Workers Compensation New York

Introduction

New York Workers Compensation is a type of insurance that provides an alternative to wages, cash compensation and / or medical care for employees suffering from work injury or illness. Under the law, almost all employers operating in the New York State area must provide worker compensation to all employees, and compensation must be paid by the employer without the need for any employee to contribute to the cost.

Claims to compensate New York workers are processed by the New York State Workers Compensation Council and compensation is paid if the employer or insurance company agrees that an illness injury is directly related to the work. However, claims can be disputed either by the employer or the insurance company. Typically, if the claim is disputed, the case will be brought before a judge specializing in workers' compensation law and will then make a decision.

The concept of blame constitutes any part of a workers' compensation claim at all, and any party is legally considered to be wrong for injury or illness. As a result of this, the payment of compensation to the claimant is not adversely affected by his carelessness, lack of increased compensation or benefits received by negligence and employers. New York Insurance Workers' Compensation Act is prohibited in New York from suing employers for negligence.

Although the majority of New York workers compensation claims involve injury, illness or disability, insurance also includes employees against work-related deaths. In such cases, survivors' benefits will be paid to dependents. The employee loses all right to compensation if the worker is injured as the sole result of poisoning during alcohol or drug abuse, or if the source of the intention is to harm themselves or anyone else.

On workers' compensation

The Workers' Compensation Act took effect on July 1, 1914, after being approved by the State Legislature of New York. Its legislation requires an amendment to the Constitution in New York, following a failed attempt to pass a similar law three years earlier. The legislation was partially inspired by the 1911 Fire Shirtwaist Triangle Factory in Manhattan, New York, which remains one of the most violent industrial disasters in US history, resulting in 146 deaths.

In essence, the adoption of the Workers' Compensation Act represents a trade-off between the interests of both workers and employers. By design, it is certain that New York workers are quickly replacing wages and coverage for medical treatment resulting from work injury or illness, apart from the error. At the same time, employers will be protected from harmful and costly lawsuits related to their negligence, such as manslaughter claims.

At the same time, in almost all cases, workers will lose their ability to sue employers on the basis of negligence causing injury or illness, or death, while employers will lose the right to appeal claims made by employees by allocating Blame the employee, as long as there is a work-related reason.

And decided the outcome of the disputed claims filed under the Workers Compensation Act through the New York State Workers 'Compensation Council. "Effectively, an agency can be seen working in a similar manner to the court of law, providing worker compensation and judges' law to oversee cases. At a hearing, or by written decision based on evidence considered in the papers submitted by the claimant, insurer, employer and / or medical professionals.

Information for Employers

When it comes to fulfilling their obligations to provide insurance to employees in accordance with the provisions of the Workers Compensation Act the New York State has three main options.

The first option is to guarantee with the New York State Insurance Fund (NYSIF), which is the largest New York Workers' Compensation and Insurance Workers, and is officially classified as a non-profit government agency. They may also choose to insure with your insurance carrier, provided that the carrier provides the appropriate product. Instead, companies have the option to self-insure as part of trust or union or group self-insurance business plan.

Failure to provide coverage for five employees or less during a 12 month period, where appropriate in accordance with the provisions of the Workers Compensation Act, classified as a misdemeanor and carries a non-compliance penalty of not less than $ 1,000 and not more than $ 5,000. The lack of coverage of more than five employees over a 12-month period is classified as a Class E felony and is punishable by a fine of up to $ 50,000.

A subsequent failure to provide coverage, after his previous conviction for such failure, is classified as a Class D felony. This is punishable by an additional fine of up to $ 50,000 and subject to other penalties provided by law. Misrepresentation, including attempts to avoid appropriate classification or concealment of salaries, can be classified as both a criminal and civil case and punishable by various financial penalties.

Moreover, there are laws in place to protect New York workers from segregation and other forms of discrimination in the workplace after workers' compensation claim. This means that it is unlawful to shoot or discriminate against anyone who claimed or attempted to claim New York Workers' Compensation, on the basis of their claim. This protection also covers any employee who has witnessed, or is assigned to testify at the hearing of compensation workers another employee.

In the event that the New York State Workers' Compensation Council finds that the employee has been incorrectly dismissed, the Board has the power to order the employee to restore it to its previous position.This employee will also need to be paid by the employer for any loss of compensation arising from the discrimination, The work also be subject to a fine penalty ranging from $ 100 to $ 500.

Similarly, injured or disabled employees looking to return to work on a certain measure of protection under the terms of the Americans in 1990 with the Disabled Persons Act, which specifically prohibits discrimination in the workplace against persons with disabilities. More information on the implications of this law can be discussed with the New York State Workers' Compensation Council "by visiting a district office.

What is covered by the law?

