Situations That May Affect The Calculation Of Aww
- If you only work for part of the year at one job, and work part of the year at another.
- If you work less than four days per week.
- If you did not substantially work a full year before your injury.
- Wage expectancy consideration may be given if you were less than 25 years old on the date that the injury occurred. You might be entitled to an AWW that is higher than the one set by applying the formula to the Employer’s Statement of Wage Earnings Preceding Date of Accident .
- If you were working for more than one employer at the time you were injured, you might be entitled to have your AWW set by adding both weekly salaries together. This may be called concurrent or dual employment, depending upon the circumstances.
What Types Of Injuries Are Covered By New York Workers Comp
New York state law determines exactly what types of injuries are covered by workers comp insurance, but there are general guidelines that can help employers understand what typically qualifies for a workers comp claim.
The types of injuries typically covered by workers comp are:
- Injuries that are not the result of intentional self-harm or harm from drug use, alcohol use, or fighting
- Injuries that fall within the general course and scope of the workers employment, such as long-term occupational injuries, including back strain from repetitive motion
For more information about the workers comp claim process, visit our learning center.
Can I Also Sue My Employer Or A Third Party For An On
In most cases, you cant sue your employer for your workplace injury. Workers trade the right to sue their employer in exchange for the employer, giving up most of the legal defenses that used to be available to employers.
Because of the trade discussed above, workers compensation benefits are considered the exclusive remedyor only option for recovery against your employer for an on-the-job injury.
This rule does not apply where the employer causes intentional injury or fails to provide workers compensation insurance. In these cases, you have the right to sue the employer and can recover damages over what would have been allowable from a workers compensation claim.
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Can A Nurse Case Manager From The Insurance Company Come With Me To See My Own Doctor
Only if you let them!You are entitled to your medical privacy with your own doctor.We don’t suggest nurse case managers come to the doctor’s office, much less invade the examination room. They should not be allowed to call your doctor directly or fax him/her forms as they might end up hurting your case.
Who Are Exempt From Workers Compensation Insurance In New York
All employers in the New York state are required to provide workers comp coverage. Some exemptions include:
- Certain real estate salespeople, media sales representatives, insurance agents and brokers who work under a contract that defines them as independent contractors
- Coaches and supervisors of athletic teams operated on a nonprofit basis as long as they arent professional athletes or work for a professional athletic organization
- People who volunteer their time and services to nonprofit organizations and are not compensated for it
- People who work in religion, including:
- Duly ordained, commissioned, or licensed ministers, priests, and rabbis
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How To File A Workers Comp Claim In New York
Its a good rule of thumb to notify your supervisor and your companys human resources department as soon as possible when you realize you have a work-related injury or illness assuming, of course, your injury is not catastrophic.
Always seek medical attention in cases of emergency such as a broken leg or torn muscle, for instance, as opposed to slow-onset carpal tunnel syndrome. Your survival and recovery are more important than the paper trail demanded by bureaucracy. Well talk about notification deadlines below.
Workers compensation is overseen by the New York State Workers Compensation Board, aka, The Board, with headquarters in Schenectady.
Begin the process by filing a C-3 employee claim form online. You also may acquire paper forms through your employer or the NYS Workers Compensation Board. If you lack access to a computer, you can visit any of the nine statewide Workers Compensation Board offices or satellite service centers to file a claim.
Need the customer service toll-free number? Its 632-4996. Thats also the go-to number to get language help.
Paper forms can be mailed to The Board:
NYS Workers Compensation BoardBinghamton, NY 13902-5205
Scanned forms and related digitized documents can be emailed: .
A word of caution: Read through the form first before you begin filling it out. You may have questions about the questions that are answered as you work your way to the end.
Some of what you will need to complete the form:
Medical Benefits And Workers’ Compensation
Since you have been injured, you will definitely require medical treatment. The New York State Workers’ Compensation Board states, “The injured or ill worker who is eligible for workers’ compensation will receive necessary medical care directly related to the original injury or illness and the recovery from his/her disability.”
