When Does Workers’ Comp Start Paying in New York?

4 mins reading time

An injury on the job due to an accident or contracting an illness due to an unhealthy exposure to a substance at work can be frightening. This is especially true if you are unable to work for an extended length of time due to your condition. Fortunately, New York State has labor laws to protect you, so you do not have to go without medical treatment or struggle with a total loss of income while you recover. The coverage for these benefits is called workers’ compensation. Workers’ comp is a valuable benefit, but the drawback is the application is complex, and the process to receive benefits can pose many challenges to workers looking to receive benefits.

Have you been hurt on the job? If you cannot perform your job due to a work-related injury, contact Terry Katz & Associates as soon as possible. New York’s application system in particular, and any errors or missing information on the application can delay or deny benefits. Our attorneys are highly experienced with filing workers’ compensation claims and will make sure your claim is filed completely and correctly. They will also help you understand your rights as an injured worker in New York State and what disability benefits you may also be eligible to receive.

Do I Have to Pay for Workers’ Comp?

Under New York State Labor Law §2 and 3, all employers operating in NYS are required to provide workers’ compensation coverage for their employees, with limited exceptions. Employees do not contribute to the cost of workers’ compensation insurance; insurance premiums are 100% paid for by employers. Workers’ comp benefits include cash benefits and medical care for employees who suffer an injury or become ill due to an accident or work-related conditions. Coverage is available for both full-time and part-time employees.

What is the Pay Schedule from Workers’ Comp?

To receive benefits, an injured worker must file a workers’ compensation claim. Once the employer or insurance carrier agrees that the injury or illness is work-related, they will approve the claim, and cash benefits will begin. However, many workers commonly find it difficult to be approved for benefits because their employers deny their claim. If this occurs, cash benefits will not  be paid until a workers’ compensation law judge makes a determination. In some cases, an employee is able to receive disability payments while a workers’ comp claim is under dispute. Still, the coverage will be subtracted by any money paid out from future compensation awards once approved.

The good news is if your employer’s insurance company does approve your workers’ comp claim, you become immediately eligible to receive specific cash benefits. The payment you receive will come in the form of a temporary disability benefit and will be paid weekly under New York State Workers’ Compensation rules. The formula used to calculate the benefit an injured employee can receive is:

2/3 x average weekly wage x % of disability = weekly benefit

It is important to know that you will not be paid for the first seven days, even if you immediately file a claim. In New York State, cash benefits are not paid for the first seven days of a worker’s disability, unless the disability goes beyond 14 days. In that case, a worker may receive wage compensation dating back to the first work day off the job. 

What Types of Payments Can You Receive From Workers’ Compensation?

In addition to temporary disability, other cash benefits, you may be eligible to receive temporary partial disability benefits, permanent partial disability benefits, and permanent total disability benefits. 

Surviving spouses and minor children also are eligible to receive a cash benefit. The worker’s spouse and children can share two-thirds of their loved one’s average weekly wage for the year before he or she lost their life in a work-related accident (subject to a maximum amount). Surviving families members can also receive money to pay for funeral expenses, up to $12,500 in metropolitan New York. Some beneficiaries may qualify to receive a lump-sum settlement. 

Where Do Workers’ Compensation Checks Come From?

Workers’ compensation checks come from an employer’s insurance company. Each state does this differently, but in New York, employers can choose to either a) obtain coverage from a NYS -operated fund or they can b) utilize a private insurer to cover their workers’ comp obligations. Once cash benefits commence, the money will come directly to you from the designated insurance carrier.

Will Taking a Light-duty Job Affect Your Workers’ Comp Payments?

Once a workers’ comp file is claimed, injured workers have to be careful about their activities because it may look as if they are faking an injury or illness. If a medical provider determines you can perform light or an alternative duty, then this is OK to do. Your medical treatment, along with costs for transportation to your appointments, is still eligible under workers’ comp coverage if you return to work.

Under NYC criteria, if you are allowed to return to work but cannot perform the job you did at the same rate of pay you earned before, you may be entitled to receive a benefit that pays two-thirds of the difference between your prior salary and your current one. Unfortunately, with a workers’ comp eligible injury, wage loss is often involved. Our skilled personal injury lawyers can help ensure you receive the maximum benefits you are eligible to receive.

