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New York Workers’ Compensation Benefits

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MTA Bus driver, injured in a trip and fall accident.

Workers’ Compensation is your right as an injured New York employee. If you are injured or become ill as a direct result of your job, you’re eligible to receive health care and lost wages. By law, your employer must provide these benefits to you, without making a determination of fault. You do not have to prove employer negligence to qualify for Workers’ Compensation. And your employer cannot deny you benefits if your own carelessness contributed to your injury or illness.

Types of injuries/claims

What Types of Injuries Qualify for New York Workers’ Compensation?

If you’ve been injured on the job in New York, you may be wondering whether your injury qualifies for Workers’ Compensation benefits. In New York, Workers’ Compensation covers a wide range of injuries and illnesses that arise out of and in the course of employment. At Aronova & Associates, we help injured workers understand their rights and secure the benefits they deserve.

Types of Claims

In New York, Workers’ Compensation is a state-mandated insurance program that provides financial and medical benefits to employees who suffer job-related injuries or illnesses. The system is no-fault, meaning workers are entitled to benefits regardless of who was responsible for the injury. In exchange, employees generally cannot sue their employer for damages outside of the Workers’ Compensation system.

These injuries occur suddenly due to an accident or unexpected event in the workplace, such as:

  • Slips, trips, and falls in the workplace
  • Physical assaults while on the job
  • Falls from ladders or elevated surfaces
  • Injuries caused by heavy lifting or manual labor
  • Motor vehicle accidents occurring during work-related travel

An occupational disease claim refers to a claim based on a medical condition or illness that develops over time as a direct result of a worker’s job duties or work environment, rather than from a sudden accident or injury. Common examples include:

  • Carpal tunnel syndrome from repetitive typing
  • Respiratory conditions due to exposure
  • Hearing loss due to long-term noise exposure

A consequential injury is not caused directly by the original workplace accident but occurs because of the limitations, conditions, or treatment related to the original injury. The law allows these secondary conditions to be covered under the same Workers’ Compensation claim if a clear connection can be shown.

  • A worker injures their right knee on the job. Months later, due to limping or overuse, they develop pain or injury in the left knee or lower back.
  • A worker suffers a shoulder injury and then develops depression or anxiety due to chronic pain and limited mobility.
  • A worker uses crutches or a brace and then falls at home, injuring another body part.

These injuries occur suddenly due to an accident or unexpected event in the workplace, such as:

  • Post-Traumatic Stress Disorder (PTSD) following a workplace incident
  • Anxiety or depression caused by extreme workplace stress

Certain work activities require repetitive motions that can lead to long-term injuries, including:

  • Carpal tunnel syndrome from typing or assembly line work
  • Tendonitis from repetitive lifting or tool usage
  • Rotator cuff injuries from overhead work

Workers exposed to hazardous conditions may develop illnesses related to their job, such as:

  • Respiratory conditions (e.g., asbestosis, silicosis, occupational asthma)
  • Hearing loss from prolonged exposure to loud noises
  • Skin conditions caused by chemical exposure

Heavy lifting, falls, or sudden impacts can lead to severe back and spinal injuries, including:

  • Herniated or bulging discs
  • Fractured vertebrae
  • Chronic lower back pain due to workplace strain

In some cases, workers may qualify for compensation due to work-related psychological conditions, including:

  • Post-Traumatic Stress Disorder (PTSD) following a workplace incident
  • Anxiety or depression caused by extreme workplace stress

What Should I Do if Injured
on the Job

If you are injured on the job in New York State, follow these steps to protect your rights and ensure you receive Workers’ Compensation benefits:

Report the Injury Immediately

Notify your employer as soon as possible, but no later than 30 days after the accident. Failure to report within this timeframe may jeopardize your claim. It is best to notify your employer in writing as this can be used as evidence to prove notice was given.

Seek Medical Attention

Visit a healthcare provider authorized by the New York Workers’ Compensation Board. Inform them that your injury is work-related so they can document it properly. Inform the provider that your injury is work-related so they can submit the necessary medical reports.

Consult a Workers’ Compensation Attorney

Contacting a Workers’ Compensation attorney at the outset simplifies the complicated process of filing and pursuing a Workers’ Compensation claim. If your claim is denied or benefits are delayed, an experienced Workers’ Compensation lawyer can help you navigate the appeals process and ensure you receive the full benefits you deserve. Even if your claim is accepted, an experienced Workers’ Compensation can help ensure you receive the compensation you are entitled to. Workers’ Compensation is an adversarial system, your employer’s Workers’ Compensation insurance carrier will have an attorney there fighting for them, you should have an attorney present fighting for you.