Under the New York Workers Compensation Act, almost all public and private employers of at least one person must provide their employees with insurance coverage of workers' compensation. In addition, evidence of compliance with the law must be shown by presenting a prominent C-105 model, "compliance observed," in each workplace. Specifically, employers must provide compensation coverage for New York workers following:

• The employees were executed in any business outside on behalf of the business for profit. This includes full-time employees, part-time employees, borrowed or leased employees, family members and most subcontractors. It also includes volunteers doing business for a profit-oriented organization.
• Domestic workers work for 40 hours or more per week through one employer. This includes baby sitters, drivers, nannies, cooks, maids, domestic servants, servants and gardens. The number of hours worked including time spent eating or sleeping in the workplace, as well as assignments or other duties performed off-site, as long as they are carried out to the employer.
• Farmer and long workers like the employer pay them at least $ 1,200 in the previous calendar year. In most cases, this is a thorough relatives of farmers, with the exception of the wife and his children minors. However, they also require coverage if they operate under an express lease contract.
• Teachers are academic year, except those used by New York City, as well as assistants in public schools, including those in New York City.
• New York State employees, including any volunteers who are officially classified as under state employment. This definition should be based on the guidelines contained in article 1, section 3 of the document entitled "New York Code - WKC - Workers' Compensation".
• Provincial and municipal employees who are involved in the work and which are legally defined as "hazardous", in accordance with the guidelines contained in Article 1, Section 3 of the document entitled "New York Code - WKC - Workers Compensation" - for example building bridges and installing boilers, Cable and heavy machine operation, manufacturing or handling chemicals or explosives.
• All corporate staff, as long as the company concerned has more than two officers and / or two shareholders. Officers in one or two companies should be covered by the person if the company has other employees, although these officers are able to voluntarily exclude themselves from coverage.
• Almost all workers who receive financial compensation to work on behalf of non-profit organizations. For the purposes of this Act, compensation shall include remuneration, housing, food, and any other benefits considered to be of monetary value.
• Any other factor determined by the New York workers' companies. Council shall be an employee and not specifically excluded from coverage in accordance with the provisions of the Workers Compensation Act.

Generally, companies are not allowed to require workers from New York to obtain special compensation coverage for their employees, or require them to contribute financially towards workers' insurance policy compensation. An exception is made if the employee is legally classified as an independent contractor, in which case a business may insist on seeing evidence that the contractors have valid coverage on their own.

Which is not covered by law?

While the vast majority of New York workers are covered under the Workers Compensation Act, there are a number of notable exceptions. In such cases, employers are not obliged to provide compensation coverage and, usually, these workers are not legally recognized as employees. More specifically, workers are not covered by the following New York Workers Compensation Act New York:

• Those who voluntarily provide their services to non-profit organizations and receive any compensation for their efforts. It should be noted that any funds used exclusively to offset the expenses incurred during the implementation of this work are not classified as compensation.
• Religious leaders and members of religious groups who perform their religious duties.
• Police officers and firefighters in New York City, as well as sanitation workers by provisions made by the New York State Public Towns Act covered. It is important to note that some officers in uniform from other municipalities can be excluded from coverage under the law.
• Husband and / or his minor children from the employer who works as a farmer, except in cases where work is undertaken to exit under an express contract of lease.
• New York workers are involved in teaching or hand-held ability or on behalf of a charitable, religious or educational institution. Note that cleaning and keeping files, moving furniture, playing musical instruments, cutting in the garden and carrying books or flyers are all classified as manual work.
• Owners, partners and officers in one or two companies person, if that company has no employee and no other people and provide services that are an integral part of the business. If not covered by law, and these people are still able to obtain voluntary coverage if they so desire.
• Real estate salesmen, insurance agents and media sales representatives who voluntarily signed a contract that provides that they are independent contractors.
• People, including children under the age of 18, who perform casual work or yard work in or around family residence. In this example, the word "casual" sometimes means, without regularity and without a plan or method. Coverage required if the person concerned processes a power-driven mechanism.
• American Foundation employees, assuming that the company is owned by the same Native American tribe. However, both American and non-original Native American employees of these projects are able to obtain coverage on a voluntary basis.
• No New York workers are already covered under other workers' compensation scheme. These may apply to federal government employees, railway employees between states and persons working in various maritime professions.

Like some other groups mentioned above, contractors are not covered by law, and employers who take on their services do not need to provide them with coverage. However, there have been cases where the New York State Workers' Compensation Council has the sub-rule to be an employee after they have sued the general contractor.For this reason, subcontractors often require the public to cover their own.

Employee or Independent Contractor?

Sometimes, the line between an employee of any individual can be obvious. For this reason, the New York State Workers' Compensation Board takes a number of different factors into consideration when trying to determine whether a person must, under the Workers Compensation Act, be classified as an employee or an independent contractor.Three of the most important factors are considered in more detail Detail below:

Right to observe

The concept of control is often the point of contact when trying to define the relationship between the employer. If the business or any person within the business, able to control the way in which the work is carried out by the worker, it indicates the work done by the employee. On the contrary, if the person doing the work is the one who controls the way that it is performed, this indicates that they may be an independent contractor.

work nature

Another important point of view about the nature of work is done, especially with regard to the usual course of business of the recruitment company. If the work performed is similar in nature to the basic work of the company, this indicates that the worker may be an employee. If the work done by a person varies greatly in the work that is usually undertaken by the hiring company, it means that the person is an independent contractor.

Payment method or payment

The payment method is an additional factor which can be taken into consideration when attempting to place any employee or any independent contractor status. An employee will tend to pay wages at a group rate, be it a clock, daily, weekly or monthly. Independent contractors, meanwhile, can be given cash compensation to accomplish a specific task, regardless of the time it takes.

None of the above factors are in isolation, a decisive factor in the employee versus contractor independent debate, but they can be used as a basic guide.If all three factors indicate that the person is an employee, or all three indicate that the person is an independent contractor, it is fairly safe to assume this is the case. However, there are other factors to consider, the final decision will often require a judgment of the judge of the compensation law.

