Employee Rights Under Worker's Compensation
Medical Benefits
As an employee in New York, if you sustain a work-related injury or illness, you are entitled to medical benefits. These benefits cover the costs of medical treatments, hospital stays, and necessary surgeries. You have the right to choose your healthcare provider from the list of authorized providers by the New York Workers' Compensation Board.
Wage Replacement Benefits
If your injury or illness prevents you from working, you are eligible for wage replacement benefits. The benefits continue until you can return to work or until you've reached maximum medical improvement.
Permanent Disability Benefits
In cases where an injury results in a permanent disability, employees are entitled to permanent disability benefits. These benefits are calculated based on the severity of the disability and the impact on the employee’s ability to work. New York law categorizes disabilities as permanent total or permanent partial, each with specific compensation structures.
Death Benefits
In the unfortunate event that a work-related injury or illness results in death, the employee’s dependents are entitled to death benefits. These benefits include a portion of the deceased employee's average wages and coverage for funeral expenses.
Employee Responsibilities Under Workers Compensation
Reporting Injuries Promptly
Employees must notify their employer within 30 days of the incident.
Cooperating with Medical Examinations
Employees are required to cooperate with medical examinations conducted by the healthcare providers. This includes attending scheduled appointments and following the prescribed treatment plans. Non-compliance can lead to a reduction or suspension of benefits.
Filing a Claim
Employees must file a claim with the Workers' Compensation Law New York within two years from the date of the injury or illness. This involves completing the necessary paperwork and providing supporting documentation.
Employer Responsibilities Under Workers Compensation
Providing Coverage
Employers in New York are legally required to provide workers compensation insurance for their employees. This insurance covers the medical and wage replacement benefits that employees are entitled to in case of a work-related injury or illness.
Maintaining a Safe Workplace
Employers must maintain a safe workplace to minimize the risk of injuries and illnesses. This includes complying with occupational safety and health regulations and providing necessary safety training to employees.
Promptly Reporting Injuries
Employers are also responsible for promptly reporting injuries to their workers compensation insurance carrier. This ensures that the claims process can begin without unnecessary delays.
Cooperating with Investigations
Employers must cooperate with investigations conducted by the New York Workers' Compensation Board or the insurance carrier. Providing accurate information and documentation is crucial for the fair adjudication of claims.
Dispute Resolution in Workers Compensation Claims
Contested Claims
Sometimes, claims may be contested by the employer or the insurance carrier. Common reasons for contesting claims include disputes over whether the injury or illness is work-related or disagreements over the extent of the disability. When a claim is contested, the case is brought before the Workers' Compensation Board for resolution.
Hearings and Appeals
If a claim is denied or if there is disagreement over the benefits, employees have the right to request a hearing before a workers compensation law judge. If either party disagrees with the judge's decision, they can file an appeal with the Workers' Compensation Board.