File a Workers’ Compensation Claim

If you retain a Workers’ Compensation attorney, this matter will be handled by the firm you hire. If you chose to move forward without an attorney, you must submit a C-3 form (Employee Claim) to the New York Workers’ Compensation Board within two years of the injury or diagnosis of a work-related illness. Failure to do so may result in the disallowance of an otherwise compensable claim.

Follow Your Doctor’s Orders

Adhere to the prescribed medical treatment and attend all follow-up appointments. Keep copies of all medical reports and receipts.

Keep Records of Everything

Maintain documentation of your injury, medical visits, missed workdays, and any correspondence with your employer or insurance carrier.

Respond to Employer or Insurer Requests

Your employer’s insurance carrier may require an Independent Medical Examination (IME). Cooperate, but be cautious of insurers attempting to minimize benefits.

The Benefits of Filing a Workers’ Compensation Claim in New York

If you’ve been injured on the job, filing a Workers’ Compensation claim can provide critical financial and medical support. At Aronova & Associates, we help injured workers navigate the complex New York Workers’ Compensation system to secure the benefits they deserve.

Medical Benefits
  • Covers all necessary medical treatments, including doctor visits, surgeries, medications, and rehabilitation.
  • No out-of-pocket costs for covered medical care.
  • Reimbursement for travel expenses to and from medical appointments.
Payments While You Are Out of Work or Earning Less Due to Injuries

If your injury prevents you from working, you may receive weekly cash benefits.
Typically, wage benefits cover up to two-thirds of your average weekly wage, subject to statutory limits. The statutory limits can be found below.

  • Average weekly wage (AWW) is calculated by looking at the your earnings in the year prior to your work injury to determine your AWW, either by way of a weekly divisor or multiple depending upon.
  • If you did not work a full year prior to your injury, the wages of a similar worker at your employer may be required to determine your AWW.

Medical opinions regarding degree of disability are used to determine wage benefit amount

  • For example, if you are found to have a 50% disability you would be entitled to 2/3 your AWW multiplied by 50% subject to the statutory limits below.
Compensation for Permanent Disabilities

Schedule Loss of Use (SLU) Award

  • Lump-sum monetary award granted to injured workers who sustain permanent functional impairments to specific body parts due to work-related injuries. This award compensates for the loss of wage-earning capacity resulting from the permanent disability.
  • Body parts/conditions that qualify for a SLU award include your extremities (arms, legs, feet, fingers, etc.), eyesight, hearing and facial disfigurement.
  • Your doctor will perform an evaluation and determine whether or not you have any loss of use as determined by the Workers’ Compensation Guidelines for Determining Impairment.
  • The SLU percentage is multiplied by the maximum weeks assigned to the injured body part. This result is then multiplied by two-thirds of the worker’s average weekly wage (AWW) to determine the total award.

Classification

  • Should you be unable to return to work after your accident you may be entitled to payments for a number of years depending upon.

Permanent disability benefits are available if you cannot return to work.

Death Benefits

To receive survivor benefits, a Death Claim must be filed with the Workers’ Compensation Board.

If an injured worker dies from a compensable injury or illness, the surviving spouse and/or minor children-or other dependents as defined by law-are entitled to weekly cash benefits.

These benefits are calculated based on the deceased worker’s average weekly wage.
If there is no surviving spouse or minor children/other dependents who are entitled to compensation, the surviving parents or the estate of the deceased worker may be eligible for a one-time payment of $50,000.

Dependents, as defined by law, may also file a claim to be reimbursed for funeral expenses if the worker’s death was due to a work-related injury or illness. Funeral expenses may not exceed $12,500 in the following counties: Bronx, Kings, Nassau, New York, Queens, Richmond, Rockland, Suffolk, and Westchester. In all other New York counties, funeral expenses may not exceed $10,500.

A claim for death benefits may be filed by:

  • A surviving spouse or dependent child(ren);
  • Dependent grandchildren;
  • Dependent parents or grandparents;
  • Dependent siblings;
  • Non-dependent parents or the estate of the deceased, if there is no surviving spouse or dependent.

