FAQs

A. Workers’ Compensation is insurance that provides cash benefits and/or medical care for workers who are injured or become ill as a direct result of their job.

Employers pay for this insurance, and may not require the employee to contribute to the cost of compensation. Weekly cash benefits and medical care are paid by the employer’s insurance carrier, as directed by the Workers’ Compensation Board. The Workers’ Compensation Board is a state agency that processes the claims and determines, through a judicial proceeding, whether a worker will receive benefits and/or medical care, and how much he/she will receive.

In a Workers’ Compensation case, no one party is determined to be at fault. The amount that a claimant receives is not decreased by his/her carelessness, nor increased by an employer’s fault. However, a worker loses his/her right to workers’ compensation if the injury results solely from his/her intoxication from drugs or alcohol, or from the intent to injure him/herself or someone else.

A claim is paid if the employer or insurance carrier agrees that the injury or illness is work-related. If the employer or insurance carrier disputes the claim, no cash benefits are paid until the Workers’ Compensation law judge decides who is right. If a worker is not receiving benefits because the employer or insurance carrier is arguing that the injury is not job-related, he/she may be eligible for disability benefits in the meantime. Any payments made under the Disability Program, however, will be subtracted from future Workers’ Compensation awards.

A. SOMETIMES under certain circumstances, an injured worker can apply for unemployment or state disability benefits. Each case must be viewed individually. However, when a worker is deemed partially disabled and unable to do his particular job, yet able to perform light duty work which is not available, he/she may apply for unemployment benefits. The injured worker may also collect a partial payment from Workers’ Compensation. Also, an injured worker should file a New York state disability benefits claim when the Workers’ Compensation insurance company denies the claim as being work-related, pending a final determination by the Workers’ Compensation Board.

A. ALL physicians and chiropractors who accept Workers’ Compensation can treat an injured worker. Initially, any hospital will accept the patient on an emergency basis but follow-up care should be with the WC Board-approved doctor. The injured worker should see his/her doctor at least once per month for any period of time he/she claims to be disabled and unable to work in order to prove the disability status to the WC Board and be paid for the lost of wages.

A. NO. There are essentially no costs to the injured worker. All necessary medical treatment is paid by the Workers’ Compensation insurance company. No co-payments should be paid by the injured worker. Any test or procedure costing more than $1000 needs preapproval and, of course, ordinary treatment or therapy privileges should not be abused. The worker is entitled to reimbursement for his/her “reasonable” expenses for medications and travel for treatment visits. Additionally, an injured worker is not permitted to pay a lawyer directly for legal services. Instead, any attorney’s fee must be approved by a WC Law Judge first and deducted from an award to the injured worker only if an award is obtained. Otherwise, no fees are payable.