When an employee is injured on the job, the process of applying for worker’s compensation can be confusing and overwhelming. This is particularly true for those living and working in the state of New York. The state’s worker’s compensation system is designed to provide financial support and medical benefits to employees who have been injured or become ill as a result of their job. However, the application process can be complicated and time-consuming, requiring individuals to navigate a variety of forms and procedures. In this article, Eastcoastlaws.com will provide an overview of the worker’s compensation system in New York and offer guidance on how to apply for benefits. We will explore the eligibility criteria, the different types of benefits available, and the steps involved in filing a claim. By understanding the worker’s compensation system in New York, employees can ensure that they receive the support they need during difficult times.
How Does Workers’ Comp Work In New York
Workers’ compensation is a system designed to provide benefits to employees who have suffered injuries or illnesses on the job. In New York, the workers’ compensation program is administered by the New York State Workers’ Compensation Board. Here is how workers’ comp works in New York.
- Employer Coverage: In New York, most employers are required to provide workers’ compensation coverage for their employees. This coverage includes all full-time and part-time employees, including minors and undocumented workers. Self-employed individuals can also purchase workers’ compensation insurance to cover themselves.
- Reporting Injuries: Employees who have suffered an injury or illness on the job must report the incident to their employer within 30 days of the occurrence. Failure to report within 30 days can result in the denial of benefits. The employer must then report the incident to the workers’ compensation insurance carrier within 10 days. This will initiate the workers’ compensation claim process.
- Claim Process: Once the workers’ compensation insurance carrier has been notified of the injury, they will investigate the claim to determine its validity. The insurance carrier may request additional information, such as medical records or witness statements, to evaluate the claim. If the claim is accepted, the insurance carrier will provide the injured employee with benefits.
- Benefits: In New York, workers’ compensation benefits include payment for medical treatment related to the injury or illness, temporary total disability benefits, permanent partial disability benefits, and permanent total disability benefits. The amount of benefits varies depending on the severity of the injury and the employee’s average weekly wage.
- Appeals Process: If an employee’s claim is denied, they have the right to appeal the decision through the New York State Workers’ Compensation Board. The appeals process involves a hearing in front of a workers’ compensation law judge. The judge will review the evidence and make a determination on the claim.
- Penalties: Employers who fail to provide workers’ compensation coverage can face penalties, including fines and criminal charges. Employees who fail to report a workplace injury within the 30-day time frame may lose their right to workers’ compensation benefits.
What Are The Requirements To Qualify To File A Workers’ Compensation Claim In New York?
In order to qualify to file a workers’ compensation claim in New York, an employee must meet the following requirements:
- The person must be an employee: Only employees are covered under workers’ compensation laws in New York. Independent contractors and volunteers are not eligible.
- The injury or illness must be work-related: The injury or illness must have occurred while the employee was performing work-related duties. This includes injuries that occur on the employer’s premises, during business travel, or while using equipment provided by the employer.
- The employee must notify the employer: The employee must notify their employer of the injury or illness within 30 days of the incident. Failure to provide timely notice may result in the loss of workers’ compensation benefits.
- The employer must have workers’ compensation insurance: In New York, most employers are required to carry workers’ compensation insurance. If the employer does not have insurance, the employee may be able to file a claim with the New York State Uninsured Employers Fund.
- The claim must be filed within the time limit: In New York, workers’ compensation claims must be filed within two years of the date of the injury or illness, or within two years of the date when the employee knew or should have known that the injury or illness was work-related.
It’s important to note that some industries have specific requirements or exceptions for workers’ compensation coverage. For example, farm workers have specific eligibility criteria, and volunteer firefighters and ambulance workers are eligible for certain benefits. If you have questions about your eligibility for workers’ compensation in New York, it’s recommended that you speak with an attorney or the New York State Workers’ Compensation Board.
Exceptions To NYS Workers’ Compensation Requirements
While most employers in New York are required to provide workers’ compensation insurance to their employees, there are some exceptions to this requirement. Here are some common exceptions to the NYS workers’ compensation requirements:
- Sole Proprietors: Sole proprietors are not required to carry workers’ compensation insurance for themselves. However, if they have employees, they must provide workers’ compensation coverage for those employees.
- Business Owners Who are Corporate Officers: Business owners who are officers of a corporation may choose to exclude themselves from workers’ compensation coverage. However, if they choose to be covered, they must provide coverage for all other employees.
- Family Members: Family members of a sole proprietor or partnership are not required to be covered by workers’ compensation insurance. However, if they are employees, they may choose to be covered.