Law regarding the outside of the state employers

Many employers who are physically stationed outside New York State have employees who live in New York State work for them. These New York residents usually travel to work sites outside the state and in such cases, the employer is not required to implement New York Workers' Insurance Compensation. Exceptions to this rule are if the employees perform work for a business owner within New York State, or the employee is subject to guidance or supervision from the employer while they are in their home country.

On the other hand, some employers outside the state need one or more employees to do business within New York State. For example, work outside the state is to implement the construction project within New York State. In most cases, these employees will be classified as New York workers, and the employer will be required to have a regular New York complete workers' corporation. Insurance policy in place for them.

Moreover, some New York companies need employees to do temporary work assignments outside New York State. In general, the New York policy is employed in the state of compensation covering these employees if they suffer from work injury or illness outside the state. As such, they are still classified as New Yorkers and are still eligible for compensation. Similarly, some workers who work regularly outside of New York may be classified as New Yorkers by the Board if the employer controls the work outside of the State of New York.

Illness, injury and disability

Workers' compensation may be paid to New York workers who suffer from illness, injury or disability caused by accidents in the workplace. Any such incapacity must arise "through work" and an adequate lead time of the accident and its causes must be given to the employer. New York Workers' Compensation Act prohibits workers from taking other legal action against the employer, although they may still be able to sue third parties.

To establish the state of New York Workers Compensation, the worker must be able to establish a "causal relationship" between injury or illness, and their workplace. This can only be done by obtaining a medical report, which firmly states that any accident in the workplace or situations within the workplace was the cause of the disability.

Successful claim to compensate workers requires that the employee was "at work" at the time of the accident. This means that injuries to a travel accident either to or from work are not covered by legislation, subject to exceptions, as in cases where travel workers are part of their paid working day.

It is essential that the employer be notified of the incident within 30 days. This notification can be a verbal start, but must be placed in the form of a written report ahead of time 30 days. If the damage is the sole result of alcohol or drug abuse, or arises from an attempt by an agent causing harm to themselves or to another employee, any claim for compensation is likely to be rejected.

If a New York worker suffers from a work injury to the extreme, such as an arm or leg, if they suffer from a scar on the face, or if they suffer either loss of sight or hearing loss caused by an accident at the workplace, they may be entitled to additional compensation, even if The damage did not cause them to lose any time at work. If the working time is lost and the pay replacement benefits are paid, this is usually deducted from the final compensation.

However, not all injuries to the parties will be eligible for an additional compensation award. In such cases, the employee will not be entitled to compensation for loss of income caused by time away from the workplace.

Disability Classifications

For the purpose of awarding compensation, work-related disability is divided into a number of different categories. Cash benefits paid through the New York Workers Compensation scheme are directly linked to the ratings listed below. In most cases, the extent of injury and classification of disability is determined by the health care provider of the injured worker.

Partial temporary disability

This happens when injured New York workers only lose some of their ability to earn pay, and loss of this ability is only on a temporary basis.

Total temporary disability

This happens when the injured New York workers lose their ability to earn a full wage, but the loss of this ability is only on a temporary basis.

Permanent partial disability

This happens when injured New York workers only lose some of their ability to earn pay, but the loss of this ability is on a permanent basis.

Total Permanent Disability

This happens when the injured New York workers lose their ability to earn fully pay, and the loss of this ability is on a permanent basis.

distortion

This occurs when the injured New York workers suffer significant and permanent deformation on the face, head and / or neck.

The permanent partial disability category is divided into two sub-categories:

Schedule for ease of use (SLO)

This occurs when an injured New York agent has the use of the upper limb (finger, hand, wrist, arm, shoulder), lower (toe, foot, ankle, knee, leg, thigh) permanently, or suffers loss of hearing sight.

Change the table

This occurs when an injured New York agent suffers from a permanent disability involving a part of the body rather than by a subclass of its coverage. Some examples of parts of the body that may be affected include non-table of the brain, heart, lungs and spine.

It should be noted that according to the rules set by the New York Workers Compensation Council, the total disability is categorized as being unable to do any work at all, while partial disability means the person is able to perform certain actions. These definitions do not take into account the nature of the person's work prior to disability. This means that anyone who is capable of doing their previous job at all can only be considered a partial disability.

To provide an example, a professional guitarist may suffer an injury in their hands, leaving them completely unable to continue their work as a musician. Despite this fact, they may still be able to perform other types of work away from this particular area. If this is the case, instead of being categorized in a completely disabled counter for previous works that as a guitarist, they are classified as partially disabled in general work.

Occupational Diseases

In addition to injuries and illness, New York also compensates workers for occupational diseases. A professional illness is a condition that stems from the type of employee's employment, not from the circumstances the worker is exposed to or exposed to. In most cases, at odds with injury and occupational diseases develop over a period of time, not from a single accident or accident, although there are exceptions to this.

Examples of occupational diseases include cirrhosis among New York workers working in asbestos removal jobs, and asthma bakers among bakery workers. In each of these examples, the exposure to a particular substance has been caused over a period of time. Exposure to asbestos is the root cause of cirrhosis, while exposure to dust dust is the root cause of asthma bakers. In both cases, exposure was in the workplace.

