Getting injured on the job can result in serious consequences. Fortunately, New York State’s workers’ compensation system guarantees medical benefits for workplace injuries and illnesses. The system is designed to make it easier for workers to pay off medical expenses.
However, the process of filing a claim can be complicated and frustrating. It’s possible to make it less difficult by learning what to expect and how a worker’s compensation attorney can help every step of the way.
What is Workers’ Compensation?
Every employer in New York is required to carry workers’ compensation insurance for workers that are injured or become ill as a direct result of their job. Employers pay for this coverage and employees are not required to contribute to the cost of compensation. Of course, not every worker is aware of workers’ compensation laws, so it’s critical that every worker knows their rights when considering filing a workers’ compensation claim.
Any medical care or weekly cash allowance that an injured worker receives are paid for by the employer’s insurance carrier. The Workers’ Compensation Board is a state agency that processes claims and determines whether the injured party is reimbursed with cash benefits and/or medical care, and the amounts received.
Work Related Injuries and Eligibility
It is an employer’s duty to provide a safe work environment by means of proper training, maintenance, and precautions for employees. The risk of accidents is always present, but some work injuries occur from the lack of compliance with federal Occupational Safety and Health Administration (OSHA) standards. However, even if an injury is due to an employee’s own negligence, the injured is always entitled to workers’ compensation if the injuries were sustained in the course of his or her work.
Workers’ compensation covers a wide range of injuries and illnesses from short to long-term effects. The laws are purposefully written broadly to ensure the majority of workplace injuries qualify for coverage. Some common examples of conditions that are covered are:
- Sprains or broken bones from slips, trips, or falls occurring on a job site
- Repetitive motion injuries to the back and neck from heavy lifting
- Occupational diseases such as mesothelioma from asbestos exposure, or carpal tunnel syndrome
- Toxic exposure to harmful chemicals, whether typical cleaning supplies or chemicals involved in manufacturing
- Occupational eyesight or hearing damage from harmful conditions in the workplace
- Injuries sustained from assault or violence at the workplace
In order to qualify for workers’ compensation, an injury or illness must have occurred during one of the following:
- While performing any duty or operation related to the job
- While being exposed to chemicals or other hazardous material through the normal course of work
- While on a job site, or off-site but performing tasks or duties related to work
Most Dangerous Jobs by Industry in Inwood, NY
Generally, the more physically demanding a job is, the more likely an employee will suffer physical injuries. Most people would assume construction is the most dangerous industry for workers (it is one of the deadliest).
However, the U.S. Bureau of Labor Statistics released a list of the most dangerous occupations for workers and the results are far more diverse. The following occupations suffer the greatest amount of workplace injuries each year, according to yearly averages from the Bureau of Labor Statistics:
- Health Care and Social Assistance
- Retail Trade
- Accommodation and Food Services
- Transportation and Warehousing
- Wholesale Trade
- Administrative and Waste Services
- Other services except public administration
- Professional and Technical Services
Keep in mind that there is greater employment among industries such as healthcare and retail, so it makes sense that such industries have the highest recorded numbers of injuries.
However, even though these statistics don’t necessarily indicate that these industries are more dangerous than those like construction, transportation and manufacturing, it is clear that it is not only construction workers who need to worry about getting seriously hurt on the job. Remember that every employer in New York is required to carry worker’s compensation insurance.
It’s important for residents of Inwood and surrounding areas such as Marble Hill and Washington Heights to know the risks of these occupations when considering the community’s local jobs and employment. A recent community report lists the majority of local residents’ employment in Inwood:
- Educational Services, Health Care, and Social Assistance (26%)
- Accommodation, Food Services, Arts, Entertainment (16%)
- Retail Trade (14%)
- Professional, Scientific and Technical Services (10%)
Everyone should be prepared in the event of an accident in the workplace and know their rights to proper compensation for their injuries.
The Claims Process Step by Step
There are steps to take from the moment an accident occurs that will help maximize benefits and make the process go as smoothly as possibly.
Immediately after Injury
- Obtain any necessary medical treatment and notify a supervisor about the accident and how it occurred
- Notify the employer of the accident in writing as soon as possible, but within 30 days
- Seriously consider contacting a specialized New York workers’ compensation lawyer to ensure deadlines are met while maximizing potential benefits
- File a claim with Form C-3. This must be done within two years of the accident or within two years after the injured worker knew or should have known that the injury was related to employment.
