The current U.S. laws governing compensation for people injured while at work grew out of 19th century labor reforms. During the Industrial Revolution, millions of people took on dangerous occupations. When they were injured at work, they generally had a choice of continuing to work through their injuries, or losing their jobs. Too poor to afford attorneys, these workers had no way of meeting the costs of their recovery or compensate for time off work, and with a labor surplus, employers had little reason to improve unsafe working conditions.
Starting in the mid-1800s in the U.S., reforms gradually gave workers greater access to legal counsel and just compensation. To avoid clogging the court system with millions of workplace injury cases each year, the states established Workers’ Compensation Boards or Commissions. States also mandated that employers carry workers’ compensation insurance to cover claims.
If you’ve been injured “on the job” in Western New York, the New York State Workers’ Compensation Board will handle your case. You will have to file an Employee Claim (C-3) with the Board. The Board will try to process your claim quickly, but recovering damages to cover all of your needs won’t be straightforward. You’ll need to know what is and isn’t covered; you’ll need to evaluate a settlement offer from your employer’s insurance; and depending on the circumstances of your injury, you might need to consider if other parties might be liable for your injury, and if further legal action could be in your best interests.
Before you start the legal process of seeking compensation, there are a few important concepts you need to understand.
In general, you can’t sue your employer if you were injured at work.
The Workers’ Compensation Boards and workers’ compensation insurance coverage are designed to keep the courts clear of workplace injury compensation cases, which in theory is good for both employers and employees: it reduces legal fees for both sides, quickens the compensation process for the injured party, and prevents the employer and employee from entering an adversarial relationship. These benefits and protections come at the cost of the worker’s right to sue an employer for a workplace injury.
The only exceptions are cases of egregious and intentional misconduct. If your employer knowingly creates dangerous conditions, coerces you into doing something dangerous that goes beyond the reasonable expectations of responsibilities and inherent risk for your job, or attacks you, you may be able to make a personal injury claim.
While you generally can’t sure your employer, there may be a third party liable. Many types of employment are not isolated, and put workers in potentially dangerous situations involving people other than coworkers.
For example, truck drivers risk collisions or other road accidents while on the job. The Workers Compensation Board would handle an injury claim from a truck driver injured while working, but if another driver was at fault in a collision, the truck driver might sue that person as well. Depending on the extent and type of the truck driver’s injuries, this second legal action might be necessary to achieve a full recovery.
If your employment requires you to use a product that caused your injury – as, for example, any kind of construction equipment, dangerous chemicals, or power tools – and you were injured because that product was defective or improperly labelled, you might be able to make a product liability claim against the manufacturer or retailer.
There are limits to workplace injury compensation coverage.
As a rule, an employer’s workers’ compensation insurance should cover all medical bills and treatment required for an employee’s recovery from a workplace injury or occupational disease. However, “required treatment” is not entirely up to doctors (or the injured workers) to decide.
The Workers Compensation Board sets forth guidelines that address different types of injuries and acceptable treatments. These are not comprehensive, and while the Board does update these guidelines periodically, they do not keep perfect pace with the advance of “best practices” in medicine. If your doctor wants to prescribe treatment not covered under the guidelines, he or she will have to apply for a variance, using an MG-2 form to explain why the treatment is necessary. The Board is not bound or guaranteed to grant any variance. Your case may end up in front of a judge, at which point you’d need an attorney to fight for your right to the best care.
If your employer’s insurance denies your claim, you still have options.
Your employer or employer’s insurance carrier may challenge your injury or occupational disease claim, and request to deny payment. In this situation, your claim has been “controverted”: this triggers a process that could end up in a judge denying your claim, and even in the best case scenario delays your access to monies to pay for your recovery.
If an employer’s carrier has challenged your claim, you may apply for New York State disability benefits during controversion. You can receive those benefits during the controversion process. If you win your claim, your employer’s workers’ compensation carrier would have to reimburse the disability benefits carrier. If your case has been controverted, you should consult with a workers’ compensation attorney to discuss if filing for disability benefits might be necessary to protect you during your recovery.
The Local Source for Reliable Representation
If you’ve been injured at work, you need an experienced workers’ compensation attorney in Buffalo NY to guide you through the process of seeking just compensation. The law firm of Cole, Sorrentino, Hurley, Hewner & Gambino P.C. has a 45-year history of providing excellent workers’ compensation, personal injury, real estate, estate planning, bankruptcy, and family law representation to clients in Buffalo and Western New York.
Attorneys Jerry A. Gambino and Jeffrey K. Moncher have distinguished themselves in the field of workers’ compensation law. Both have served on the Erie County Bar Association’s Workers Compensation Committee, and enjoy a reputation for knowledgeable, attentive, and confident representation among their clients and colleagues.
To learn more about workplace injuries and the legal processes that follow, browse our Definitive Guide to Workers’ Compensation Law in New York. You can also find more resources on our legal videos page.