However, occupational diseases do not include all exposure to certain substances and include a number of other pathological conditions resulting from performing work duties over a period of time. For example, people who work in writing-based occupations often suffer from problems with their fingers, hands or wrists, due to the repetitive nature of the work, while heavy machinery operation workers can develop a number of conditions caused by repeated vibrations. In either case, these can be classified as occupational diseases under the Workers Compensation Act.

Time constraints for New Yorkers A lawsuit involving a professional illness is a high and different technique of suffering from injuries or illnesses, because it takes a number of factors into consideration, including the date of first medical treatment and the date of the first occasion when the factor of working time has been lost. However, the time limit for filing a claim is usually later than the two dates listed below:

• Two years on the date of the person has become affected by a professional disease.
• Two years on history the person became aware that the disease was due to the nature of their work.

In the end, the disability will be set by the New York Workers Compensation Board and will use that date when assessing whether a claim has been filed in time. For this reason, encourage employees to make a claim as soon as possible after learning that their condition is a professional disease, with a clear causal link to their work.

If a professional illness includes hearing loss, the time deadlines for submitting slightly different claims. Basically, in such cases, the waiting period for the worker to file suit for their own choice either: three months from the date of removing the factor of harmful noise in the workplace, or three months from the date of leaving the occupation worker where they have been exposed to harmful noise. The last day of whichever is chosen is a three-month period from the day the disability began, according to the New York State Workers' Compensation Council. "

the death

Unfortunately, in some cases, workers in New York lose their lives as a direct result of their occupation. In cases where death is caused by an accident at the workplace or accident, or in cases where the New York claimant dies from current injury compensation, survivors, children or other legal dependents may have the right to claim damages in the form of entitlements Death and survivors.

It is necessary to understand that in order to be eligible for death benefits and survivors, the person's death must result from an injury or a condition that was causally linked to their work. This means that injured workers who claim workers' compensation, but then disappear through unrelated means, or means that are not directly related to injury based on their work, will be discontinued. In this case, the survivors and / or other dependents will not receive any additional compensation as a result of death.

Benefits of the claim

There are three major compensation benefits available to New York workers who are injured during work, with each type of utility providing assistance for different circumstances. The type of compensation benefits received by the claimant depends largely on the nature of their injuries. In many cases, workers may be entitled to more than one type. Three main categories of interest are listed below:

Compensation or cash benefits

These are usually paid to injured workers New York who have suffered from a work-related disability or illness and suffered from loss of earning capacity as a result. Compensation entitlements are usually calculated at a rate of two thirds of the average weekly wage of the worker during the previous 12 months, taking into account legal limits.

These benefits are not paid for the first seven days of disability, unless the mark exceeds 14 days, where points will be paid from the first day. In some cases, such as with injuries to limbs or face, it may be due to compensation benefits, even if the working time is not lost as a result of injury.

Medical benefits

These are paid in order to cover the cost of medical care necessary, assuming such medical care is directly related to the accident at the workplace or accident mentioned. These can include hospital-related costs, diagnostic tests, physiotherapy, nursing services, physician services, dental services, X-ray exams, prescription drugs and various other forms of medical care.

It should be noted that any treatment of health care providers, including physicians and chiropractors, must be registered with the State Workers' Compensation Board of New York, except in emergency situations.

Death and survivor benefits

This is payable in the event of the death of a worker as a result of a work-related injury. In such cases, the surviving spouse, minor children and / or other legally dependent dependents are entitled to weekly payments, based on the average weekly worker's earnings before his death. Funeral expenses of the deceased worker paid, subject to legal maximum also.

If the deceased has no spouse or dependents, the surviving parent or estate may be entitled to a lump sum.

Additional benefits

Additional benefits are the fourth type of interest associated with New York insurance workers compensation, although these are much less common. In essence, the added benefits of providing additional financial aid to New York workers have been thought to be adversely affected by rising costs. The total amount received through a combination of either compensation or death benefits and additional benefits can not exceed $ 215 per week.

At present, there are only two groups of people eligible to apply for additional benefits:

New York workers are classified as both fully and permanently disabled, as a result of an injury in the workplace or illness, and if the disability was incurred prior to January 1, 1979, widows or widowers receive death benefits and survivors as a result of death related to work from their husbands, 1 January 1979.

In order to apply for additional benefits, the eligible person must complete the SC-64 form, which can be obtained by calling 518-486-3361. Once the form has been submitted, the process of administrative follow-up, before a final decision is made on whether to grant or not to grant additional interest payments.

An overview of the claims process

Typically, the process of claiming compensation after a work injury or illness is relatively unclear. However, there are many basic stages of the process and there are many deadlines in place. The following is the breakdown of step-by-step process claims, starting with the treatment phase:

Step 1 - Medical treatment

If the worker maintains an injury, illness or occupational disease, the first step should be to obtain any necessary first aid or medical treatment immediately. Except for emergencies, and the health care provider should be authorized or coded through the New York State Workers Compensation Council. "In addition, if the employer is a participant in the preferred provider organization (PPO) or an alternative dispute resolution system (ADR), it may be An employee is required to receive treatment from their health care providers.

The cost of any medical treatment is to be paid by either the employer, the insurance company and the employer, assuming the claim is indisputable. This means that healthcare providers do not bill the employee directly for any treatment. However, an employee may be required to sign a form of A-9, which recognizes that the patient may be required to pay for treatment costs in the absence of a claim by New York workers. Not fully followed, or if the Board rejects a claim for any reason.

