FAQs
Faqs workers’ compensation – understanding workers’ compensation
What is workers' compensation?
Workers’ compensation benefits are available to employees of New York businesses for any injuries or illnesses caused by their work. These benefits include wage replacement, coverage for necessary medical treatment, and reimbursement for any out-of-pocket medical expenses associated with the injury or condition. Workers’ compensation benefits are intended to be provided promptly without the need to prove who is at fault for the injury or condition.
Who is covered by workers' compensation?
While states laws vary, New York requires nearly all employers to provide workers’ compensation coverage for their employees. If you are an employee working in New York, you are almost certainly covered under workers’ comp.
What should I do if I was hurt at work?
Though it can be an intimidating thought, you should alert your employer as soon as possible. Failure to notify your employer within 30 days from the time you become aware of your injury or condition MAY jeopardize your eligibility for workers’ compensation benefits. You should also obtain medical treatment as necessary and keep all medical bills or related receipts. You should inform your medical provider that your injury is work-related.
How long do I have to file a claim for workers’ comp?
Some injuries are not the result of a trauma or accident but occur over time. These types of injuries are generally known as “occupational” or “repetitive stress” injuries. In these cases, a claimant has two years to file a claim from the date they knew or should have known that their condition was related to some aspect of their work. You will need to fill out the Employee Claim form (C-3). This can be completed online, over the phone (1-866-396-8314), or by filing a paper form by mail or in person at any Workers’ Compensation Board customer service or district office. You should be notified through the mail if any action is taken in regard to your workers’ compensation claim.
Is it hard to make a workers' compensation claim?
The paperwork involved in this process can be complicated and difficult. Many individuals choose to use an attorney to fight for compensation, as dealing with the injury and trying to get back to good health is more important than trying to navigate a complex system. At Hinman, Howard & Kattell, our team can pursue the claim on your behalf, allowing you to concentrate on your recovery.
Does my employer have to hold my job open or accommodate my disability, if I get hurt at work?
Generally, no. Depending on the number of employees, however, employers may be required to comply with the mandates of FMLA and temporarily hold an employee’s position. Some employers are also obligated to either hold an injured worker’s position open or accommodate an injured worker’s limitations through an employee benefit program (usually outlined in an employee handbook), through collective bargaining (union), or individual employment contracts.
Should I hire an attorney now, or wait and see how things go?
We recommend that every injured worker obtain a free case review. We can help by informing you of your rights. If you choose to retain us, we can protect your interests in the event of lost time from work or reduction in earning capacity, and pursue payment of medical bills. The real benefit to hiring a skilled, experienced attorney promptly is that he or she will be in a better position to keep your case on track and avoid common errors that can require significant effort to fix later on in your case.
Our family has an attorney; Does it matter if I hire an attorney who does not practice workers’ compensation law or social security disability (SSD) law on a regular basis?
Workers’ Comp and SSD are areas of the law that have unique processes in terms of administration and practice. A lawyer who knows the procedural and substantive aspects of areas like workers’ compensation disability claims and social security law will be better able to explain your options and maximize your benefits.
Faqs workers’ compensation – Lost wages and medical bills
Can I recover my lost income?
In most workers’ compensation cases, insurance carriers and certain employers are required to compensate injured workers for income that was lost due to the injury. However, there are cases in which the injured individual does not receive the lost income, for a variety of reasons. Our team can help you recover your lost income and ensure that you receive the benefits to which you are entitled.
I was hurt and can't make a living. what do I do?
Work-related injuries are very common in New York, and the legal team at Hinman, Howard & Kattell, LLP has helped thousands of clients get the most compensation that is available under the law for such accidents.
If I am unable to go back to work or make as much as I did prior to the injury, am I entitled to wage replacement?
Yes. In most cases, permanent head, neck, and back injuries (and serious appendage injuries) provide wage replacement if you make less money than you did before the accident.
If I am permanently unable to return to work, am I also entitled to disability retirement benefits through my place of employment?
If you are unable to return to your past work, you may be entitled to long-term disability or disability retirement benefits. You should contact your employer regarding all sources of potential benefits to determine what benefits you may have available. The attorneys at Hinman, Howard & Kattell have experience in coordinating these benefits.
How much can I expect to get as a settlement?
In some cases, an injured worker chooses to waive certain rights to which they are entitled, such as lost wage and medical benefits, in exchange for a lump-sum settlement from the insurance carrier. Each case has unique circumstances. Depending upon the nature of the injury, the amount available for settlement can vary greatly. In cases where the injuries suffered were catastrophic, such as paralysis, the amount received can be substantial. Others are less extreme. The attorneys at Hinman, Howard & Kattell have substantial experience in counseling clients on whether settlement is appropriate and negotiating favorable settlements with insurance carriers and employers.
If I am injured at work, what medical bills are paid?
