You’ve probably heard that if you are injured on the job, workers’ compensation pays for your medical care. But did you know there are several other types of workers compensation benefits for which you may qualify?
In most workers’ compensation cases, no individual party is held responsible. Even if you contributed to your injury or illness through carelessness — excluding intentionally injuring yourself or being under the influence of drugs or alcohol — the benefits you receive through workers’ compensation remain the same. On the other hand, the amount you receive through workers’ compensation insurance doesn’t increase if your employer is at fault.
If the insurer and your employer agree, or if the court sides with you in the event of a disputed claim, you may be eligible for the following workers compensation benefits.
Types of Workers Compensation Benefits
For workers who are hurt or become ill and are eligible for workers’ compensation, medical treatment “directly related” to the illness or injury — along with recovery from any resulting disability — is covered, the New York State Workers’ Compensation Board notes. If you receive care under workers’ compensation, your health care provider must be authorized by the board other than in emergency circumstances.
If your case is not in dispute, your employer or the employer’s workers’ compensation insurance carrier pay for your medical coverage. In this case, the health care provider will not collect payment from you. However, you may be asked to sign form A-9, indicating that you take responsibility for paying for your treatment if your workers’ compensation claim is rejected or if you decide not to pursue your claim.
In some cases, you also may be eligible for reimbursement for mileage to get to and from the medical office for treatment of your medical condition related to your job. In addition, if you or a pharmacy submit a claim to the workers’ compensation insurer for reimbursement of a medication for your illness or injury, the carrier must pay within 45 days. If the claim is in dispute or the medication is not for a condition related to your illness or injury, the carrier is required to pay any undisputed part of the bill and notify you or the pharmacy in writing within 45 days.
If you suffer from a total or partial disability related to a medical condition you developed because of your job, you will not receive cash benefits for the first seven days. However, if your disability extends beyond 14 days, you may be awarded cash benefits extending back to the first day of work you missed. You receive medical care under workers’ compensation regardless of the length of your disability.
The amount you receive is based on your average weekly wage for the past year. The state uses the following formula to calculate your weekly cash benefits: 2/3 x average weekly wage x % of disability. However, your weekly benefit is limited to maximums set by the state.
These workers compensation benefits — which cannot exceed $215 per week in combination with weekly benefits and death benefits — are available to individuals determined to suffer the greatest impact from rising costs. You may be eligible for supplemental benefits if you fall into one of the following two categories:
- You were classified as permanently and completely disabled due to an injury or disability you suffered at work before Jan. 1, 1979.
- You are a widow or widower receiving death benefits following the death of your spouse before Jan. 1, 1979.
Social Security Disability Benefits
If you become seriously disabled — either permanently or for a continuous period of at least a year — due to a “medically determinable physical or mental impairment,” you may be entitled to Social Security benefits on a monthly basis.
Surviving spouses, minor children and other legal dependents of workers who die from a “compensable injury” may be eligible for weekly cash benefits. The amount of the benefits is two-thirds of the worker’s average weekly pay for the year prior to the worker’s accident. The weekly benefit cannot exceed the weekly maximum regardless of the number of dependents.
If the deceased worker has no surviving dependents who are entitled to compensation, the worker’s surviving parents or the deceased worker’s estate may receive as much as $50,000. In addition, some funeral expenses may be covered.
Consult with an Experienced Workers’ Compensation Attorney
Workers’ compensation cases can be complex, and it can be difficult to understand the intricacies of your specific situation. If you’ve been injured on the job or you suffer from an illness related to your work, don’t leave your future to chance. Contact the offices of Paul Giannetti, Attorney at Law, at (866) 868-2960 for a free consultation to ensure you receive the compensation to which you’re entitled.