Workplace injuries lead to substantial difficulty, especially if you cannot work until you recover. That is why New York requires every employer to carry workers’ compensation insurance. It can ease your recovery by paying medical bills and reimbursing you for lost wages.
But if your employer or insurer interferes with your work accident claim, a difficult situation becomes more challenging. Here is what to know about workers’ compensation claims and your rights.
What should I do if I am injured on the job?
Seek medical treatment immediately. If serious, report to an emergency room. Delaying treatment can make it easier for your employer, or their workers’ compensation insurance carrier, to argue that the injury was not work related.
Next priority should be notifying your employer. You have 30 days to do so, but it is better for your case if you notify them immediately. That allows for any work-related injury compensation to kick in sooner and helps you appear credible. Many fraudulent claims arise from employees attempting to claim an injury was work-related way after the fact.
Finally, complete a claim information packet and file it with your local Workers’ Compensation Board (WCB) office. You have two years to file this information and if you hire an attorney, they will help you with this step.
How should my employer follow up on my injury damages report?
If your employer hears of the injury before you receive medical treatment, they should release you from work so you may proceed to a healthcare clinic. They may will refer you to a healthcare provider who is authorized by the WCB. This does not apply if you were injured in an emergency situation.
However, employers are not allowed to insist that you use a particular provider. Self-insured employers may insist you stay in-network but if you have a provider you prefer, you have the right to seek treatment from them. Chances are, if you have employer-provided health insurance, your medical provider is already in-network, so this usually is not an issue for most employees.
Once they are aware of the injury and its circumstances, your employer should investigate and report the claim to their workers’ compensation insurance carrier. They may also fill out a Form C-2F which is their report of your injury to the WCB.
Will I receive lost wages while I am recovering?
If your employer pays your wages, they can be reimbursed by the WCB. It is often recommended they do so for the first week since injuries arising from workplace conditions may arise from employer negligence. In that case, your employer will owe you for lost wages anyway.
After the first week, you are eligible for workers’ related injury compensation benefits. These amount to two-thirds of your average weekly wage. Currently, these benefits are set to a weekly maximum which at this time is $870.61. This changes every July.
If there is negligence involved in your injury, then your employer could owe you the difference between the benefit and your regular wage. This is pursued in a damages action and is also relevant if your injury is so severe as to render you incapable of working at your previous occupation.
Can my employer fire me?
Employers cannot fire employees who file for workers’ compensation benefits. The same is true of any coworkers who testify on your behalf if your claim goes to hearing. Employers are not allowed to retaliate against workers who file or participate in a claim.
If you are terminated for pursuing workers’ compensation, your employer may face a fine ranging from $100 to $500. You may also be able to pursue a civil action under the Americans with Disabilities Act.
If you are terminated and suspect discrimination, file Form DC-120 with the WCB to start a investigation. If the WCB finds that you were improperly discharged, the WCB will order your former employer to restore your job and any lost wages.
I suspect that my employer is in violation of workers’ compensation laws. What should I do?
All New York employers must carry workers’ compensation insurance. If you are discouraged from seeking medical treatment or making a report, there is a good chance that your employer is in violation of the law.
Once you receive medical treatment, fill out the online whistleblower form. This will start an investigation from the WCB. Next, you may need to hire an attorney. There is a good chance that you may need other avenues for ensuring you receive medical treatment and wage compensation.
Sometimes, workplaces with a high rate of work accidents attempt to keep claims from being reported, even if they carry insurance. If you run across this evasive behavior, it is likely you may be in for a fight because your employer is attempting to avoid a premium increase.
Workers’ compensation is your right in New York when you sustain a workplace injury. You should not be terminated for filing a claim and your wage loss and medical bills should be covered.
Navigating Challenges in Workers’ Compensation Claims
Sometimes, workers face challenges during the claim process. Common issues include disputes over the nature of the injury, the treatment required, and whether the injury is work-related. In such cases, having legal representation can be invaluable. An attorney experienced in workers’ compensation can help navigate these challenges, represent your interests, and ensure that you receive the benefits you’re entitled to.
Tips for a Smooth Workers’ Compensation Claim Process
- Keep Detailed Records: Document everything related to your injury and the claim process, including dates of medical appointments and correspondence with your employer or their insurance carrier.
- Adhere to Treatment Plans: Following your doctor’s advice and adhering to the treatment plan is crucial for both your recovery and the success of your claim.
- Communicate Effectively: Stay in regular communication with your employer and the insurance company. Promptly provide any requested information.
Can A Claimant Refuse Recommended Medical Treatment?
Under the New York State Workers’ Compensation Law, an injured worker cannot benefit from unreasonable refusing a mode of medical treatment. This does not mean that if a doctor recommends a certain course of treatment, that an injured worker must go forward with that specific treatment.
However, the appellate division case of Wilkins v. NY Power Authority decided in March 2011, found that a schedule loss of use award was inappropriate where all of the physicians unanimously recommended that the claimant complete a course of physical therapy which he refused to do.
On the other hand, there are many circumstances where invasive procedures are recommended. In those circumstances, the claimant is not required to undergo surgery simply because a doctor has recommended it. However, when all doctors agree that conservative care such as physical therapy is needed before the claimant will reached maximum improvement, the treatment should be completed.