The goal of New York’s workers’ compensation system is to assist you in recovering from a work-related illness or accident by paying for some of your missed wages, providing medical care, and assisting you in returning to work. It is best for every worker to read more about workers’ compensation benefits in New York. In this article, Eastcoastlaws.com will explain the type of workers’ compensation benefits in New York and how they are calculated.
What are Workers’ Compensation Benefits in New York?
Workers’ compensation benefits in New York is a no-fault insurance program that provides medical, wage replacement, and death benefits to employees who are injured or become ill as a result of their job. These benefits are paid by the employer or their insurance carrier and are designed to help employees recover from work-related injuries or illnesses without the need to go to court. The specific benefits available in New York include medical expenses, temporary disability benefits, permanent disability benefits, and death benefits.
Medical Benefits for Workers’ Comp
Medical benefits for workers’ compensation in New York cover all reasonable and necessary medical expenses related to an employee’s work-related injury or illness. This includes hospital stays, doctor visits, prescription drugs, physical therapy, and other medical treatments. The employer or their insurance carrier is responsible for paying these costs, and the employee does not have to pay any out-of-pocket expenses. Additionally, if an injured employee needs to see a specialist or receive specialized treatment, the employer or insurance carrier must approve and pay for these services. The goal of medical benefits in New York’s workers’ compensation system is to help employees recover from their injuries and return to work as soon as possible.
Temporary Disability Benefits in New York
Temporary disability benefits in New York provide wage replacement to employees who are unable to work due to a work-related injury or illness. These benefits are intended to provide financial support to employees while they are recovering and unable to work. The amount of temporary disability benefits an employee may receive is typically two-thirds of their average weekly wage, up to a state-determined maximum.
To be eligible for temporary disability benefits, an employee must be unable to perform their regular job duties due to their injury or illness, and the injury or illness must be work-related. The employee must also provide medical documentation of their condition and disability to the employer or insurance carrier.
Temporary disability benefits are typically paid for a maximum of 26 weeks, although in some cases, the duration may be extended if the employee’s recovery is ongoing. The goal of temporary disability benefits is to provide financial support to employees during their recovery, so they can focus on getting better and returning to work.
Total Temporary Disability
Your temporary disability payments, up to a maximum amount, will be equal to two-thirds of your average weekly wage if your doctor certifies that you are temporarily 100% handicapped. Depending on the date of your injury, there is a legal maximum. Ex: The maximum weekly compensation for injuries sustained between July 1, 2020, and June 30, 2021, is $966.78. (The New York Workers’ Compensation Board (WCB) maintains an updated list of the maximums on its website for additional injury dates.)
Partial Temporary Disability
You are eligible for partial temporary disability payments if you can work to some extent while healing from your injuries but are unable to return to your full pre-injury job (and the associated pay). Two-thirds of the gap between your typical weekly pay and your existing earning capability will be covered by these benefits (up to the same cap mentioned above).
Your earning capability is typically determined by how much money you actually make for this reason. For instance, if your average weekly salary was $900 and you were working a part-time job that paid $300, you could get paid the difference of two-thirds ($600), or $400 every week. The WCB may, however, assign you an earning capacity that is appropriate in the circumstances if you are not working at all, such as if your employer has not provided you with a light-duty position that accommodates your partial impairment (but not more than 75% of your pre-injury wages).
Permanent Total Disability Benefits
Your doctor will assess you to determine whether your injury has left you with lasting limits once your medical condition has stabilized to the point where it wouldn’t improve even with more treatment (a stage known as “maximum medical improvement”). If the doctor certifies that you are completely handicapped, you will be paid two-thirds of your typical weekly income for as long as you are disabled.
Due to your limits, you are typically unable to work at all. However, wounded workers who have specific sorts of disabilities (such as the loss of both eyes, legs, or limbs) may be permitted to work a limited number of hours while still receiving disability benefits.
Permanent Partial Disability Benefits
Depending on the body parts affected, New York offers three distinct ways to distribute payments for permanent partial disability.
Scheduled Loss-of-Use Awards
A schedule for calculating permanent partial disability benefits for hurt workers who can no longer utilize certain bodily parts is included in New York law (eyes, ears, and parts of the upper and lower limbs). You will get two-thirds of your typical weekly income (up to the legal limit) for the specified number of weeks, multiplied by the percentage of your lost use if you have lost some use of one of these bodily parts permanently. The timeline, for instance, places a hand’s complete loss of function at 244 weeks. You would be paid for 122 weeks if you have only lost 50% of your use.
Instead of receiving cash each week, you can ask for a one-time reimbursement. Your award is reduced by any cash benefits you have previously received.
You may be eligible for permanent partial disability compensation if you have a permanent impairment to your spine, head, organs, or another portion of your body not included on the schedule. The compensation will be equal to two-thirds of the difference between your typical weekly wage prior to the injury and your current earning potential (as determined based on your specific disability and state guidelines). According to a calculation in New York law, the maximum number of weeks you can get these benefits will depend on the proportion of your lost earning potential. For instance, if you’ve lost 91% of your earning capacity, you’ll only be eligible for benefits for no more than 500 weeks; if you’ve lost 15% of your earning capacity, you’ll only be eligible for benefits for no more than 225 weeks.
If your injury resulted in a serious, permanent disfigurement of your face, head, or neck, or if a workers’ compensation judge determined that the disfigurement of certain other parts of your body could impair your ability to earn a living, you might be eligible for an additional award of up to $20,000.
New York workers’ compensation also provides additional benefits, including:
- Vocational rehabilitation. If you can’t return to your former job because of your injury, you may be eligible for a vocational rehabilitation program or job placement services.
- Death Benefits. When an employee dies as a result of a work-related injury in New York, the surviving spouse, children, or other dependents may receive death benefits, according to a formula based on the number of surviving children. Workers’ compensation will also pay reasonable funeral expenses for the deceased employee, up to a maximum that depends on the county.
Limitations of Workers’ Comp Benefits
By now, it should be clear that workers’ compensation will not fully cover all of your losses. Although it may appear harsh, this is a trade-off for employees’ compensation: You don’t need to demonstrate that your employer was at fault for the injury in order to collect compensation very fast. However, you typically aren’t permitted to file a lawsuit against your employer in an effort to recover the full amount of your lost wages as well as other damages like pain and suffering.
However, there are a few specific situations in which you might be allowed to file a lawsuit for a workplace accident outside of the workers’ compensation system. Consider speaking with a workers’ compensation lawyer if you think your situation might fall under one of these exclusions or if you’re having problems getting workers’ compensation benefits. A competent lawyer in this field can clarify how the law pertains to your circumstance and make sure you receive the recompense you are due.