The Different Losses Covered by the Worker’s Compensation Policy in New York

Worker's Compensation Policy

New York City is home to more than 18 million people. With so many citizens, the Empire State’s companies and employees are more vulnerable than most cities.

Most companies in New York are required to hold workers’ compensation insurance. Workers’ compensation allows New York employees to receive payments to help them recover from work-related injuries or illnesses. It is your job as a company owner to get insurance coverage.

If you live in New York and have suffered injuries at work, talk to a workers’ compensation law firm that may assist you in completing the paperwork for your workers’ compensation claim or petitioning a refused workers’ compensation claim.

Although some individuals can handle the initial filing of a claim on their own, dealing with the appeals process may take time and effort.

Thankfully, legal assistance is accessible, so you do not have to undergo the procedure alone. A workers’ compensation attorney can assist you with each phase.

Here are the different losses you can recover through worker’s compensation as an employee in New York.

Lost wages

In most circumstances, workers’ compensation will not cover your whole paycheck. To establish the amount of compensation you may be entitled to in New York, a formula based on “average weekly pay” is used.

The maximum weekly benefit amount is $400 per week; anybody out of work for more than 14 days will also be eligible for benefits for the first week missed.

Medical expenses

Anybody injured on the job has the right to have their medical expenses covered by worker’s compensation insurance.

Preapproval is not required unless the medical visit will cost more than $1,000. Some of the expenses that may be reimbursable include:

X-Rays and CT/MRI – If the accident victim’s doctor authorizes the testing, X-rays, MRI, and CT scans may also be reimbursed. Bear in mind that if the cost of these tests is estimated to exceed $1,000, the claimant must get prior clearance.

Routine and follow-up doctor’s appointments – Your workers’ compensation payments cover all doctor’s visits required for your care and treatment. Even if you have additional health insurance, you must submit your expenses to your worker’s compensation insurer.

Medical equipment – If your injury necessitates the use of medical equipment such as crutches, canes, wheelchairs, or other devices, you must submit a bill as well as a prescription from your doctor to be compensated via worker’s compensation.

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Prescription medications – Any medication necessary to treat a work-related sickness or injury is typically covered.

The prescription and bill must be presented in the same way as medical equipment. Individuals who shop at CVS (Caremark) may not have to pay for their prescription medications out of pocket.

Rehabilitation expenses – In almost all circumstances, if you need rehabilitation treatment to return to your existing employment or be retrained for a more appropriate role due to your accident, these expenses will also be paid.

Mileage and transportation allowances must be claimed by giving the provider’s name, address, and appointment date.

These receipts must be presented if you use public transportation or pay tolls. There is no payment for travel to and from workers’ compensation hearings.

Remember that if a worker becomes disabled or dies on the job, further benefits are available. Benefits for disabled employees may include:

Continuing wage payment – Whether your handicap is permanent or temporary, you will be entitled to a specific amount of earnings that will be paid on an ongoing basis.

Even if you can return to work part-time, you may be eligible to continue receiving pay. The formula for your continued wage compensation is usually established based on your pre-accident income and current salary.

It is possible to pay up to two-thirds of the difference. If you cannot return to work, you will receive a permanent disability payment based on the applicable formulae. If the employee qualifies for social security disability, these benefits will be terminated.

Continuing medical treatment – If you need to continue seeking medical treatment, even if you have returned to work, worker’s compensation will cover the costs.

Death benefits – If an employee dies on the job, worker’s compensation payments are awarded to their spouse or dependent children.

The same calculation used to calculate your weekly payments will be utilized, and the family will receive an extra payment for funeral costs.

Work-related extremity compensation

One aspect of worker’s compensation insurance that is sometimes ignored is injuries that do not result in any time away from work. Certain workers may be eligible for a lump sum payment if they are injured in any of the following:

  • Limbs include the fingers, toes, hands, arms, feet, and legs.
  • Scarring – Scarring on the face may be eligible for compensation.
  • Sight/hearing – Someone who has lost sight or hearing.

In most cases, you will be given a “one-time” reward. But, if the injury causes you to miss work, the ultimate award may be reduced by the monetary compensation you get while out of work.

New York’s workers’ compensation statute of limitations

In New York, the statute of limitations for workers’ compensation is two years. This period starts either on the date of the injury or the day the claimant should have reasonably become aware of a work-related injury.

For example, if an employee falls and injures their back, they may return to work immediately and not need medical care.

If they develop back discomfort a few weeks later, which is proven to be the consequence of the fall, they have two years from the date of diagnosis to submit a workers’ compensation claim.

Work-related hearing loss has a somewhat varied statute of limitations. In such an instance, a worker must wait 90 days after the loss to make a claim.

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