It’s important to make sure the C-3 form is submitted to the appropriate Board District Office. Residents of Inwood, Washington Heights and Marble Hill PUMA are to mail the form to:
New York State Workers’ Compensation Board – Manhattan District Office
215 W. 125th Street
New York, NY 10027
Within 48 Hours of the Accident
To qualify for compensation, an injured person must seek treatment from doctors that are authorized by the New York State Workers’ Compensation Board (WCB). Click here to find a conveniently located WCB authorized doctor health care provider.
Doctor’s Initial Report C-4 must be completed by the doctor within 48 hours after he or she provides treatment. The doctor should know to send copies to the employer or employer’s insurance carrier, the injured worker, and any legal representative for the injured worker.
Within 10 Days of Notification of the Accident
The employer must report the injury to the Workers’ Compensation Board and the insurance company they carry.
Within 14 Days of Employer Reporting the Accident
The insurance company will send the injured worker a Statement of Rights within 14 days after receiving the employer’s report OR with the worker’s first benefit check, whichever comes first.
The insurance company may also require the injured worker to use one of their providers to obtain additional testing. If necessary, they will send the injured worker a notice to arrange testing within these same 14 days.
Within 18 Days of Employer Reporting the Accident
The insurance company will notify the Board stating either that payment of benefits has begun, or the reasons why payments are not being made.
The reasons payments may not begin are either that the claim is being disputed or that the amount of time off the job for the worker is less than 7 days. Cash benefits are not paid for the first 7 days of the disability unless it extends beyond 14 days, in which case the worker receives cash benefits from the first day off the job.
Every 2 Weeks from the Accident
The insurance company will continue to make payments of benefits to the injured worker if the case is not being disputed.
Every 45 Days
The doctor must submit progress reports to the Board for each follow-up visit. The form gets sent to the Board, insurance carrier, injured worker and his/her legal representative.
After 12 Weeks
The insurance company will “consider the necessity of rehabilitation treatment” for the injured worker.
How Much Does Workers’ Compensation Pay in Inwood, NY?
There are three types of benefits injured workers may be eligible to collect: medical benefits, cash benefits, and supplemental benefits. What an injured worker may receive depends on variables including:
- How much the worker was getting paid in the past year
- The severity of the injury or illness
- How long the disability will keep the worker from working
- Costs of the medical care needed as a result of the injury or illness
There is no cap for the amount of medical benefits provided through workers’ compensation. Injured workers are supposed to be equally compensated for any medical expenses required for healing and rehabilitation.
Coverage is supposed to include costs for diagnostic testing, operations and procedures, and any prescribed medications.
Anyone unable to work for more than 7 days qualifies for cash benefits to compensate loss of wages. The New York WCB uses an equation to determine the amount you can collect from cash benefits:
2/3 X weekly salary X % of disability = weekly cash benefit
The maximum benefit amount is based on the New York State Average Weekly Wage for the previous calendar year and adjusts every July 1. More information and the schedule of benefits can be found here.
These benefits were made available to those thought to be most affected by rising costs. They are only available to those who are classified as permanently and 100% disabled as the result of a work-related injury that occurred before 1979.
They are also available to widows or widowers receiving death benefits as the result of the death of their spouse occurring before 1979. For those eligible, supplemental benefits cap at $215 every week.
How a Workers’ Compensation Lawyer Will Help
Learning how to file a claim and coordinating with various offices and facilities is extensive and time consuming, especially when recovering from a painful injury. Essentially, there is no room for error without risk of compromising a claim. A workers’ compensation lawyer has the necessary knowledge and expertise to successfully navigate the process while making sure the worker’s best interest comes first.
Often, insurance companies and employers will relentlessly try to avoid payment or pressure the employee to return to work prematurely. A lawyer will ensure deadlines are met with completed paperwork and collect critical evidence to build a successful claim.
Free Consultation with an Inwood, Manhattan Workers’ Compensation Attorney
Sobo & Sobo has successfully represented injured workers in NYC for decades. We understand the stress and frustration caused by an injury on the job and know what it takes to settle a favorable compensation claim. Our bilingual staff at our Inwood location is prepared to better serve the Spanish-speaking community working and living in Manhattan including those in Washington Heights and Marble Hill.
For a free consultation call 212-544-8892 or contact us online. Whether your workers’ compensation claim was denied, you’re in the process of filing, or have yet to begin, our attorneys are ready to help.