New York law requires that your employer’s insurance carrier pay for your medical treatment for the injury. However, it is worth noting that you cannot just get your medical treatment from anywhere – you have to get medical treatment from a health care provider that has been authorized by the Workers’ Compensation Board. Typically, you will be directed by your employer and/or your employer’s insurance company to go seek medical care from a specific provider or location. The insurance carrier will only pay your medical bills if you get treatment at an approved health care provider.
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What If I Already Have An Ongoing Claim
Simply fill out the inquiry form on this website, and we will then forward to you a form 110a for your signature. This will allow us to access your New York state workers compensation file so we may review it in detail. We will then contact you within 72 hours of the receipt of the 110a and then knowledgeably discuss your case in detail and provide you an informed opinion. Should you not wish to retain our firm, there is no fee or obligation resulting from our review of your file.
Are Workers’ Compensation Hearings In New York Open To The Public
Yes, they are public hearings. You can sit in on the hearing. However, individual judges may ask you to identify who you are and why you are there. If you are attending a hearing with a friend or family member you can advise the judge of that. If you may potentially be a witness in a case, then the Judge will likely ask you to sit outside the hearing room until you are called to testify.
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My Doctor Has Requested Authorization For Treatment That Has Been Denied By The Carrier What Can I Do
If the carrier wants to object to certain medical treatment, they must do so based upon a report from their medical consultant indicating that the treatment is either not needed or not causally related to this accident. In the event they obtain such documentation this question will normally be presented to an administrative law judge who may require the deposition of the doctors involved.
Why Did The Insurance Company Reduce My Check If I’ve Been Injured On The Job
YOUR CHECK WAS REDUCED BECAUSE THAT’S HOW THE INSURANCE COMPANY SAVES MONEY EVEN IF YOU ARE STILL DISABLED.
Often times it is clear that you are disabled because of a job accident. However, just because you have a legitimate injury and disability does not mean that the insurance company or the workers’ compensation board will allow payments to you!There are many reasons why your weekly benefit check could and often is reduced, such as:
Remember: It makes sense that you should receive a benefit if you are disabled, unfortunately, the workers’ compensation law is a vast administrative/bureaucratic system that turns on the smallest facts and often does not consider the needs of the actual injured worker!
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What Types Of Work
Under New York law, employers are required to provide workers compensation for all employees through an insurance plan or via self-insurance.
Additionally, New York workers compensation states that injured workers’ are entitled to receive benefits for any type of injury, regardless of what caused the injury.
Therefore, all types of workplace injuries can qualify for workers compensation. Some of the most common types of injuries that we help with include:
Did you suffer an injury not included above? Don’t worry.
We represent all injured workers in New York regardless of the type of injury sustained.
To learn more about specific work-related injuries click here.
How Long Can I Claim Workers Comp Benefits Under New York Law
Suppose the workplace accident or date of disablement was on or after March 13, 2007. In that case, the maximum number of weeks that benefits are payable is determined by the employees loss of wage-earning capacity. The New State Workers Compensation Board provides the following maximum time limits for cash benefits per percentage of wage-earning loss:
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What Is The Best Thing I Can Do To Ensure That I Received My Full Benefits
Level the field, and put our experience on your side. Contact our office and give us the opportunity to review your file in detail to see if we can be of assistance.
Disclaimer: Prior results cannot and do not guarantee a similar outcome with respect to any future matter, including yours, in which a lawyer or law firm may be retained.
In the absence of a recovery, no fee will be charged, and you are not responsible to repay Silverman, Silverman & Seligman, P.C., for the expenses and disbursements incurred.
Contingent fee rate is computed after deduction of costs, disbursements and other expenses of litigation.
How Long Does It Take To Settle A Workers Comp Case In Ny
The clearance procedure from CMS can take anything from four to eight months all by itself. Even in the event that all parties reach an agreement over the amount of the settlement, the MSA/CMS process may still need to be carried out. This procedure will add many months of delay to the final settlement.