Step 2 - notify the employer

The supervisor must be notified verbally about an incident or incident as soon as reasonably possible. It should include information about what happened and how it happened. In addition to this verbal communication, the employer must be notified of the incident or more formally occurring, in writing. Again, it must be done as soon as possible, yet no later than 30 days from the accident.

The employer may not be notified in writing within 30 days that the employee loses their eligibility to claim compensation. In the case of a occupational disease, rather than an injury, this notice period has been extended within two years of disability, or within two years of the discovery claims that the condition is, as relevant to the employment date at a later date.

Step 3 - Claim workers' compensation

In order to claim New York workers compensation, you will need an employee to fill out the "Claim Form Employee Compensation (C-3)" and send it to the appropriate county office of compensation workers board. Ideally, this claim must be made as soon as possible, but must be filed within two years of the accident, or two years for the employee to know that the injury was due to their working conditions.

New York workers who fail to file a claim during the two-year deadline may lose their right to compensation.

The treating physician must complete the form of "initial report physician (C-4)" and send it to the appropriate county office within 48 hours of the accident. A copy of this report should also be sent to the employee, employer and insurance company. At the same time, the employer is obliged to report injuries to the Board and to the insurance company within 10 days of the date of being notified of an incident or incident.

Step 4 - Acknowledgment of employee rights

Once the insurance company has received the required notice of an accident or incident from the employer, he must then submit the injured worker with a written statement, specifying the extent of their legal rights. This notice must be submitted within 14 days of receipt of notice from the employer, or sent with payment of the benefits of the injured worker, depending on which of these dates is as soon as possible.

In the event that the insurance company requires the injured worker to use the contracting network in order to obtain their diagnostic tests, the worker must be notified of this fact at this stage of the process. Claims should be provided with both name and contact information for this network at the same time.

Step 5 - Start making use of payments or disputes

Within 18 days of receiving notification from the employer, the insurance company must start paying the benefits and notify the board that the payments have started, assuming that the lost time of work exceeds seven days. There are some cases where the insured may not make the payment at this time, as if there is no lost work time, or if the disability period is less than seven days. If this is the case, the insurance company must notify the employee, employer and board and why not pay.

On the other hand, if the insurance company decides to challenge the claim, the New York State Workers Compensation Board must be notified "in order to formally initiate the dispute process.

Step 6 - Progress reports and doctor rehabilitation

Assuming that the insurance company did not object to the claim for compensation, the payments should be paid bimonthly. At the same time, every 45 days, the physician must fill out a form entitled "Progress Report Doctor (C-4.2)", which allows them to provide updated information about the patient's progress, and send them to the Board.

Once the injured New York workers have been reached mark 12 weeks of recovery or treatment, the insurance company that deals with their claim is able to consider the possibility and / or the need for rehabilitation. In most cases, voluntary rehabilitation programs, although there are circumstances that can be mandatory for interest payments are compensation for follow-up.

How to sue

If a staff member gets sick or gets sick at work, to ensure that they receive the compensation they deserve, they should complete the form of the board entitled "Employee's Compensation (C-3)". This should be done as soon as possible after injury, or after the establishment of this condition has a causal relationship with the workplace, the employer must also be notified of how, when and where the injury or illness occurred.

Although the claim must be filed as soon as possible, it is necessary that the New York Workers file no claim for compensation within two years of an incident or incident causing injury, or it has been developed within two years of the date that the illness or condition was defined as a result of the circumstances Work, or nature of work.

There are a number of ways to submit the form of "Employee Compensation Claim (C-3)", as shown below:

• Send a hard copy of the form entitled "Employee Claim Compensation (C-3)" to the Central Post Office Compensation Workers in State 'New York.
• Full Form "claim for employee compensation (C-3)" over the telephone by contacting the New York Workers Compensation Board "at 1-866-396-8314 and speak to a member of the team.
• Complete the web copy of the form "Claim Employee Compensation (C-3)" and submit it online.

A hard copy of the Claimant's Compensation Claim Form (C-3) can be obtained directly from the New York State Workers Compensation Board by visiting any customer service site or county office.In addition, a request for a hard copy to be sent out can (877) 632-4996. The web version of the form can be found in the online forms section of the board website.Usually updates are sent on request via mail.

Claims involving the death of New York workers were slightly different and require a relative to submit a board model entitled "Claim for compensation in case of death (C-62)", along with any request for documentation. The carrier must notify the board and insurance death as soon as possible, and when available, a copy of the death certificate should be provided.

In addition, the board form entitled "The Proof of Death (C-64)" will need to be provided by the last therapist, while the funeral home dealing with the deceased will need to fill out a form entitled "Proof of Burial and Funeral Expenses (C- 65). Again, all three of these forms can be obtained from the customer service center, the provincial office or from the website of the board. The model packed by the last therapist needs to explain how the death is causally linked to the work, or to the previous work injury.

Disputes, appeals and hearings

After a claim has been filed for compensation by the employee and the employer and the insured have the right to contest the claim. In such cases, companies New York workers. The Board may decide to hold a hearing or multiple sessions, or make a decision in writing by examining the documents submitted by the employee, employer or insurance company and the medical profession on both sides of the discussion.

If the body decides the dispute should be settled through hearing, the hearing will supervise the judge's compensation law, which will be allocated by the board. Throughout the proceedings, the judge may decide to accept the testimony, review the medical evidence and allow other evidence to be submitted. At the end of the hearing, the judge either ruled a claim to be compensable, or a ruling in favor of the employer and carrier insurance.