- Farm Workers: Farm workers are covered by workers’ compensation insurance, but there are some specific eligibility criteria that apply to them. For example, farm workers must have worked a certain number of days or earned a certain amount of money to be eligible for coverage.
- Volunteer Workers: Volunteer workers are not typically covered by workers’ compensation insurance. However, certain volunteer firefighters and ambulance workers are eligible for certain benefits.
- Federal Employees: Federal employees are covered by a separate workers’ compensation program, which is administered by the federal government.
It’s important to note that even if an employer is exempt from the workers’ compensation insurance requirement, they may still choose to provide coverage for their employees. If you have questions about your eligibility for workers’ compensation in New York, it’s recommended that you speak with an attorney or the New York State Workers’ Compensation Board.
What Is Covered By New York State Workers’ Compensation?
No matter where small business owners choose to get coverage in the state of New York, workers’ compensation benefits can help cover:
- Medical expenses for sick or injured workers who become ill or hurt from their job
- Repetitive stress injuries, like carpal tunnel or tendonitis
- Lost wages if your employee misses work while recovering from a work-related injury or illness
- Funeral costs if your employee loses their life in a work accident or from an illness caused by their work
- Ongoing medical treatment, like physical therapy
- Disability benefits if a work-related injury or illness causes a temporary or permanent disability and your employee can’t return to work
How To Apply For Worker’s Compensation In New York
If you have been injured or become ill due to your work in New York, you may be eligible for workers’ compensation benefits. Here are the steps to apply for workers’ compensation in New York:
- Report your injury or illness to your employer: As soon as you become aware of your work-related injury or illness, report it to your employer in writing. Your employer should then provide you with a workers’ compensation claim form (Form C-3) and instructions for completing it.
- Complete the claim form: Complete the claim form as soon as possible and submit it to the Workers’ Compensation Board (WCB) either online, by mail, or in person. Along with the form, you should also submit any medical records or other supporting documents related to your injury or illness.
- Wait for a decision: After your claim has been submitted, the WCB will review your case and make a decision about your eligibility for workers’ compensation benefits. This process can take several weeks, and you may be required to attend a hearing or provide additional information.
- Receive benefits: If your claim is approved, you will receive workers’ compensation benefits, which may include medical care, cash benefits for lost wages, and other related expenses. If your claim is denied, you have the right to appeal the decision.
Call: 866-396-8314. A Board representative will take your information and complete the C-3 form.
Submit a paper C-3 form. You can get a paper form from your employer or from the NYS Workers’ Compensation Board.
What You Need To Apply For Workers Compensation Claims
- Your contact information
- Basic employment information such as employer name and address, your job title and duties, and your gross pay rate
- How the injury happened, where you were and what you were doing when it occurred (with as much detail as possible), and if you reported it to your employer
- The nature of the injury/illness, the parts of the body affected, whether you received treatment, and if you lost time from work
Contact one of the bureaus or offices at http://www.wcb.ny.gov/content/main/Contact.jsp#bureauOfficeContactInfo Monday, Thursday, Friday 8:30AM-4:30PM and Tuesday, Wednesday 8:30AM-6:00PM.
How Much Does Workers’ Comp Pay In NY?
The amount of workers’ compensation benefits you can receive in New York depends on the severity of your injury, the extent of your disability, and other factors. Here are some general guidelines for how workers’ compensation pays in New York:
- Medical care: Workers’ compensation in New York covers all necessary medical care related to your work-related injury or illness. This includes doctor visits, hospitalizations, surgeries, and prescription medications. There is no limit to the amount of medical care that can be provided.
- Cash benefits for lost wages: If you are unable to work due to your work-related injury or illness, you may be eligible for cash benefits for lost wages. The amount of these benefits is calculated based on your average weekly wage (AWW) before the injury, up to a maximum set by law. For injuries that occurred after July 1, 2021, the maximum weekly benefit is $978.96, and the minimum is $150.
- Permanent partial disability: If you have a permanent partial disability, meaning that you are able to work but have a permanent impairment, you may be eligible for a cash benefit. The amount of this benefit is based on the severity of your impairment and is calculated using a schedule set by law.
- Total disability: If you are totally disabled and unable to work, you may be eligible for weekly cash benefits equal to two-thirds of your AWW, up to the maximum set by law. For injuries that occurred after July 1, 2021, the maximum weekly benefit for total disability is $978.96.
- Death benefits: If an employee dies as a result of a work-related injury or illness, their dependents may be eligible for death benefits. These benefits are typically two-thirds of the employee’s AWW, up to the maximum set by law.