Guide To The Workers’ Compensation Process
Our Guide To Workers’ Compensation
No one goes to work thinking they will be injured. For most of us, our job represents our identity, is a source of social interaction and gives us a sense of pride. We of course also work to provide for ourselves and our family. At Buckley, Mendleson, Criscione, and Quinn, P.C., we understand this. We also know that being injured on the job is the last thing you intended or wanted.
Over the past century, the workers’ compensation attorneys at Buckley, Mendleson, Criscione, and Quinn, P.C., have built a solid reputation for quality legal representation in and around Albany, New York. For generations, we have ensured that injured workers get the compensation they need to stay financially viable while they recover. When a worker needs an advocate, Buckley, Mendleson, Criscione, and Quinn, P.C., is there.
What Steps Should I Take In My Workers’ Comp Case?
Understanding what to do after a work-related accident is important when filing a workers’ compensation claim. Every workplace injury situation is different.
For example, if you are injured by faulty equipment then you may take steps to file a third-party lawsuit. Or if the company knowingly puts workers at risk, there may be unique facets to the case that would entail a different approach whereby the employer faces criminal prosecution and heavy fines.
However, generally speaking, there are certain steps to every New York workers’ compensation case. Here are some of the steps that should be taken after a workplace injury occurs:
- Get medical care. Even if it seems like a strained back muscle or the cut isn’t that deep, or it “probably wasn’t” a concussion, it’s important to be seen right away. First, it will bring you and your family peace of mind to get an evaluation and diagnosis. Concussions, for example, do not always present right away or in the same way. Only a specialist can assess you. Second, if you are injured and it prevents you from going back to work, you have the required documentation. The doctor can then complete the preliminary medical report (Form C-4). The form is mailed by the doctor to the district office, to you, and to your employer or your employer’s insurer. Seeing a doctor can only help you. Do not let pressure from supervisors or “safety goals” prevent you from taking care of yourself.
- Report the injury to your supervisor, boss or employer. This should be done as quickly as possible, the same day or week of the accident or injury. However, any time within 30 days is acceptable.
- Look for a “written statement of your rights” from your employer. You must receive this within two weeks (14 days) of reporting the accident or injury.
- You should receive payment of your benefits from your employer’s insurance company within 18 days of your employer filing the report. If you do not receive payment, you should receive notice that the claim is being disputed.
- File a claim with the New York State Workers’ Compensation Board. This should be done as soon as possible and must be done within two years of the accident or injury. This will be done by filling out Form (C-3) and mailing it to the appropriate district office. You must do this after the injury and after notifying your employer of the injury or accident.
Understanding Workers’ Compensation Progress Reports
Additionally, after your claim is submitted, you should receive progress reports. These should come every 45 days, beginning after you receive your initial workers’ compensation payment. This is done on the Doctor’s Progress Report (C-4.2) Form. The form is a very simple two-page form that the doctor fills out. It asks about billing information, results of exams, tests and treatment that is being provided. It also has a section for the doctor to describe the findings of the tests and what percentage of impairment there is. The final section requires the doctor to identify whether the worker can or has returned to work, if there are any restrictions or limitations to that work, and if vocational rehabilitation is an option.
What Does The New York Workers’ Compensation Board Do?
The New York State Workers’ Compensation Board is tasked with protecting the rights of workers and their employers. The board does this by working to make sure that when a worker is injured on the job or suffers an illness, that worker gets the benefits they are eligible for. The board also works to make sure that companies comply with the law in regard to these benefits. The board serves a broad range of people besides workers and employers including lawyers, medical providers, insurance carriers and the media. The board also provides services relating to:
- Hearings, appeals and disputes regarding a workers’ compensation claim
- Business monitoring
- Complaint investigation
- The establishment of medical guidelines for doctors and medical professionals who treat injured workers
- Assistance to workers who need help with the New York workers’ compensation process
If you appeal your decision, a panel of three board members will review your case. They will either affirm, modify or rescind the previous decision. The panel can also “restore the case to the calendar” so that they can get more information. There are more steps involved in the appeals process. An experienced workers’ compensation attorney can advise you to those steps. The stated mission of the board is to “vigorously enforce the state workers’ compensation laws to protect injured workers and ensure fairness among New York State businesses.” The board can be contacted at 877-632-4996.
Do I Need To Hire A Workers’ Compensation Lawyer?
Many people wonder whether they are able to represent themselves in a workers’ compensation case. It is not required, but it is advisable to work with a workers’ compensation attorney. The legal language or “legalese” can be overwhelming, and the process, while seemingly straightforward, is often fraught with snags and obfuscation.
A seasoned workers’ compensation attorney from a solid, reputable firm is one way to take the burden off of yourself and your family. An attorney will take care of the paperwork and make sure all documents are filed on time to the appropriate offices. An attorney will also act as a buffer and liaison between you, your boss, your employer and the insurance company.
When you are injured, it is not the best time for you to take on the role of a legal advocate. An attorney can help you at any time during the process, from the day of your injury to when you file with the New York Worker’s Compensation Board. An attorney is invaluable if you are appealing the decision of the board after being denied compensation.
Workers’ compensation attorneys are motivated to help you succeed because they work on a contingency fee basis. That means the attorney does not get paid unless you win a successful settlement. This fee is usually 10 to 15% of the settlement award. A settlement award typically includes the cost of all medical treatment received and any treatment needed in the future because of the injury. A settlement also generally covers current and future lost wages, and any disability payments.
How Much Does Workers’ Compensation Pay?
There is a formula used to determine benefits for New York workers. The formula is 2/3 x average weekly wage x % of disability = weekly benefit. So, if your pay is $700 per week and you are totally disabled (100%) and can’t work due to your injury, then you would receive $467 per week. If you are paid that same $700 per week but are only 50% disabled (working part time, for example) then your benefit would be $233 per week. If you go back to work but can’t do the same job for the same pay, workers’ compensation benefits may pay you 2/3 of the difference in pay. There are maximums to the amount a worker can receive. For July 1, 2020 to June 30, 2021, the maximum is $966.78 per week for both total and partial payments. The weekly maximum for injuries sustained between July 1, 2021 and June 30, 2022 is $1,063.05. Cash benefits are paid only in some cases.
Get A Free Question And Answer Session With A Workers’ Compensation Attorney
We know you have questions. We have answers. We offer a free question and answer session with one of our attorneys so that you have a better understanding of your rights, your options and how we may be able to help. Call 518-430-0026 and set up an appointment. You can also reach us via firm email.