Valuable legal help for injured workers in central New York
No one wants to be injured at work or suffer a disease caused by work. Work-related injuries and diseases have many consequences. Not only is your health and income affected, you may also lose important employment benefits such as health insurance and retirement benefits.
In addition to spending your days at hospitals, doctors and therapist offices trying to recover, you are thrust into a system with laws, rules, and regulations generally new and unfamiliar to you. You want to do the right thing, but may be unsure about what to do or say. You do not want to make a mistake that will harm your case.
MCV Law understands the difficult situation you face
Since 1983, Meggesto, Crossett & Valerino, LLP has practiced before the Workers’ Compensation Board and New York courts representing injured workers and their families from across central New York. Our attorneys are active members of the Injured Workers Bar Association of New York, The New York State Bar Association and the Workplace Injury Law and Advocacy Group.
There is no charge to have your case evaluated. We are awarded a fee only after a Workers’ Compensation Law Judge approves it and only if we have produced a result for you. The workers' comp attorneys at MCV Law will discuss attorney fees and costs with you before any request is submitted to the judge.
Protecting injured workers
Injured workers are supposed to quickly receive medical care and wage replacement benefits, while employers and insurance carriers are supposed to act in good faith and provide medical care and money benefits in a timely manner. The Workers’ Compensation Board is supposed to timely assemble and index cases and resolve disputes in accordance with statutes, rules and regulations. Unfortunately, the system rarely performs as it should. Many times employers or their insurance carriers dispute claims, fail to file the required documents and drag their feet or otherwise frustrate the injured worker's claim.
The Workers’ Compensation Board has, in recent years, changed the manner in which claims are started, administered and resolved. Additionally, the board has recently instituted new Medical Treatment Guidelines and procedures that have frustrated all parties involved and that have significant effects on injured workers’ ability to get medical treatment.
The New York workers' compensation lawyers at MCV Law understand the law, the procedures, and their application in real life. Our attorneys take time to review the case, meet with the injured worker and formulate a strategy tailored to the particular needs of the case. We employ a skilled staff that is available to help with the day-to-day issues involving prescription drugs, mileage reimbursement, and return-to-work issues. Our firm helps injured workers at all stages of their claim, from initial filing, to hearings, through negotiations and ultimately to resolution or settlement.
Trustworthy, experienced representation
We handle workplace injury and disease claims, including:
- Construction site accidents
- Nursing home accidents
- Hospital accidents
- Factory, manufacturing and warehouse accidents
- Trucking and automobile accidents occurring at work or on the way home
- Chemical and hazardous material exposures
- Industrial and occupational disease claims
- Carpal tunnel
- Hearing loss
- Lung diseases
What we do first on a New York workers' compensation claim
First, we must determine where you, the injured worker (now called the claimant) are in the system.
We want to know the answers to the following questions:
- Has the employer’s insurance carrier accepted your case?
- Or is your case being contested by the employer or the employer’s insurance company?
- Are you being provided the medical care you need?
- Are you being paid lost wages?
- If so, is the weekly or biweekly amount being paid correctly?
Has the employer’s insurance carrier accepted your case, or is your case being contested?
Generally speaking, the employer or the employer’s insurance carrier must either accept or deny ("controvert" in workers' compensation language) your case within a specific time frame. This timeframe depends on when the injury occurred, when notice was given to the employer and/or when the documents, if any, have been filed with the board. When the Workers’ Compensation Board has received all of the correct documentation, they will index your case. The indexing of your claim starts the clock running. Your case is not indexed simply because you have a Carrier Case Number; rather, you need to obtain a New York State Workers’ Compensation Case Number for your case to be indexed.
Once your case is accepted, it is not guaranteed that the Workers’ Compensation Board will schedule a hearing for you. Instead, the board may attempt to manage or adjudicate your case on papers alone. You may receive Administrative Decisions, Proposed Decisions or other correspondence from the board. These documents are very important because they can affect your future rights and obligations. Without a hearing, you may not have an opportunity to tell your story or have your rights explained by a judge. Many clients come to us when they receive documents from the Workers’ Compensation Board. We take the time to explain exactly what the papers mean and what steps are needed to make sure that your rights are protected.