The claim should be considered compensable, the judge who oversees the case and then determine the amount to be paid and the duration of the compensation, based on the standard board model. On the day the judge's decision comes, both parties have 30 days to file an appeal. An appeal must be made in writing and submitted to the Board for review.

Assuming that the appeal is granted, the appeal process will be overseen by a committee of three members of the Board. This panel can then either confirm the judge's original decision, make amendments to the judge's decision, or overturn the judge's decision. Instead, they may decide to return the case to the original judge, allowing the record to be compiled.

The final decision of the panel must be the majority decision, but there is no need for a unanimous decision. However, if the decision is not unanimous, either party may submit a request for full Board review. At this point, the full board then decides either to confirm the decision, amend the decision, or cancel the decision.

Any appeal to the final decision of the Board Committee should be made to the Appeals Division of the Supreme Court of New York State. This appeal must be submitted within 30 days of the Committee's decision. Interested parties may also appeal in the end decision of the Appeals Division, but must take their case to the Court of Appeal to do so.

If the judge's decision is challenged, the insurance company does not need to make claims with the weekly benefit payments while the case is being considered by the board board. However, if the court upholds the judge's decision, the claimant's compensation and medical bills must be paid, even if the decision of the committee is appealed to the Appeals Division.

It should also be noted that at any time during the dispute and appeals process, the claimant is entitled to legal representation from any lawyer or authorized representative. However, this is prohibited by a lawyer or a licensed representative from requesting or accepting fees directly from the claimant. Instead, the fees for legal services provided by the board of directors will be determined and deducted from the compensation.

Medical treatment Legal aspects

Once a compensation claim has been accepted by the insurance company, or has been upheld by a claim by New York state companies and workers. "Council, workers must cover medical expenses.However, any treatment physicians, chiropractors or other doctors must have a confession Officially by the Board.Prohibits doctors from billing directly injured workers and must instead send any bills and reports to the insurance company and board.

Law in New York requires insurance companies to cover any associated medical costs, including those associated with assessment, diagnosis and treatment of work-based injuries. If a competitor to New York workers. Dispute is disputed or otherwise challenged, either to send the case to arbitration or a hearing will be held. During this time, health care providers must wait to receive payments and injured New York workers must not be expected to pay the bill at the same time.

You may request standard medical services, tests and procedures that cost less than $ 1000 by a doctor or chiropractor without the prior approval of the insurance company. However, insurance companies have greater rights when so called special services, as long as they have a cost of more than $ 1,000.

In these circumstances, the carrier is able to send their medical advisors to assess the injured worker and decide whether or not the procedure is necessary. This assessment must occur within 30 days of the insurance company receiving a request for medical expenses, and claimants must provide such medical examinations when needed, or risk losing their right to compensation.

Furthermore, the insurance company is able to insist that claimants receive any X-ray, CT scans, MRI and other diagnostic tests through a network of service providers or utilities that have made a contract with. However, the injured worker must be notified of this condition in writing. Injured New York workers must comply with these requests, unless it is a state of emergency, or lack of such facility at a reasonable distance.

What should be done to the injured workers?

A number of key actions that injured New York workers should follow while claiming workers' compensation. Acknowledging what is expected can protect workers from losing their right to claim, while also ensuring that they receive all compensation that is legally entitled.

Claimants must regularly see a doctor, as they can prove their disability only, legally, through medical reports. As a general guide, every medical report from a doctor is usually enough to prove disability over the next six weeks, although this is a approximation. The doctor's instructions should also be followed closely, in order to speed up the recovery process and maximize the chances of returning to full working capacity.

If so requested, claimants must attend any independent medical examination dates as well as any of the hearings that are scheduled by the New York State Workers Compensation Council. "Injured workers attending a hearing must bring with him a copy of the medical report on most up to History, as well as any evidence of current gains.

The insurance company that deals with the claim is obligated to compensate plaintiffs for travel to and from certain medical appointments, as well as some out-of-pocket expenses. For this reason, when possible and / or appropriate, injured workers must track miles from and to medical appointments with doctors and therapists, and keep a record of any expenses arising from the relevant recipes. The exact price of this payment will be determined by the New York State Workers Compensation Board. "

Finally, compensation claimants should aim workers New York to return to their places of work as soon as they are able to do so. In the event that the injured worker returns to work, but makes less money as a direct result of their disability, they should carefully follow their profits and make copies of their pay stub and / or tax documents. This is because workers with low returns may still be eligible for compensation.

Rehabilitation services

The New York State Workers' Compensation Council has its own rehabilitation staff, including doctors and counselors, claiming examiners and social workers, who provide a comprehensive rehabilitation package for New York-affected workers. This is possible, or helps to relieve the symptoms of disability as much as possible.

Ultimately, the goal of the rehabilitation program is to help injured workers return to work, where possible, and help people live and work to the fullest extent possible. There are three major rehabilitation services in offer, these are detailed below:

Vocational Rehabilitation

This type of rehabilitation is aimed at helping the disabled worker determine the best way to return to their previous job, by providing guidance and support.

Medical Rehabilitation

This type of rehabilitation is aimed at restoring the person to maximum potentials, using exercise and conditioning techniques. Medical rehabilitation can only be recommended by the doctor and the rehabilitation process will also be the same under the supervision of the doctor.

