What Does Workers’ Comp Cover in New York?

work related injury

Suffering a major injury at work could be devastating. You could lose wages and get saddled with medical bills.

The cost of worker’s compensation claims caused by a motor vehicle average nearly $80,000. Slip and fall accidents typically cost close to $50,000.

The average American cannot afford to suffer this type of injury. The solution is to file a worker’s compensation claim.

Read on to learn if your work-related injury is covered by worker’s comp. Here is how you can tell if you have a case or not.

Get Medical Treatment

First, you need to see a doctor and get treatment. Your initial treatment is handled differently than a routine sick visit.

Presuming the company has worker’s compensation insurance, you must visit an in-network doctor or hospital. Failure to stay in-network can jeopardize the validity of your claim.

After 30 days in the initial treatment plan, you can seek out your own doctor. It is imperative that your doctor is authorized by New York’s Worker’s Compensation Board (WCB) – an NYS WCB Authorized Medical Provider.

Also, it is important to remember that medical bills are not sent to your private insurance. Instead, they are sent to the WCB and your employer’s health insurance company.

The vast majority of medical services are covered by worker’s compensation insurance. This includes everything from hospital and doctor visits to physical therapy, chiropractic, acupuncture, and psychiatry.

You will also be reimbursed for any additional expenses incurred seeking medical treatment. Reimbursement includes travel expenses like parking, tolls, and mileage. Make certain to keep a record of all expenses incurred to ensure adequate reimbursement.

You Are an Employee

The next requirement for a claim is that you were an employee of the company. This requirement must be true at the time of the injury.

Your claim may be denied if your work status is in question. Employees that quit or get fired are less likely to get a claim approved.

Independent contractors are not eligible for worker’s compensation. This affects many freelance employees and workers in the “gig” economy. For example, an
Uber® driver cannot file a worker’s comp claim while injured on the job.

Meet the Deadline

Another potential issue for your claim is meeting the deadline. Each state, including New York, has a deadline for filing a worker’s compensation claim.

In New York, you have 30 days after an injury to file a claim. However, experts recommend submitting a claim immediately after the injury. The best tactic is to contact the state agency that handles claims right away to get the process started.

Gather Evidence

Your employer may not accept your version of the events leading up to an injury. For instance, they may argue that you were not supposed to be working at the time of the claim.

This often happens to hourly employees that get injured after their workday is supposed to be over. There are many employer objections that can lead to a denied claim.

To prevent this from occurring, you should collect any pertinent evidence that helps your claim. In addition, there may be witnesses that can support your version of the events.

Meet State Guidelines

Each state sets specific guidelines for worker’s compensation claims. Some states are more generous than others.

There are some states that will accept psychological injuries, while others do not. You must check with your state’s guidelines to see if your injury meets the legal standard.

Is Your Work-Related Injury Covered? A Recap

If you are injured at work, it is time to start getting your ducks in a row to file a claim. It is important to collect your evidence, provide notice, and submit a claim immediately.

Call 1-800-897-8440 to find an experienced workers’ compensation doctor near you. Don’t delay, call and get help now!