Frequently Asked Questions About New York Workers' Compensation

Frequently Asked Questions About New York Workers' Compensation

Q: What is workers' compensation?

A: Generally, workers' compensation provides an exclusive remedy for work-related injuries and illnesses without regard to who was at fault. In New York, a worker injured or sickened on the job is usually eligible for workers' compensation benefits consisting of partial wage replacement, medical-bill coverage and some vocational-rehabilitation expenses. In the case of a work-related death, workers' compensation benefits are usually available to most surviving spouses and dependent children, to certain other relatives or to the decedent's estate.

Q: What kinds of injuries are covered?

A: New York workers' compensation law provides benefits for injuries, occupational diseases and death arising out of and in the course of employment. Examples of medical problems commonly covered by workers' compensation include repetitive motion injuries like carpal tunnel syndrome; injuries from falls; injuries from contact with dangerous equipment; back injuries and pain; hand and wrist injuries; diseases from exposure to dangerous substances; burns; and mental impairment, unless the psychological injury is caused by an employer's lawful, good-faith personnel action.

Q: In addition to workers' compensation benefits, may I bring a lawsuit against my employer?

A: Workers' compensation is usually the exclusive remedy against an employer for a work-related injury, illness or death. New York recognizes an exception and allows a separate lawsuit against the employer if the employer intentionally harms the employee or directs another to do so. In a different scenario, New York law allows an employee to either sue his or her employer or to make a workers' compensation claim if the employer fails to maintain legally required workers' compensation insurance coverage.

Q: What happens if I was to blame for my work-related injury?

A: Generally, if your own negligence contributed to your work injury, you are still eligible for workers' compensation, a so-called no-fault program. Nonetheless, in New York, workers' compensation is not available if the employee's injury was caused by his or her own intentional action either to harm another person or to injure himself or herself. However, benefits may be awarded for death from suicide if the suicide was a result of mental problems from work-related injury or stress. Benefits are also not allowed when a worker's injury is caused solely by his or her intoxication from alcohol or drugs. Practically, intoxication is rarely the only cause of injury.

Q: What should I do if I am injured on the job?

A: You should first seek emergency treatment. With some narrow exceptions, in New York, the employee or his or her authorized representative must give written notice of the injury to the employer within 30 days of the injury or death from injury. In the case of occupational disease, the employer must receive notice either within two years of disablement or from when the employee knew or should have known the illness is work related, whichever is later. The law has specific content and delivery requirements for the notice. Sometimes verbal or constructive notice is considered adequate if the employer is not prejudiced. In addition, the workers' compensation claim must be filed with the chair of the Workers' Compensation Board (WCB) within two years of the accident or death from accident or, in the case of occupational disease, within two years of disablement and from when the employee knew or should have known that the illness is work related.

Q: Can I see my own doctor for treatment of a work injury?

A: New York law gives the injured employee the right to choose his or her treating doctor. Almost always, the chosen physician must be on a list of those authorized by the WCB chair to treat workers' compensation claimants. Unauthorized interference with an employee's selection of medical provider is a misdemeanor. However, the employer may designate the physician in an emergency, if the employee asks the employer to do so, if a transfer to a new provider is in the employee's best interest or if the employee chooses an unauthorized provider.

Q: My employer refuses to pay workers' compensation benefits for my work-related injury. What is my next step?

A: In New York, the vast majority of workers' compensation claims are voluntarily paid by employers. When an employer disputes a claim, the Workers' Compensation Board (WCB) has the power to conduct an investigation and the authority to decide whether the claim is valid. Either the employer or the claimant may request an evidentiary hearing on the matter before a workers' compensation referee and both parties have the right to representation by attorneys at the hearing. The law provides mechanisms for further agency review of the initial decision by the WCB or its chair, and eventually for review within the state court system.

Q: Are all New York employers subject to the workers' compensation law?

A: Almost all New York employers are subject to the state workers' compensation laws. However, a few types of employers and employees are exempt, but some are covered instead by similar programs on the state or federal level. Depending on your job, an attorney can educate you about the types of benefits to which you may be entitled if you incur a work-related injury or disease.

Q: What if I was injured in the Sept. 11 attacks?

A: New York enacted a special law for workers' compensation claims of Sept. 11 workers and volunteers. Workers or volunteers connected to the attacks in any way, including rescue and clean-up workers, and volunteers, had until September 11, 2010, to register with the New York Workers' Compensation Board to preserve their future right to file for workers' compensation. However, anyone who worked or volunteered to help in the aftermath of the attacks should speak with a lawyer about other possible legal remedies, including health or other benefits under the federal Zadroga Act passed in January 2011 or compensation through neighboring state governments for workers with residence there. In addition, survivors of deceased Sept. 11 workers may be eligible for workers' compensation death benefits, and a special New York state law also allows surviving domestic partners of such workers eligibility for death benefits.

Q: What are the New York Medical Treatment Guidelines?

A: Effective December 1, 2010, medical treatment for all work-related injury and disease covered by New York workers' compensation must comply with detailed, complex treatment guidelines if any of the following body areas are involved: lumbar, thoracic or cervical spine; shoulder; or knee. The new standards apply to all medical treatment even if the problem started before the effective date of the law. Broadly, the guidelines authorize only certain tests and treatment in particular situations, with allowance for further testing authorization and alternative treatment with appropriate permissions. The goal of the guidelines is to get the worker back on the job within six months when possible and to direct efficient, focused treatment.

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