If your case is controverted, (the word used to tell you that your case is being disputed) a hearing will be held, but not until all the correct documents have been filed. Until the controversy is resolved, the injured worker will not be paid weekly compensation and may have trouble finding medical care. Generally speaking, the Workers’ Compensation Board tries to resolve controverted cases within 90 days of the first hearing. Therefore, it is important to make sure your case is in order before the date of the first hearing.
If your case is controverted, you may apply for New York State Disability Benefits (NYSDB). If you receive NYSDB and later win your workers’ compensation case, you will be required to pay back the amount of disability benefits your received.
Statute of limitations
During the initial review of your case, the workers' compensation attorneys at MCV LAW will determine if you have any statute of limitations problems. Generally speaking, New York Workers’ Compensation Law has a two-tier statute of limitations. The law requires that you give written notice of your injury to your employer within 30 days of the accident that caused your injury or the time the you first had knowledge that you have a work related injury or illness AND that you file a claim, (commonly referred to as a C-3) within two years of the injury or date you become disabled.
Even if you think your case is accepted, you need to be aware of the statue of limitations. You need to make sure that your employer and/or its insurance company has the same understanding of your claim as you do.
A word of caution: It is a crime to commit workers’ compensation fraud. Often, fraud will be asserted because of what was not said or included in a document, such as a claim form (C-3). You must be sure to prepare all documents with care. The attorneys at MCV Law help you complete the appropriate forms to make sure that your rights are protected and that you will not be accused of fraud.
Are you being provided the medical care you need?
Section 13 of the New York Workers Compensation Law entitles injured workers to causally related medical treatment. What constitutes causally related medical treatment is commonly disputed by employers and insurance carriers. The board has treatment guidelines for some injuries that are supposed to resolve conflicts and afford speedy treatment. Currently, the treatment guidelines deal with injuries to the shoulder, neck, back and knee.
Medical treatment also includes the medicines that are prescribed by doctors and hospitals, as well as treatments performed by physical therapists, chiropractors and other medical providers. Depending on where you live or your employer, you may have to see a particular set of doctors or have certain diagnostic tests, such as an MRI, performed at a facility chosen by the insurance carrier.
Medical care also includes the cost of your transportation to and from visits with medical providers. The attorneys and staff at MCV Law will explain how you can get reimbursed for these costs.
Are you being paid lost wages? If so, are these payments accurate?
If your case is accepted and you are out of work, you should be receiving lost wage payments. Generally speaking, you are entitled to two-thirds of your average weekly wage (AWW) up to certain limits, depending on the date of your accident or disability. Usually you are paid the full two-thirds if you have a temporary total disability. If your disability is less than total, you will be paid a percentage of the total rate.
It is very important to make sure your AWW is correctly set because it controls your wage benefits for the life of the case. If you have more than one job, you may be able to include the other job(s) in the AWW calculation. Your AWW is calculated by looking at your earnings or the earning of a similar worker for one year prior to your accident or date of disability. If you are under 25 years old at the time of injury, you are entitled to have your AWW increased at the time of permanency, this is called a Minor’s Wage Expectancy.
If you are currently working but earning less than you did prior to your workplace injury as a result of your injury or disease, you can collect up to two-thirds of the difference between your pre-injury wages (AWW) and your post injury wages. Payments of this type are called reduced earnings. Reduced earnings are a very important concept, especially in cases involving the neck, back and other serious injury cases.
Labor market attachment
Payments typically continue during your period of disability and recovery. However, if you have a partial disability and have not returned to work, you may need to take certain actions to protect your right to continued payments. It is very important to show that you remain attached to the work force. If you fail to do so, the insurance company may argue that you have voluntary removed yourself from the work place and therefore argue that you are not entitled to ongoing lost wage payments. Because of this defense, care should be taken before deciding to resign, retire, or otherwise leave your job(s) as a result of an accident.