Who Pays My Bills While Waiting for My Workers’ Compensation Payments?

It can be challenging to pay your bills while you are out of work and waiting to be approved to receive a workers’ compensation cash benefit. In the meantime, you may be eligible for other federal, state, and county-based services to help you out financially while you are waiting for a workers’ comp approval. When you consult with one of our knowledgeable NYC workers’ compensation lawyers, they help you make a financial plan. Our attorneys at Terry Katz & Associates are familiar with potential resources to help their clients receive financial assistance, pay child care, or gain access to services for people with disabilities while they are waiting.

Does Workers’ Compensation Cover My Medical Bills?

After a workplace injury or work-related sickness is diagnosed, your employer, their insurance company, or the state (if they are the insurer) will most likely cover medical expenses for your treatment as soon as a workers’ compensation claim is filed. Your doctor and other healthcare provider bills will be paid even if your claim is still in pending status.

  • If you suffer an injury or become ill from work, be sure to see a healthcare provider as soon as you are able. NYS Workers’ Compensation law requires you to report your employer’s injury in writing within 30 days. However, you should report it as soon as possible after the incident and make an appointment to see your doctor. The more documentation you have early on in the process, the easier it will be to get your medical bills paid.
  • If you seek medical treatment before reporting your accident to your supervisor, send a copy of your medical bills to your employer or the insurance company they designate so they can process the bills and make payment for your treatment.
  • If you reported your injury or illness and then sought treatment, tell your medical provider you have already or will file a workers’ comp claim. Your doctor can then bill your employer or their insurance company directly.

Under NYS Workers’ Compensation rules, you will have to go for an independent medical examination (IME) once you file a claim. This doctor, which more than likely will be one you do not know, will examine you and determine the extent of your work-related injury and ascertain the cause. Then, the medical provider will report back their findings.

New York State workers’ comp rules allow you to visit a certified doctor or one who is approved by the Workers’ Compensation Board. This is not necessarily the doctor; your boss directs you to see. Having the experienced workers’ comp law firm of Terry Katz & Associates by your side will ensure you are able to be examined by a doctor of your choice. Obtaining our legal representation will also help to ensure you receive fair treatment, along with a trustworthy diagnosis.

When Do I Receive Non-Medical Benefits?

Unfortunately, you will not receive your non-medical benefits until your claim is officially accepted. This includes payments for temporary disability benefits (compensation for time lost), permanent disability benefits (loss of earning power compensation), and other workers’ comp benefits. Once your claim is approved, it will still take some time to receive your non-medical benefits. This is because a full process includes a doctor certifying you are physically unable to return to work.

If you are denied workers’ comp benefits, this means you will not receive any non-medical benefits unless the decision is overturned. To get the decision overturned, you must file – and win – an appeal. Your workers’ comp attorney at Terry Katz & Associates can ensure you have the best chances of winning an appeal and receiving your non-medical benefits as quickly as possible. You have a better chance of succeeding with a skilled workers’ comp attorney by your side.

How to Check Your Workers’ Compensation Claim Status

New York State Labor Law mandates employers to pay for financial and medical benefits for workers injured on the job. Despite this requirement, employers routinely deny many of the initial claims made by workers. The skilled workers’ comp attorneys at Terry Katz & Associates will meticulously follow your claim’s status to ensure it is processed in a timely fashion.

Start Today With a Free Consultation With Our Top NYC Workers’ Compensation Lawyers

If you suffer from a work-related injury and seek benefits to cover your bills and living expenses, the process of filing for workers’ compensation benefits can be daunting. This is understandable because the process is quite complicated, and, for many workers, it is easy to miss a page or a step that can lead to a claim receiving an initial rejection. It is vital to get your claim correctly to avoid any potential delays that may push your injury claim past New York State’s statute of limitations. Securing legal assistance significantly increases your chances of receiving the maximum amount of compensation benefits.

The attorneys at the Terry Katz & Associates law firm are highly versed in both New York State personal injury and workers’ compensation laws. Our team will ensure your claim is accurately filed, and we will keep you informed on its progress. Call our law office at 888-488-7459 or complete the online form today for a free consultation.

Terry Katz, Esq.

Terry Katz, Esq., the founding Member of the firm, handles all aspects of Workers’ Compensation and Social Security Disability cases.

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