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What is Workers’ Compensation?
Workers’ compensation is an insurance system for people who are hurt at work. This factsheet provides information about the system in New York State.
All employers must provide workers’ compensation coverage for all employees. There are a few exceptions. For example, domestic workers -- who work in private homes doing work such as cleaning or babysitting – are only covered if they work at least 40 hours/week for the same employer.
Some other examples of exemptions are New York City police, firefighter, uniformed sanitation workers and teachers who are covered by other compensation systems. A few other exemptions exist as well. You are covered starting on your first day of work. Workers who are not U.S. citizens, even undocumented workers, are covered.
What are the Benefits?
Workers’ compensation provides four kinds of benefits:
- Medical Care - Your medical expenses may be paid for as long as you need it, possibly even for the rest of your life. This includes paying for doctors visits, medical procedures, physical therapy, medications and travel to and from the doctor.
- Lost Wages - If your injury or illness causes you to lose at least eight days of work, you may receive part of your wages. You can receive 2/3 of your pay before taxes each week, up to a maximum of $400 per week. You don’t have to pay taxes on this benefit.
- Other Cash Awards
- You may also receive these additional payments:
- Permanent Partial Disability - If your condition results in an ongoing disability, you may be entitled to receive Permanent Partial Disability (PPD) benefits for as long as you remain disabled.
- Scheduled Loss of Use Award - There are cash awards if you lose a limb, or lose the use of a limb.
- Reduced Earnings - If you cannot go back to your normal work, and you have to take a job that pays less than you used to make, Workers’ Compensation can pay you 2/3 of the amount of earnings you lost
- Rehabilitation - If you are unable to work because of your injury, you may be eligible for a rehabilitation program that will teach you new job skills.
How Do You Get Workers’ Compensation Benefits?
If you are hurt on the job, you must take these steps to be considered for benefits and make sure to meet all of the deadlines. You may want to consider getting a lawyer before you take these steps – see section below. (Of course, for medical emergencies, consult a doctor immediately.)
1. See a Doctor Right Away
You must have a doctor determine that your injury or illness was caused by your job. Choose your own doctor instead of going to one chosen by your employer, such as at the Employee Health Service. You can see any doctor you want, as long as he or she is registered as a workers’ compensation physician. Before you schedule your appointment, make sure the doctor accepts workers’ compensation as payment. This means you will not have to pay the doctor. The occupational health clinics listed in this factsheet are a good place to find a doctor who understands work-related injuries and illnesses. Or your lawyer can refer you to a doctor who accepts workers compensation. Or contact the Workers’ Compensation Board for a list of possible doctors.
Your doctor must fill out a workers’ compensation medical form (Form C-4) to begin your case.
2. Notify Your Employer and Your Union (if you belong to one)
You have 30 days to provide your employer with notice of your injury or illness. Although it isn’t necessary, it is always best to have things in writing. If you have an illness or a condition that has developed over time, you have 30 days from the time you knew your condition was work-related to notify your employer. The Workers’ Compensation Board will require your employer to complete a form (Form C-2).
If you are a member of a union, notify your union representative as well so that they may assist you in filing your claim. Also, some unions have Workers’ Compensation lawyers on retainer.
3. File a Claim with the Workers’ Compensation Board
You must also complete and submit a form (Form C-3) officially notifying the Workers Compensation Board that you are filing a claim. You can get a copy of the Form C-3 by calling the Workers’ Compensation Board at 718-802-6933 or on the internet at: www.wcb.state.ny.us/content/main/form/c3.pdf. If you have a lawyer, ask him/her to assist you with filling out this form to ensure that it is done properly. If you do not file on time, you will lose your right to receive benefits. You have two years to file your claim from the time that you knew your injury was work-related. But, don’t wait too long! This is a long process and the later you file your claim, the longer it will take to receive your benefits.
Form C-3 that you fill out and Form C-4 from your doctor must both be submitted before the Workers’ Compensation Board will start your file. Once your claim is filed, you will receive a Case Number from the Board within about three weeks.
Do You Need a Lawyer?
You do not need a lawyer to file a claim; however, it is almost always a good idea to consult with an experienced workers’ compensation lawyer or licensed representative. This is especially true if you do not speak English well, your case is complicated, or your claim is disputed. A lawyer may be very important to helping you get the benefits you deserve.
You should never pay out-of-pocket fees. If you win your case, a judge will decide what fee the lawyer receives. This fee will be paid directly from your award to the lawyer.
Employers often dispute claims, so even with a lawyer, you will need to be persistent in pushing your case. (You may need to be persistent with your lawyer as well!) Don’t be afraid to ask questions if you don’t understand what is happening. Keep copies of all records, papers and letters and show them to your lawyer or legal representative. Keep track of all deadlines and dates for appointments and meetings to prevent delays.
What If You Haven’t Lost Time From Work?
Even if you have not lost any days from work, you may still want to file a claim.
You may wish to file a claim so both your current and future medical care can be provided, if needed. While it may seem easier to use your health insurance, there is a danger. Workers’ compensation will provide ongoing medical care for your condition, even if your job or insurance changes. If you use your health insurance for your medical care and later change your mind, it may be harder to establish a workers’ compensation claim.
Also, once your claim is established, you can re-open it if your condition gets worse or forces you to lose time from work in the future.
New York State Workers’ Compensation Board
For questions about workers’ compensation contact the Workers’ Compensation Board
General Information: 800-877-1373
Advocate for Injured Workers: 800-580-6665 www.wcb.state.ny.us
New York Committee for Occupational Safety and Health (NYCOSH)
NYCOSH is a non-profit organization that is dedicated to the right of every worker to safe and healthy workplace. We provide training, technical assistance and strategic advice to workers to help them combat hazards. We also advocate for the enforcement of workplace safety and health laws and regulations and for the establishment of better laws to protect workers.
For more information about workers’ compensation and other health and safety issues, contact NYCOSH at (212)227-6440 or at nycosh@nycosh.org.
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