What Does New York Workers’ Compensation Insurance Cover?

Workers’ Compensation Insurance in New York covers the majority of employees in the state. Employers are required by state workers’ compensation laws to purchase and maintain workers’ compensation coverage for their employees. There are only a handful of narrow exceptions to the law.

What is Covered By Workers’ Compensation Insurance?

If your employer has workers’ compensation insurance, the majority of work-related injuries, illnesses, and accidents are covered. However, workers’ compensation does not cover all occupational injuries and accidents.

To be covered by workers’ compensation insurance for an accident, illness, or injury:

  • The employee is protected by law.
  • The employee’s illness, disability, or injury must be directly related to his or her job duties.
  • The accident or incident occurred while the employee was performing job-related responsibilities.
  • The employee gave written notice to the employer within 30 days of the incident that caused the illness or injury.
  • The treating physician’s report indicates the illness or injury was caused by an accident or incident at work.

Upon approval of a workers’ compensation claim, the employee may be eligible for one or more benefits provided by workers’ compensation insurance.

Workers’ Compensation Benefits in New York

If you are injured on the job, you may be eligible for workers’ compensation benefits. Cash Benefits and Medical Treatment are the two most common types of workers’ compensation benefits.

When an employee is unable to work due to a work-related illness or injury, the workers’ compensation system supplements the employee’s income with cash benefits. The amount of cash benefits is proportional to the employee’s pre-accident earnings.

An injured worker is eligible for a weekly cash benefit equal to two-thirds of his or her average weekly wage. The maximum weekly cash benefit allowed by law cannot be exceeded. Annual adjustments to the maximum cash benefits are made on July 1st.

If your injury prevents you from returning to work, you may receive up to the maximum cash benefit allowed. If you are able to work, you may be eligible for partial cash benefits that increase your earnings up to two-thirds of the total disability amount.

Workers with work-related illnesses or injuries covered by workers’ compensation are entitled to receive reasonable and necessary medical care. The treating physician or health care provider must be approved by the Workers’ Compensation Board, unless the worker requires emergency medical care.

If the workers’ compensation carrier or employer approves the claim, the employee will receive treatment at no cost. Additionally, the employee may be reimbursed for travel to and from doctor’s appointments.

Other Workers’ Compensation Benefits

In some instances, additional types of workers’ compensation benefits may be available.

The surviving spouse, minor children, and other legally defined dependents may be eligible for death benefits if a worker dies from a work-related illness or injury. In addition to funeral expense reimbursement, the dependents may be entitled to weekly compensation.

If there are no surviving heirs entitled to compensation, the worker’s estate may be eligible to receive a $50,000 lump sum payment. The funds are distributed to the legal heirs by the estate.

Workers who sustain disabilities as a result of an accident on the job may also receive assistance from one or more rehabilitation programmes. When possible, the programmes assist workers in returning to work or adjusting to the limitations imposed by their work-related disability.

Included in rehabilitation services are:

  • Vocational rehabilitation
  • Strategic placement
  • Medical rehabilitation
  • Human Services

Participation in rehabilitation programmes does not result in the loss of financial benefits. If you are unable to work, you continue to receive disability-related cash benefits. Participation in rehabilitation programmes is typically voluntary.

A worker who is permanently disabled due to an injury or illness sustained on the job may be eligible for disability benefits. There is no maximum number of weeks for which an employee can receive total disability benefits.

Workers who suffer from a partial disability receive cash benefits based on the severity and type of their disability. The severity of the disability is determined when the patient reaches Maximum Medical Improvement (MMI), which is assumed to occur within two years of the injury date.

Filing for Workers’ Compensation Benefits

The workers’ compensation system ought to be simple. An injured worker submits a claim and receives benefits. However, not all workers’ compensation cases are so straightforward.

Employers and insurers deny numerous workers’ compensation claims. In addition, they seek to devalue disability claims, limit medical treatment, and reduce cash benefits.

Employees may retain a workers’ compensation attorney for assistance with a claim or, if applicable, to pursue a third-party negligence claim. Consult a workers’ compensation attorney as soon as possible if your employer or its insurance provider is denying your workers’ compensation benefits.

Contact Our Personal Injury Law Firm

Contact Abrams Law Group for a free consultation if you’ve been hurt in an accident and require legal assistance.

Abrams Law Group
104-70 Queens Boulevard, Suite 502
Forest Hills, NY 11375
(718) 997-9797

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