Take Action Today

Filing a Workers’ Compensation claim ensures you receive the medical care and financial support needed to recover and protect your future. Don’t navigate the Workers’ Compensation process alone. Let our experienced attorneys fight for your rights.

What to do when your claim is denied

What to Do If Your New York Workers’ Compensation Claim Has Been Denied

If you’ve been injured on the job in New York and your Workers’ Compensation claim has been denied, you may feel frustrated and uncertain about your next steps. At Aronova & Associates, we understand how critical these benefits are to your recovery and financial stability. Fortunately, a denied claim does not mean the end of the road—you have options to fight for the benefits you deserve.

Common Reasons for Denial

Understanding why your claim was denied is the first step in the process. Some common reasons include:

Missed Deadlines

Failing to report your injury to your employer within 30 days or missing filing deadlines with the Workers’ Compensation Board.

Disputes Over Whether the Injury Was Work-Related

Your employer or their insurance carrier may argue that your injury did not occur in the course of employment.

Lack of Medical Evidence

If medical records don’t support your claim or the insurance carrier’s doctor disputes your injury, your claim could be denied.

Pre-Existing Conditions

If the insurer claims your injury is due to a pre-existing condition rather than a workplace accident, they may deny benefits.

Steps to Take After a Denial

The denial notice from the insurance carrier as well as your employer’s pre-hearing conference statement, should outline the reason(s) for the denial. Carefully reviewing these documents can help you determine the best course of action.

At the hearing, you will present your case before a judge, who will determine if your case is compensable and if you are entitled to benefits. It is highly recommended to have an experienced Workers’ Compensation attorney represent you at this stage to ensure your rights are protected.

If the judge denies your claim at the hearing, you can escalate your appeal to the Workers’ Compensation Board’s Panel Review by filing an RB-89 form.

How Aronova can help

Navigating the litigation and appeals process can be complex and overwhelming. At Aronova & Associates, we will

  • Review your case and identify the best legal strategy.
  • Gather and present compelling medical and employment evidence.
  • Represent you in hearings and appeals to fight for the compensation you deserve.

Don’t Give Up—We’re Here to Help!

A denied Workers’ Compensation claim doesn’t mean you’re out of options. Our experienced attorneys at Aronova & Associates are ready to fight for your rights. Contact us today for a free consultation and let us help you get the benefits you deserve.

Do I need an attorney?

Do You Need a Workers’ Compensation Attorney in New York? Understanding Your Rights

If you have been injured on the job in New York, you may be wondering whether you need to hire a Workers’ Compensation attorney. While some claims may be straightforward, many injured workers face challenges that make legal representation essential. Understanding when to seek legal help and the benefits of hiring an attorney can make a significant difference in the outcome of your case.

When Should You Hire a Workers’ Compensation Attorney?

While some minor workplace injuries may not require legal assistance, there are several situations where retaining an attorney is strongly recommended:

Your Claim is Denied 

Insurance companies frequently deny claims, arguing that the injury was not work-related among many other reasons.

Your Benefits Are Delayed or Inadequate

If you are not receiving timely wage replacement benefits or your medical treatment is being denied, an attorney can fight for what you are owed.

You Have a Pre-Existing Condition

Insurers may try to attribute your injury to a prior condition rather than your workplace accident.

Your Employer Retaliates Against You

If you experience workplace retaliation, such as demotion, termination, or harassment, after filing a claim, an attorney can help protect your rights.

You Have a Permanent Disability

If your injury results in a permanent partial or total disability, the process for obtaining fair compensation can be complex and may require legal advocacy.

You Need to Appeal a Decision

If your claim has been denied, you have the right to appeal, but doing so requires navigating strict legal procedures and deadlines.

A Third Party May Be Liable

In some cases, a third party (such as a contractor or equipment manufacturer) may be responsible for your injury. A Workers’ Compensation attorney can evaluate whether you have a separate personal injury claim.

Benefits of Hiring a Workers’ Compensation Attorney

An experienced Workers’ Compensation attorney provides numerous advantages, including:

In New York, Workers’ Compensation attorneys work on a contingency fee basis, meaning they only get paid if you win your case. There are no retainer fees or out-of-pocket costs.

Attorneys ensure you receive the maximum wage replacement and medical benefits you are entitled to.

The legal process is complex, and missing a deadline can jeopardize your claim. An attorney ensures all filings are accurate and timely.

Insurance companies often try to settle cases for less than what workers deserve. An attorney fights to secure a fair settlement.

