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William W. Crossett, IV crossett@mcvlaw.com Kimberly A. Slimbaugh kslimbaugh@mcvlaw.com

Areas of Practice

Workers' Compensation

In New York State, if you are injured on or by reason of your job, you are entitled to Workers' Compensation benefits. The benefits are made up of medical care that is causally related to your injury or disease, and money if you are totally or partially disabled.

Generally speaking, Workers' Compensation benefits are paid by your employer's insurance company. Your medical benefits start as soon as you are injured. Your money benefits should start if you have been out of work for more than two weeks. Benefits continue as long as you are disabled.

Money Benefits

If you are totally or partially disabled, you are entitled to money benefits. The amount of your benefit is based on your Average Weekly Wage. The Average Weekly Wage is figured by looking at your earnings for the last year. If you have more than one job, wages from both jobs can be included.

You can collect up to two-thirds of your Average Weekly Wage, but, as of July 1, 2009, not over $600 a week. If your disability is not total, you may be awarded partial benefits.

Medical Benefits

You are entitled to medical treatment that is causally related to your injury or disease. You may choose your own hospital, doctor, therapist, or chiropractor. If your medical provider wants to do a test or procedure that costs more than $1000, permission must be obtained from the insurance company. The law says that if the insurance company doesn't object within thirty days of the request that permission is assumed.

Workers' Compensation Facts

- In 2002, there were almost 370,000 hearings held before the New York State Workers' Compensation Board. - In 1998, 1.7 million workers lost time from work because of a work-related injury or illness. Almost 60 percent of those workers had at least one year of service with their employer when they suffered their injury or illness, and more than one quarter had over five years of service.

Often the insurance company will have their doctor examine you to help them decide if they should pay for the test. During the examination, the doctor may also comment on your degree of disability. You must go to the doctor that the insurance company chooses.

If the insurance company will not pay for the test or procedure, you may ask for a hearing. The Judge may order the insurance company to pay.

New York State Workers' Compensation does not guarantee that you can return to your job. If you cannot return to your job or earn the same amount of money because of your injury, you may be entitled to continuing money benefits. If you have a permanent loss of use of an extremity, as may result from a fracture, you may be entitled to a scheduled loss of use.

Statute of Limitations

The Workers' Compensation Law of the State of New York includes very specific limitations as to:

• When you must report an injury. (30 days)
• When you must file a claim. (2 years)
• How much and how long you can collect benefits.

In addition, fraudulent receipt of benefits is a crime punishable by imprisonment and/or loss of all benefits.

The information presented here is general in nature and is not a substitute for detailed legal advice. We urge each and every injured worker to meet with an attorney and obtain information and advice that is specific to their case.