Selective Placement

This type of rehabilitation is aimed at those people who have suffered from permanent disability, and aims to help them find a specific job, which will suit their abilities.

In most cases, rehabilitation is completely voluntary, although it may be mandatory for people with certain types of SLU disability. Claimants who decide to participate in one of the qualifying offers are still entitled to receive their money benefits, based on the extent of their condition or injury. Moreover, claimants who return to work, but are unable to earn their former wages due to disability are entitled to a reduced rate of compensation.

Any injured workers should obtain further information contact the Rehabilitation Rehabilitation Unit of the New York State Workers' Council. "Applications for voluntary rehabilitation services on offer can be completed by re-submitting the form of the Board entitled" Request Services ".

social services

The Social Services Council also provides New York workers suffering from occupational injury or illness. Provide social workers with a wide range of services and work with families to help them meet the challenges of disability through existing work. All claimants are entitled to compensation for workers and their families social services and are provided at no additional cost. These services include, but are not limited to:

• Advocacy on behalf of New York workers is affected by disability-based work.
• Site of dependents in cases where the death factor has suffered for work-related reasons.
• Negotiate with utility companies, landlords, etc. in order to ease financial burdens.
• Arrange home care for claimants.
• Working with families, in order to create a realistic budget more suitable for their low income.
• Help patients try to get work and / or medical records.
• Referral to community agencies capable of providing more assistance to injured workers.

All social services provided are strictly confidential. Requests for services can be made in writing for, calling or visiting the Social Services Unit at the New York State Compensation Board employees in the state. "Instead, referrals can be made by anyone who is officially recognized as a party of interest for the case.

Social security benefits

There may be a particular example where injured workers can also be entitled New York claiming New York Workers' Compensation to receive monthly social security benefits. This will usually be in cases where the disablement factor has become seriously, either on a permanent basis or for a continuous period of more than one year. This decline may be either physical or moral, but must be medically determined.

Social security benefits are classified as federal disability insurance benefits. It should be noted that, however, that New York workers companies. No board applications for social security benefits are processed and any claims are distinct from claim to compensate New York workers. Additional information on social security benefit payments can be obtained by contacting the Social Security Administration or by visiting one of its field offices.

interest rates

In general, interest rates are determined based on the type of payment of compensation received. There may be some conditions in which New York workers companies. The Board uses its own discretion to grant additional compensation, but the standard interest rates are given below:

Cash benefits

Claimants who are either partially or fully disabled as a result of work-based injury qualify for cash benefits once they are disabled for seven days. However, unlike medical expenses, payable regardless of the duration of the disability, cash benefits are not paid for the first seven days of injury, unless the disability continues beyond the 14-day mark. In these cases, cash benefits will be paid from the first working day missed.

To provide an example, this provision means that a person who has been disabled for 21 days will receive cash benefits from the first missed day of work, but the person who is disabled for 14 days will only be eligible for cash benefits for the second week of disability, Exceeding the 14 day barrier.

The amounts of compensation were determined using a uniform mathematical formula, based on the average weekly income of the injured worker in the previous year and the extent of their disability. Disability is calculated as a percentage, so anyone with total disability is 100% disabled, while a person with partial disability can be considered 50% disabled.

The standard formula for determining the amounts of cash benefits is as follows:

2/3 of average weekly working wage x Disability rate = weekly interest rate

For example, the presence of an injured worker with an average weekly wage of $ 300, and total disability receive a weekly subsidy amount of $ 200. This is because 2/3 of $ 300 is $ 200 and no other discount is made depending on how much disability. A partial disability claim with the same average weekly wage would receive a weekly benefit amount of $ 100, because it is classified as 50% disabled.

New York workers who are able to return to work, but are unable to make the average of their previous weekly wages as eligible as a result of their injury to pay cash subsidies, which make up two-thirds of the difference. An exception may be made if their wages exceed legal limits.

The maximum legal benefit for cash benefits varies depending on the date of the accident. However, since July 1, 2010, the statutory limit has been calculated as 2/3 of the average New York weekly wage for the previous year. The maximum legal benefit for a particular year is the same for both partial and full claimants, except in cases where the damage occurred before 1 July 1991.

Death and survivor benefits

In cases where workers die in New York after being injured in compensation for some surviving relatives or legal dependents, the right to compensation in the form of cash benefits, as previously explained. The amount of compensation awarded in such cases is calculated in the same manner as with other cash benefits, with recipients paying an amount equal to two-thirds of the average weekly wage of the deceased worker.

This average weekly wage is calculated over the 12 months prior to the death of a worker and, as with other monetary benefits, the amount of the weekly compensation can not exceed the legal maximum effective at the time of the injury. These extremes are still in place, regardless of the number of dependents.

Sometimes, deceased New York workers do not have eligible survivors eligible to receive survivors weekly benefits. In such cases, surviving parents of a worker or real estate may be eligible for a one-time cash amount of $ 50,000.

In addition to the weekly death benefits paid to those eligible under the Workers Compensation Act, New York workers who died as a result of injury related to employment usually qualify for funeral expenses. The total allowance for funeral expenses amounts to $ 6,000 in metropolitan counties in New York, and $ 5,000 in other New York counties.

