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Workers Comp Lawyer NYC
Although New York law mandates financial and other benefits for people injured on the job through its workers’ compensation program, employers deny up to one-quarter of the initial claims of injured workers. This only adds more stress to an already uncertain situation. After a work-related injury, it can feel intimidating to go against an insurance company representing your employer. Discussing your rights with a lawyer for work-related injury claims is often the best way to obtain the maximum benefits you are legally entitled to.
The team of Long Island workers’ comp lawyers at Terry Katz & Associates have more than 30 years of experience fighting for the rights of injured workers. Whether you have received a denial of benefits, have been subject to unreasonable delays, you want to see your own doctor, or you are dealing with another common issue experienced by injured workers, we are on your side and would be happy to help. You may feel small and insignificant right now compared to the vast resources of your employer, but we will level the playing field to ensure you get a fair shot at claiming your rightful benefits.
Eligibility for Workers’ Compensation Claims in New York
Dealing with a job-related injury or illness is difficult enough but trying to determine if you are eligible for state workers’ compensation benefits can be overwhelming. Like all states, New York creates and maintains strict workers’ compensation laws to prevent abuse of the program. Unfortunately, you cannot assume that you are eligible to receive financial benefits just because you were injured on the job in New York. As your workers’ compensation lawyer will explain, you must meet the following criteria before you can apply for benefits:
- The company you work for must be mandated to provide workers’ compensation benefits to injured employees by New York law
- Your current disability, illness, or injury must have been caused solely from completing the duties associated with your employment
- You must provide your employer with written notification of the incident within 30 days
- You have obtained a medical report that confirms your disability, illness, or injury happened while on the job
Workers’ Compensation Claims: Eligibility & Filing
One of the most important things to understand about New York’s workers’ compensation system is that it operates under the premise of no-fault. That means the law does not require you to prove that your employer is at fault for causing your injuries.
As mentioned above, you only have 30 days to notify your employer that you sustained an injury on the job. However, any workers’ comp lawyer would tell you to make sure that you report the injury as soon as possible. Even if your claim is valid, you would not be able to collect benefits if you forget to notify your employer in the allotted time. Your report should include the following information at a minimum:
- All factors that caused the accident
- The exact date and time of the accident
- Where the accident took place
- Names and contact information for any witnesses to the accident
Please note, this is only an initial notification of an injury and not a claim for benefits. New York law allows you two years from the date of the incident to file for workers’ compensation benefits. You will need to complete Form C-3, called Employee Claim Form, and mail it to the nearest Workers’ Compensation Claim Office. Here are the rest of the steps you need to follow when filing your claim:
- Ask your doctor to complete Form C-4 entitled Doctor’s Initial Report and mail it to the same district office. He or she should also send a copy of the form to you, your employer, and the insurance company representing your employer. This must take place within 48 hours of your injury.
- Ask your employer to complete Form C-2 within 10 days of the incident. This form, called the Employer’s Report of Work-Related Injury or Illness, will go to the district workers’ compensation board and your employer’s insurance company.
- After receiving the C-2 report from your employer, a representative from the insurance company representing your employer will mail you a letter that outlines your rights under New York law. You should receive this within two weeks.
- If the insurer has not approved or denied the claim with seven days, it will begin to pay you benefits within 18 days.
- Your doctor must submit a progress report to the workers’ compensation board every 45 days.
- The insurance company representative will consider whether you are still in the active process of recovery if you have not returned to work within 12 weeks. The representative will also make a recommendation concerning whether you should pursue rehabilitative treatment.
You are eligible to receive specific benefits if the insurance company approves your workers’ compensation claim. This includes receiving a weekly payment that is up to 66 2/3 percent of your typical wage. Other benefits that your employer’s workers’ compensation fund must pay for include the following:
- Difference between your current and former wages if you suffered a permanent or partial disability due to an on-the-job incident
- All medical treatment related to your injury, including services provided by a chiropractor
- Reimbursement for fuel used to travel to appointments, parking fees, medication, bandages, and related items
- Compensation for a facial scar or injury to an extremity, including your arms, hands, legs, and feet even if these injuries do not prevent you from working
As you can see, there is a lot on the line when your employer’s insurance company denies your claim for workers’ compensation benefits. One of the most common reasons for denial is stating that your injury, illness, or disability did not occur at work. Your workers’ compensation lawyer from Terry Katz & Associates will work hard to uncover proof of how your injury happened as well as challenge any other denials or delays that come your way.
Another common point of contention among injured people is feeling like the insurance company controls who they can see for medical treatment. Many people prefer to see their own doctor because they feel like the one provided by the insurer is too biased towards the employer. Whatever your specific issues with your case, we understand your frustration.
What Is a Workers’ Comp ‘Independent’ Medical Examination?
After filing your claim, you must submit to an independent medical examination (IME). The purpose of this exam is for a doctor to determine the extent of your injuries as well as whether you received them at work or not. The problem that many injured workers have with an IME is that the employer chooses an authorized medical provider to complete it. While the stated purpose of the IME is for the injured worker to receive an accurate diagnosis and a customized treatment plan, some insurance companies interpret the doctor’s findings to their own advantage and limit or deny payouts to the injured worker.
One advantage to living in New York is that state law allows injured workers to choose a certified doctor or one who has received approval from the agency overseeing the workers’ compensation program. Despite this, injured employees can still feel intimidated because the insurance adjuster handling the claim makes it difficult for them to see the doctor of their choice by denying or delaying claim payments. If you find yourself in this situation, hiring an experienced workers’ comp lawyer is the best way to ensure that you get to see the medical provider of your choice.
Appealing a Workers’ Comp Denial
Workers’ compensation insurance companies provide other common reasons for denial besides claiming that an employee’s injury occurred outside of work. One is accusing the injured worker of fraud by misrepresenting an injury and another is claiming that the injury is due to a pre-existing condition instead. Once you receive notification regarding your claim, you can take one of the following three actions:
- Accept the claim as is
- Contest the claim entirely
- Contest one or more parts of the claim
You have the right to request a review from the Workers’ Compensation Claim Board within 30 days of receiving your notice. If the board approves your request, three-panel members will review the case and either modify or rescind the original judge’s decision. They may also send the case back to the judge for further consideration. You may request a full board review if the three-member panel cannot come to a unanimous decision.
When appealing a board decision, you must request assistance from the Appellate Division of New York’s State Supreme Court within 30 days. You can further appeal this decision to the New York State of Appeals.
Benefits Of Hiring A Lawyer For Work-Related Injury Claims
You are not required to have Long Island workers’ comp lawyers present if your case progresses to a hearing before the workers’ compensation board or any further forms of appeal. However, it is definitely in your best interest to do so. The workers’ comp lawyer whom you retain will have been through this process hundreds of times already and know how to address any questions that arise. Your lawyer can also present evidence and oral arguments as to why you are entitled to receive workers’ compensation benefits in New York.
Another option is to attend mediation sessions to attempt to settle your workers’ compensation claim. Mediation focuses on finding solutions both parties can live with such as modifications of job responsibilities to accommodate the injury.
Workers’ Comp Lawyer In Long Island: Free Consultation
Perhaps you are just at the beginning of your journey as an injured worker in New York and want to know more about your rights and how to file a claim. You could be further along in the process and already received a denial from your employer’s insurance company. We want to assure you that we are here to help no matter where you find yourself in the workers’ compensation process.
Please contact our office near Long Island, New York at 888-488-7459 to request a free review of your case with one of our Long Island workers’ comp lawyers. We look forward to assisting with your claim.