If your case goes to a hearing before the Workers’ Compensation Board, having an attorney advocate for you increases your chances of success.

Contact a Workers’ Compensation Attorney Today

At Aronova & Associates, our experienced Workers’ Compensation attorneys are dedicated to helping injured New York workers get the benefits they deserve. Contact us today for a free consultation and let us fight for your rights.

Independent Medical Examinations (IME) in New York Workers’ Compensation Claims

An Independent Medical Examination (IME) is a medical evaluation conducted by a doctor chosen by the insurance carrier to assess an injured worker’s condition, causal relationship between injuries and claimed accident, degree of disability, need for ongoing medical treatment, and permanent impairment in a New York Workers’ Compensation claim. The IME plays a significant role in determining the continuation of benefits and medical treatment approvals.

Purpose of an IME

Insurance carriers request IMEs to:

  • Evaluate whether the injury is work-related.
  • Determine whether the degree of the injured worker’s disability.
  • Assess whether the worker has reached maximum medical improvement (MMI).
  • Decide if ongoing medical treatment is necessary.
  • Determine whether and to what degree there is permanent impairment.
Who Conducts the IME?
  • The IME doctor is hired by the insurance carrier, but they must be licensed and registered with the New York State Workers’ Compensation Board (WCB).
  • IME doctors do not provide treatment; they only evaluate the worker’s condition and issue a medical report.
Worker’s Rights and Responsibilities

Rights:

  • The worker has the right to bring a witness (such as a friend, family member, or attorney).
  • The worker can record the exam (audio or video).
  • The worker is must be sent a copy of the IME report within ten (10) calendar days.
  • If the IME report is unfavorable and differs from that of the treating physician, the worker can challenge it by way of cross examination, questioning the doctor under oath as to the contents of their report and making arguments with respect to credibility before the Law Judge.

Responsibilities:

  • The worker must attend the IME; failure to appear may result in suspension of benefits.
  • The worker must provide a truthful medical history and answer the doctor’s questions.
  • Failure to reveal prior or subsequent injuries can result in an adverse finding by the Law Judge.
What Happens During an IME?
  • The IME doctor reviews medical records related to the injury prior to the examination.
  • The doctor examines the injured worker and may perform tests.
  • The worker may be asked about:
    • The injury and symptoms.
    • Current work limitations.
    • Treatment history and progress.
    • Prior and subsequent injuries.
  • The IME doctor then writes a report with their findings and opinion.
Potential Outcomes of an IME
  • Supports the worker’s claim → If the IME agrees with the treating doctor, benefits and medical treatment continue.
  • Disputes the treating doctor’s findings → The insurance carrier may reduce or terminate benefits.
  • Declares Maximum Medical Improvement (MMI) → If the IME determines MMI, the worker’s case may be evaluated for a permanent disability rating.
Challenging an Unfavorable IME Report

If the IME is biased or inaccurate, the worker can:

  • Submit a report from their treating physician disputing the IME.
  • Request a hearing before a Workers’ Compensation Law Judge.
  • Obtain a second opinion from another doctor (at their own cost).
  • Provide testimony to counter the IME doctor’s conclusions.
Common Issues with IMEs
  • IME doctors may favor insurance carriers, leading to biased reports.
  • Short exams (some IMEs last only a few minutes).
  • Inaccurate or incomplete reports that misrepresent the worker’s condition.
  • Denial of necessary medical treatment based on IME findings.
Best Practices for Injured Workers
  • Be honest but concise in responses.
  • Do not exaggerate or downplay symptoms.
  • Bring a witness for support.
  • Take notes immediately after the IME to document what happened.
  • Request a copy of the IME report and review it for errors.

Labor Market Attachment

Refers to an injured worker’s obligation to demonstrate a good-faith effort to remain in the workforce despite their disability. This means that if a worker is partially disabled, they must actively seek employment within their medical restrictions or participate in vocational rehabilitation programs to remain eligible for wage replacement benefits.

1. Burden of Proof on the Injured Worker

The worker must provide credible evidence that they are actively searching for work within their medical restrictions. This evidence is reviewed during hearings before a Workers’ Compensation Law Judge.

