What Are Your Benefits?
What Are You Legally Entitled To Receive?
- Lost Time/Wage Replacement
If a worker loses more than 7 days of work because of a work related injury, they can receive wage replacement benefits. The employer’s Workers’ Compensation carrier will pay the injured worker a maximum of 2/3 of their average weekly wage if a 100% disability is established. For example, if a worker’s average weekly wage is $600, the maximum the worker can receive weekly from their employer’s Workers’ Compensation carrier is $400 per week. The actual amount an injured worker receives weekly is calculated based on their level of disability and salary.
Workers’ Benefits Rates
Date of Accident Maximum Rate
After 7/1/16* $864.32
7/1/15 to 7/1/16 $844.29
7/1/14 to 6/30/15 $808.65
7/1/13 to 6/30/14 $803.21
7/1/12 to 6/30/13 $792.07
7/1/11 to 6/30/12 $772.96
7/1/10 to 6/30/11 $739.83
7/1/09 to 6/30/10 $600.00
7/1/08 to 6/30/09 $550.00
7/1/07 to 6/30/08 $500.00
Prior to 7/1/07 $400.00
The minimum weekly benefit is $150 for a date of accident after 5/1/2013
* The maximum compensation rate will change every July 1 to 2/3 of the State Average Weekly Wage
- Time Reimbursement
When an injured worker is out of work due to a work related injury and continues to receive a salary, the worker may have their vacation and sick time reinstated/restored at the disability rate.
- Lifetime Medical Treatment
If an injured worker’s injuries are protected under the law (an attorney can advise if your injuries qualify as protected), it is possible to receive lifetime medical benefits for the injuries. Medical providers treating work related injuries are subject to following treatment guidelines published by the Workers’ Compensation Board (MTG – Medical Treatment Guidelines).
The MTG only apply to certain body parts and conditions, i.e., back, neck, shoulders, knees and carpal tunnel syndrome diagnosis. If these guidelines are followed, most treatments are automatically pre-authorized. The MTG also provide for the frequency and duration of some treatment and re-evaluation. The medical provider will be responsible to request any change in these prescribed treatment protocols, not the worker.
- Accidental Expense
A claim for transportation or prescription reimbursement may be made for any expenses resulting from the work related injury.
- Reduced Earnings
If a worker returns to work while diagnosed with a partial disability and/ or is designated for light duty and their earnings are reduced, they may be eligible for a reduced earnings award. A reduced earnings award is 2/3 of the difference between the average weekly wage and reduced return to work wage. For example; if prior to the date of injury a worker earned $600 per week, and post-injury returned to a reduced salary of $400 based on light duty, a reduced earnings claim would require the employer’s Workers’ Compensation carrier to pay 2/3 of the reduction in salary would which be $133.33 a week.
- Death Benefits
If a worker dies from a compensable work related injury, the surviving spouse and/or minor children can receive weekly cash benefits. The compensation amount equals 2/3 of the deceased worker’s average weekly wage for the year before the accident. The weekly compensation may not exceed the weekly maximum, despite the number of dependents. If there are no surviving members of the family, then the workers’ estate may seek payment of $50,000. Also, in New York, funeral expenses may be paid up to $6,000 under the death benefit rules and regulations.
- Injuries to Extremities – Schedule Loss of Use
A schedule loss of use award can be granted to an injured worker who has sustained a permanent injury to an extremity. An extremity is any part of the body except for the head, neck, and back. Extremities include arms, legs, hands, feet, eyes, ears, toes and fingers. Once the medical provider has determined the worker has reached maximum medical improvement (MMI) from all treatment, they will provide an opinion as to the percentage loss of use of the extremity. Schedule Loss of use is considered 6 months after the date of accident or 1 year after the date of surgery.
Table for Weeks Awarded on Schedule Loss of Use of Body Part