If you have reached Maximum Medical Improvement (MMI), your case may be ripe for a permanency determination. A permanency finding will have different consequences depending on what part of your body was injured, whether you have returned to work with or without reduced earnings, and most importantly, the date of the injury.
Schedule loss of use
For injuries concerning extremities such as your hand or foot, you may be entitled to a Schedule Loss of Use (SLU). A SLU is expressed by your doctor as a percentage which is then converted into weeks and is multiplied by your Total Rate to determine the value of the loss. Once a value of loss has been determined, adjustments for protracted healing are made and any prior payments you were awarded are deducted. The Workers’ Compensation Law contains a table setting forth the number of weeks each body part is worth. Additionally the board has guidelines that are used by doctors to determine the percentage loss of use.
A payment of an SLU is not a settlement of your case. Even after you are awarded an SLU you are entitled to further medical care and may make an application to increase the SLU if your condition materially changes. However, before you can collect further weekly wages you must use up or exhaust the monies paid by reason of the SLU. While many see this process as fairly straightforward, our workers' compensation attorneys help you determine whether this is the correct course of action in your case and help you understand what exactly is being accomplished. There is often controversy over the percentage of SLU, which can result in litigation.
For injuries to other body parts such as the neck and back, an SLU is not available. Instead, depending on the date of injury, a permamancy finding can result in ongoing weekly-lost wage payments for life or a certain number of years. A “CAP” was placed on all injuries occurring after March of 2007. If a case involves both extremities and non-extremities or serious injuries to extremities, it is likely that a classification will be made.
Typically, a case is not ripe for classification until the injured worker has reached Maximum Medical Improvement (MMI). Controversy often exists as to whether an injured worker has reached MMI, especially in cases after March of 2007, as it is the first step in limiting the duration of benefits for an injured worker who has not yet returned to work.
Once it is determined that the claimant has reached MMI, the process becomes very unclear and contentious for injuries after March of 2007. For cases before March of 2007 the process is a bit less contentious, but it is often at this stage that much of the litigation and negotiation occurs. The goal in either instance is to maximize the duration and amount of the weekly benefit for the injured worker.
What exactly constitutes a settlement in a workers’ compensation case depends on your point of view and interpretation. Some injured workers consider it a settlement of their case when they are given an SLU or a Classification. Others consider it a victory when they have returned to work, earning what they did at the time of the injury with medical care for the injuries they suffered. Others look for an outright conclusion of their case where they give up future medical care and ongoing rights to collect lost wages in exchange for a sum on money. This type of resolution is called a Section 32 settlement.
The determination as to when and how to seek permanency and/or settle is usually one of the most important issues in an injured worker’s case. The attorneys at MCV Law work with each client to formulate a strategy that is most likely to satisfy their goal, within the bounds of the law. The attorneys and staff at Meggesto, Crossett & Valerino, LLP take pride in their ability to see the big picture and use it to our client's advantage to obtain the best result on an individual basis.
Beyond workers' compensation
Sometimes, workers’ compensation is not the only source of benefits for injured workers. If your accident was the result of the actions or negligence of someone not in the same employment, such as a building owner, subcontractor, product manufacturer or the driver of a vehicle, you may be able to bring a separate action to recover damages. The attorneys at MCV Law will look at the facts of your case to determine whether or not you may have an additional action, and if so, with your permission, pursue those other parties for a recovery in addition to your workers’ compensation benefits.
The attorneys will also use their skill and knowledge to recommend and pursue other statutory benefits such as Social Security Disability.
Contact Syracuse workers compensation lawyers at Meggesto, Crossett & Valerino, LLP online or at 315-471-1664 to see what nearly three decades of legal practice can do for you. We provide injured clients a free consultation, and we are only paid if we recover money for you.