2. Ways to Prove Labor Market Attachment

The New York Workers’ Compensation Board (WCB) recognizes several ways to demonstrate attachment:

  •  Keep a detailed job search log, including:
    • Date of application
    • Name and contact information of the employer
    • Type of job applied for
    • Outcome of the application
  • Apply to a reasonable number of jobs that fit within medical restrictions that you are qualified for.
  • Register with One-Stop Career Centers such as Workforce1 and participate in job search programs.
  • Attend resume workshops, job counseling, and interview preparation.
  • Request documentation from the program to prove participation.
  • Enrollment in Adult Education, GED programs, or skills training related to a new career path.
  • Participation in vocational rehabilitation through programs like ACCES-VR (Adult Career and Continuing Education Services-Vocational Rehabilitation).
  • Requesting modified or light-duty work from the previous employer.
  • Providing evidence of discussions or documentation of the employer’s response.

3. How the Judge Evaluates Evidence

During the hearing, the Workers’ Compensation Law Judge will assess:

  • The extent and quality of job search efforts (sporadic applications may not be sufficient).
  • Whether the worker applied for jobs within their physical limitations.
  • Participation in state-sponsored programs.
  • Any doctor’s restrictions and whether the worker sought jobs that matched those restrictions.

4. Consequences of Failing to Show Attachment

  • If the judge finds that the worker has not made reasonable efforts, wage loss benefits will be suspended.
  • The worker must establish reattachment before benefits can resume.

5. Best Practices to Maintain Eligibility

  • Consistently apply for jobs and keep a log after being directed to do so.
  • Attend career services or vocational training programs.
  • Follow medical restrictions when seeking jobs.
  • Document all efforts to present at hearings.

Frequently Asked
Questions

Am I eligible for Workers’ Compensation if I’m injured while commuting to or from work?

In general, injuries that occur while commuting (in your own vehicle, on your own time) are not covered by Workers’ Compensation.

However, there are exceptions, and you might be eligible if:

  1. You’re on a work errand during your commute (e.g., picking up supplies for your employer)
  2. You’re in a company vehicle or the travel is part of your job duties
  3. You work from multiple locations and travel is required between them
  4. Your job has no fixed office, like a traveling nurse or construction worker moving between sites
  5. You were injured in a company parking lot or immediately outside work premise

Could changing attorneys cause a delay in my Workers' Compensation case?

No, changing lawyers doesn’t significantly affect or delay your case.

There is only one fee that will be split between both firms based on the work they performed on your case.

Can I get fired for filing a Workers’ Compensation claim?

No, you may not get fired by filing a claim.  It is your legal right to file a Workers’ Compensation claim.

Can I receive Workers’ Compensation if I have a pre-existing health issue?

Yes, you may still qualify for Workers’ Compensation benefits even if you have a preexisting issue.  If your workplace incident worsens a preexisting condition that you have, you may still be entitled to workers’ compensation benefits. 

Is Workers Compensation taxable income?

Workers’ Compensation insurance benefits are exempt from taxes at both the state and federal levels. However, if you also receive Social Security Disability Insurance (SSDI) and your Workers’ Compensation affects those benefits, part of your Workers’ Comp payments might become taxable.

What is Workers’ Compensation?

Workers’ Compensation is insurance that provides medical care and wage replacement benefits to employees who are injured or become ill due to their job. It also covers certain benefits to dependents in the event of a work-related death.

Who is covered under NYS Workers’ Compensation?

Most employees in New York State are covered, including full-time, part-time, seasonal, and some volunteers. Employers are generally required by law to carry Workers’ Compensation insurance.

What should I do if I’m injured on the job?

  • Notify your employer in writing within 30 days of the injury
  • Seek medical treatment and inform the provider it is a work-related injury
  • File a claim with the New York State Workers’ Compensation Board by submitting Form C-3 as soon as possible

What benefits are available?

You may be eligible for:
  • Medical treatment for your work-related injury or illness
  • Wage replacement if you miss more than 7 days of work
  • Compensation for permanent disabilities
  • Death benefits for dependents in fatal case

Do I need a lawyer to file a Workers’ Compensation claim?

You are not required to have an attorney, but legal representation can be helpful, especially if your claim is disputed or denied.

What happens if my claim is denied?

You can request a hearing before a Workers’ Compensation Law Judge to appeal the decision. Having an attorney at this stage is strongly recommended.

How long do I have to file a claim?

You must file a claim within two years of the injury or the date you became aware that your illness was work-related.

Can I choose my own doctor?

Yes, but the doctor must be authorized by the NYS Workers’ Compensation Board. Your employer may also require initial treatment from a provider within their health care network.

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