injured or become ill while performing their duties. If you are injured on the job, it is important to understand your rights under the law and take the necessary steps to file a claim for benefits. With the help of the New York State Workers’ Compensation Board, you can receive the medical care and lost wages you need to recover from your injury or illness. 

FAQs 

1. What should I do if I am injured on the job? 

If you are injured on the job, you should notify your employer as soon as possible and seek medical attention. You should also file a claim for workers’ compensation benefits. 

2. What benefits am I entitled to under the NYS Workers’ Compensation Law? 

You may be entitled to medical care, cash benefits to replace lost wages, compensation for permanent impairments or disabilities, and vocational rehabilitation to help you return to work. 

3. How do I file a claim for workers’ compensation benefits? 

You should complete a claim form provided by your employer and return it within 30 days of your injury or illness. 

4. How long do I have to file a claim for workers’ compensation benefits? 

You must file a claim for workers’ compensation benefits within two years of your injury or illness. 

5. Can I choose my own doctor for treatment? 

Yes, you have the right to choose your own doctor for treatment under the NYS Workers’ Compensation Law. 

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Where can I get more information about workers’ compensation? 

For more information about workers’ compensation in New York State, you can visit the WCB website at www.wcb.ny.gov or call 1-877-632-4996. You can also contact a workers’ compensation attorney who can advise you on your rights and options. 

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