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Can You Get Workers’ Comp Benefits In New York For Covid
COVID-19 might be covered by workers’ comp as an occupational disease if you can show that you were exposed to the coronavirus because of the particular nature of your job. As the New York Workers’ Compensation Board has explained in a Q& A on COVID-19, you’re more likely to get benefits if the risk of exposure is “significantly higher” at your workplace. Healthcare workers and first responders are the most obvious examples of employees at higher risk, but the WCB also noted that workers in other occupationsincluding transportation and food serviceinteract closely with the public in places where there has been documented exposure to the coronavirus.
Even if you couldn’t meet the standard for an occupational disease, you might get workers’ comp benefits for COVID-19 if you could prove there was a particular exposure event, such as an interaction with a sick coworker or an outbreak at your workplace. In the past, New York courts have treated infectious illnesses as accidental injuries under certain limited circumstancessuch as when a correctional officer got tuberculosis after repeated contact with a TB-infected inmate, or when a teacher contracted mumps during a school-wide epidemic of the illness. Matter of McDonough v. Whitney Point Cent. School, 15 A.D.2d 191 .) However, it’s not clear how those cases would apply in the context of a pandemic, where the disease is widespread in the community.
How Much Should I Settle For
Each claim is different, and there is no one formula to determine how much your claim is worth.
It may be advisable to consult with a competent New York workers compensation attorney before agreeing to any settlement, especially a Section 32 Waiver, of your workers compensation claim.
Your attorney will take into account: the nature and severity of the injury the strength of any defenses raised by the insurance company the likelihood you will be able to return to gainful employment the likelihood you will need future medical or other care, and awards and settlements in similar claims.
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Should I Settle My Workers Compensation Case
This is one of the toughest questions in workers compensation and should not be undertaken lightly. In virtually all instances, the settlement of a compensation case under Section 32 of the workers compensation law will conclude the carriers obligation to pay additional compensation or medical benefits. This should be discussed with your attorney in detail, as there are many factors to be considered, including anticipated future medical expenses, the extent of ones disability, possible anticipated return to work, Social Security Disability benefits, etc. Silverman, Silverman & Seligman, P.C., has a great deal of experience in negotiating settlements on behalf of injured workers. We will be happy to discuss your particular situation in detail with you.
How Much Does Workers’ Compensation Pay
When you file for a workers compensation claim, you are entitled to receive two-thirds of your Average Weekly Wage and the Maximum Benefit.
Why are you limited in the amount of workers compensation benefits you receive?
The idea is that two-thirds of your average wage would be the equivalent of your take-home pay since workers compensation is not a taxable benefit. Said in another way, if you were earning $600.00 a week you may take home $400.00 a week.
However, there are limits on the total amount of compensation that you can receive in New York. For more information on the amount of Workers’ Compensation benefits, you may be able to receive in New York, click here.
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If Im Getting Workers Compensation Am I Entitled To Receive Cash Compensation From Another Party
Under certain circumstances, in addition to your Workers Compensation claim, you may have the right to sue another party for personal injuries if their negligence contributed to your injury. When you contact FOAs experienced New York workers comp attorneys, we automatically look at every workers compensation case to see if there is also a possible third-party personal injury case.
How Long Can I Be Covered Under A Workers Compensation Claim In New York
If you work in New York and are injured on the job, you may be entitled to workers compensation benefits. There are many different kinds of benefits you may qualify for under a workers compensation claim, and how long you can receive benefits will depend on the injury. In New York, the amount of time you are eligible for workers compensation benefits depends on the type of injury and how permanent it is. According to New York law, benefits for injuries after March 13, 2007, are capped at a maximum number of weeks, regardless of the severity of the injury or the loss of wage-earning capacity. It is critical to work with an experienced Workers Compensation attorney to ensure you obtain the maximum benefits you are entitled to under the law.
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Is Occupational Disease Or Illness Like Silicosis Or Black Lung Covered
Yes. The New York workers compensation laws cover an occupational disease. The disease or illness must be primarily caused by the work to be covered. Some common occupational diseases include hearing and vision loss, asbestosis in asbestos miners or remediation workers, bakers asthma, black lung in coal miners, HIV or hepatitis in health care workers, work-related chemical poisoning, and many other illnesses causally related to employment.
Once you show you have an occupational disease or illness, you are entitled to the same benefits as an industrial accident or work injury.
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