As a general rule, all medical bills related to the work injury or injuries are covered by the workers’ compensation insurance carrier for life. Insurance carriers and employers sometimes object to medical treatment and dispute whether treatment is actually related to the work injury, or is medically necessary. The attorneys at Hinman, Howard & Kattell are skilled and experienced in advocating the treatment plan that their clients have agreed upon with their doctors. In most cases, unless you make a full and final settlement of your case, your right to continued medical coverage of costs continues.
Will an attorney help me get my medical bills paid?
Yes. Our attorneys and qualified staff can help obtain payments of medical bills for our clients, including physician, hospital, and prescription reimbursements.
Is the insurance company responsible for prescription medications caused by my work injury?
Yes. The workers’ compensation insurance carrier is liable for necessary prescription medications along with other medical treatment. You can also receive reimbursement for out-of-pocket expenses for your prescription medications when necessary.
Should I contact a lawyer even if I do not lose time from work?
Yes. Even if you do not lose time from work, you may be entitled to a money award for loss of use of an appendage (finger, hand, elbow, shoulder, toe, foot, knee, or hip) or lost hearing, lost vision, or facial scarring. Even if you do not receive a monetary award, it is still beneficial to make sure your case is filed correctly because this can provide protection that otherwise would not exist.
How much does it cost to hire a lawyer?
All attorney fees in a workers’ compensation case are subject to approval by the Workers’ Compensation Board. You will not be charged anything out of pocket for our representation. Attorney fees are withheld from your workers’ compensation benefits and paid directly from the insurance company. Attorney fees may vary depending on the amount of time expended, the work performed and the result obtained. If no money is being paid to you, there is no attorney fee requested or granted.
Faqs workers’ compensation – My claim has been denied
Why was my claim denied?
When the paperwork for a workers’ compensation claim is missing information, it can be denied. There may be other factors that result in a claim being denied. Don’t take “no” for an answer. Attorneys at Hinman, Howard & Kattell can review and evaluate your case and help navigate you through the process.
What do I do if the insurance company denies my case?
You should immediately contact a qualified attorney for legal representation. You also should make sure a qualified physician has filed reports supporting your claim. This ensures that a hearing can be arranged before a Workers’ Compensation Judge without delay.
If my case is denied, do I qualify for any benefit while my case is being decided?
You may be entitled to short-term disability or unemployment insurance. You should contact an attorney to discuss additional benefits to which you may be entitled.
Faqs workers’ compensation – Hearing
Should I attend my workers' compensation hearings?
Usually yes, but in many situations we can appear in your place. We would need a phone number where you can be reached in the event any question arises that only you can answer.
If I do not attend a hearing, how will I know what decision is made?
You can expect to receive a Notice of Decision from the Workers’ Compensation Board within 2 weeks from the date of the hearing. We usually contact you after the hearing to report the results of the hearing and you can call our office the day following the hearing to obtain information on your case.
Faqs workers’ compensation – Other actions
Can I sue my employer for Injuries I sustain at work?
For the vast majority of injured workers, the answer is “NO.” In only very rare and limited situations are injured workers allowed to sue their employer. NYS Workers’ Compensation Law is a “no-fault” insurance system where injured workers are not required to show that someone else is legally responsible for their injury. The Workers’ Compensation Law also provides protections to employers. The greatest benefit to employers is the fact that an injured worker cannot sue them for negligence even if the injured worker could prove negligence in a court of law. It may be possible, however, to sue a negligent third party (other than your employer or a co-employee) for damages in addition to pursuing a workers’ compensation claim against your employer.
Faqs workers’ compensation – Other benefits
If I receive workers' compensation, am I also entitled to unemployment Insurance benefits if I am unable to return to my regular employment?
Possibly. If you are released to perform restricted work but your employer will not accommodate your restrictions, you should contact unemployment insurance to determine if you are eligible to obtain supplemental benefits.
What additional rights do I have if I am Injured In a motor vehicle accident at work?
Typically, no-fault insurance will make a supplemental payment between your Workers’ Compensation and 80% of your anticipated wages, along with additional benefits. In such case, you should file for no-fault benefits immediately.
If I receive workers' compensation, am I also entitled to social security disability benefits?
If you are unable to return to work for more than one year, you may be entitled to Social Security Disability benefits in addition to workers’ compensation benefits.
If I get a schedule loss of use award, does that close my case forever?
No. An award for a percentage loss of use is not a settlement of your case. It is a payment based upon your loss of use at the time of evaluation. You can continue to be covered for medical bills for the rest of your life. Within varying time limitations, you may be eligible for a re-evaluation in the event your condition worsens. All cases should be reviewed periodically.
Can I go for vocational retraining after an injury?
Yes. You may be entitled to retraining through Acces-VR (Adult Career and Continuing Education Services-Vocational Rehabilitation), a New York State vocational training office.