And return to work

With the exception of cases where New York workers continue full and permanent disability as a result of their work, the ultimate goal of New York insurance claimants should be to reimburse workers back to the workplace. These return to work must take place as soon as the workers feel they are able to, taking into account the opinion of medical professionals helping them with their claim.

It is important that claimants keep the insurance company and board up to date with no improvement to their situation or changes to their working situation. Often, interest payments will be stopped once the plaintiff has made a successful return to work, although there are many circumstances that benefit payments may still be approved, such as when the claimant is earning less than in the past, because of Disability.

Similarly, if the claimant returns to work but finds that what is sometimes absent from the work as a direct link to the disability based on their work, this classifies with the time lost intermittently and was entitled to benefit from the benefits. Both the New York Workers Compensation Board and the insurance company must be notified in these circumstances and the worker must keep records of their salaries and lost work time.

The Americans with Disabilities Act protects workers with disabilities from discrimination in the workplace, and that it is illegal for an employer to discriminate against a return worker on the basis of disability, or claim compensation for workers. However, it should be noted that employers do not usually legally obliged to maintain the position of the former worker open to them to return to.

In the absence of an unwilling and willing worker and able to return to work, but unable to do so because the employer does not have an open position for them, they are usually eligible to claim unemployment benefits. New employers are not able to question whether a worker has an existing compensation claim or a former employer and the new employer is unable to reject otherwise qualifying New York-based workers on previous compensation claims.

Duplicate questions

The following is a list of some frequently asked questions, in order to provide additional insight and insight into the way New York Workers Compensation Claims work and are handled:

Does the Labor Compensation Law cover disability?

No. As it stands, New York Workers Compensation Act covers only injuries, diseases or occupational diseases that are causally linked to occupation claimants. Disability must occur during the employment stages and arise from any nature of the work or accidental injury linked to the workplace.

How often have they paid a sum of money?

Workers' compensation is paid every two weeks. In some cases, the carrier can provide voluntary insurance payments, such as during a dispute. If this is the case, these should usually be paid every two weeks as well, although there is no legal requirement to do so, and it is mainly to the insurance company.

Is the injured worker obliged to undergo a medical examination?

Yes really. According to the provisions of the New York Workers Compensation Act, employers and insurance companies are entitled to request workers are examined before the trained doctor is injured. Any refusal to undergo such examination may adversely affect the claimant's entitlement to compensation.

Does the injured worker need to be legal representation?

New York workers are free to sue workers without legal representation, although it is advisable, especially in the most technical cases, where arguments and disagreements may be difficult to understand. Law judges provided by the Board may assist workers who are not represented by a lawyer. The costs of legal representation are established by the board of directors and workers must not pay their lawyers directly.

What is the waiver agreement Article 32?

The waiver agreement Article 32 is an agreement that has been made between the injured worker and the insurance company, in order to close the case. Agreements for negotiations should be mutually beneficial and mutually agreed upon. Once the section 32 agreement in place has been approved by the board, the case file is closed forever.

What if a situation worsens after the adoption of an agreement and article 32?

Once the waiver agreement section 32 is in place, the insurance company is no longer liable for the claim in any way. The worker will then be solely responsible for any relevant bills.

Injured New York workers can sue anyone for their injuries?

In general, New York Workers Compensation Insurance is offered in the right place to pursue legal proceedings against the employer for work injury. This means that the worker can not sue the employer on top of receiving workers' compensation. However, there may be situations where a third party can be sued if they contributed to the damage. This will need to be discussed with a qualified lawyer or his or her legal representative.

What are WCB and CC numbers?

The WCB number is allocated by the New York State Workers' Compensation Board as a means of determining a particular claim.The Registry maintains all claims for compensation, so providing a unique WCB number allows them to identify certain situations more easily.CW number, on the other hand, is The carrier number is the case submitted by the insurance company.This is used by them for the identity and processing of a particular claim.

What is the penalty for making false workers claim compensation?

Any person who deliberately falsifies or deforms their circumstances, in an attempt to sue New York Workers' Compensation, shall be guilty of a felony and may face appropriate legal repercussions. Lying about the circumstances or not telling the whole truth in order to get compensation workers New York constitutes fraud and may lead to prison sentence.

contact information

Compensation Council New York State Workers'

New York Central Address - 328 State Street, Shenktade, NY 12305-2318

Manhattan Office

Provinces Served By This Office: Bronx, New York Address: 215 West 125th Street New York, NY 10027 Tel: 1-800-877-1373 Opening hours: Monday to Friday: 8:30 am to 4:30 pm

Brooklyn Office

Provinces served by this office: Kings, Richmond 111 Livingston Street Brooklyn, New York 11201 Tel: 1-800-877-1373 Opening hours: Monday to Friday: 8:30 am to 4:30 pm

Royal Office

Provinces served by this office: Queens 168-46 91 Jamaica Street, New York 11432 Tel: 1-800-877-1373 Opening hours: Monday to Friday: 8:30 am to 4:30 pm

Staten Island Service Center

60 Gulf Street Staten Island, New York 10301 Tel: (718) -720-4466 Opening hours: Monday to Friday: 8:30 am to 4:30 pm

Provincial offices and service centers

Tel: (877) 632-4996

Injured New York workers can call this number in order to ask questions about on-the-job injuries and subsequent compensation claims. Instead, there are physical area offices and service centers at the following locations:

• Albany, New York - 100 Broadway Minnands, Albany, NY 12241