In New York, the workers’ compensation system is designed to provide benefits to employees who suffer work-related injuries or illnesses. While this system aims to be straightforward, it is often far from simple, leaving many workers feeling overwhelmed and confused. This is where the role of a workers’ compensation attorney becomes crucial.
A workers’ compensation attorney is not just a legal representative — they serve as a guide and advocate who helps injured workers navigate the complexities of the workers’ compensation system. This journey often begins with understanding the eligibility criteria for workers’ compensation, which can be daunting for many employees.
Richard H. Cole
Partner
Thomas F. Hewner
Partner
Donna L. Haslinger
Partner
Vivian P. Roche'
Partner
Keith R. Rosso
Attorney
Tasha D. Frazie
Attorney
Eligibility for Workers’ Compensation in New York
To be eligible for workers’ compensation benefits in New York, an employee must have sustained an injury or illness arising out of and in the course of their employment. This includes injuries resulting from accidents at the workplace or illnesses caused by exposure to hazardous conditions over time. However, determining eligibility is not always straightforward. For instance, employers or insurance companies may dispute whether an injury is work-related, leading to delays or denials of claims. A workers’ compensation attorney plays a vital role in such situations, gathering evidence, consulting with medical professionals, and advocating on behalf of the injured worker to establish a direct connection between the job and the injury or illness.
Filing a Workers’ Compensation Claim
Filing a workers’ compensation claim involves several steps and adhering to strict timelines. After an injury occurs, it is imperative that the worker notifies their employer promptly, typically within 30 days. Following this, a formal claim must be filed with the New York Workers’ Compensation Board. This process includes submitting medical documentation and other relevant evidence to support the claim. A workers’ compensation attorney can assist in ensuring that all necessary paperwork is completed accurately and submitted on time, minimizing the risk of claim denial due to administrative errors. Moreover, attorneys can help workers understand their rights and responsibilities throughout this process, providing peace of mind during a challenging time.
Dealing with Denied Claims
Unfortunately, many workers’ compensation claims are initially denied. Reasons for denial can include insufficient medical evidence, disputes over whether the injury is work-related, or missed deadlines. When faced with a denial, the injured worker has the right to appeal the decision. This is where a workers’ compensation attorney’s role becomes particularly vital. Attorneys can evaluate the reasons for denial, gather additional evidence, and represent the worker in hearings before the Workers’ Compensation Board. They can also negotiate with insurance companies to reach a fair settlement or, if necessary, take the case to trial. Having an attorney by your side can significantly increase the chances of a successful appeal.
Understanding the Benefits Available
Workers’ compensation benefits in New York can include coverage for medical expenses, wage replacement, and rehabilitation services. Medical benefits cover necessary treatment for the injury or illness, including doctor visits, hospital stays, surgeries, and medication. Wage replacement benefits, also known as disability benefits, provide a portion of the worker’s lost wages while they are unable to work. The amount of wage replacement depends on the severity of the injury and the worker’s average weekly wage.
Rehabilitation services may include physical therapy or vocational training to help the worker return to work. A workers’ compensation attorney can help ensure that the injured worker receives all the benefits they are entitled to and advocate for their rights if disputes arise regarding the extent or duration of benefits.
Navigating Permanent Disability Claims
In some cases, a work-related injury or illness may result in permanent disability, preventing the worker from returning to their previous job or any gainful employment. New York’s workers’ compensation system provides for permanent partial disability (PPD) and permanent total disability (PTD) benefits. PPD benefits are available when a worker sustains a permanent impairment that, while not completely disabling, affects their ability to work. PTD benefits are awarded when a worker is unable to engage in any form of employment due to their injury. Determining the level of disability and the appropriate benefits can be a complex process, often involving medical evaluations and legal arguments. A workers’ compensation attorney can guide the worker through this process, ensuring that their disability is accurately assessed and that they receive the full benefits to which they are entitled.
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Handling Third-Party Claims
In some instances, a workplace injury may involve a third party, such as a subcontractor or equipment manufacturer, whose negligence contributed to the accident. In such cases, the injured worker may have the right to pursue a third-party personal injury claim in addition to their workers’ compensation claim. A workers’ compensation attorney can evaluate the circumstances of the injury and determine whether a third-party claim is viable. Pursuing a third-party claim can provide additional compensation for damages not covered by workers’ compensation, such as pain and suffering. An attorney can help coordinate the two claims to maximize the injured worker’s recovery.
The Importance of Timely Action
Time is of the essence when dealing with workers’ compensation claims. New York law imposes strict deadlines for notifying employers of injuries and filing claims with the Workers’ Compensation Board. Failing to meet these deadlines can result in the loss of benefits. Additionally, evidence must be gathered and presented promptly to support the claim. A workers’ compensation attorney understands these time constraints and can take swift action to protect the injured worker’s rights. By acting quickly, an attorney can help prevent unnecessary delays and ensure that the injured worker receives the benefits they need to recover and move forward with their life.
Providing Support and Guidance
Beyond the legal aspects of a workers’ compensation claim, a workers’ compensation attorney provides invaluable support and guidance to injured workers and their families. Suffering a work-related injury or illness can be a traumatic experience, impacting the worker’s physical, emotional, and financial well-being. An attorney can offer reassurance and clarity during this difficult time, answering questions, addressing concerns, and providing a sense of stability. By handling the legal complexities, the attorney allows the injured worker to focus on their recovery and regain control of their life.
Advocating for Fair Settlements
In some cases, the employer’s insurance company may offer a settlement to resolve the workers’ compensation claim. While a settlement can provide a lump sum payment, it is crucial to ensure that the settlement amount is fair and adequate to cover the injured worker’s needs. A workers’ compensation attorney can evaluate the settlement offer, taking into account the full extent of the worker’s injuries, future medical expenses, and potential wage loss. If the settlement offer is insufficient, the attorney can negotiate on behalf of the worker to achieve a fair resolution. By advocating for the worker’s best interests, the attorney helps secure the financial support needed for the worker’s recovery and future.
Understanding the Impact of Return to Work
Returning to work after a work-related injury or illness can be a challenging transition. Workers’ compensation attorneys play a critical role in ensuring that this transition is handled smoothly and that the worker’s rights are protected. They can assist in negotiating a return-to-work plan that accommodates the worker’s physical limitations and medical needs. If the worker cannot return to their previous position, the attorney can explore options for job retraining or vocational rehabilitation. Additionally, if the employer retaliates against the worker for filing a workers’ compensation claim, the attorney can take legal action to protect the worker’s rights. By supporting the worker’s return to work, the attorney helps facilitate a successful recovery and reintegration into the workforce.
The role of a workers’ compensation attorney is indispensable for injured workers seeking justice and fair compensation. From filing claims and appealing denials to securing benefits and advocating for fair settlements, the attorney serves as a dedicated advocate throughout the entire process.
Contact Us Today, and Let Us Work for You
At Cole, Sorrentino, Hurley, Hewner & Gambino, P.C., our experienced attorneys are committed to helping injured workers in New York achieve the best possible outcomes. Contact us today for a consultation and let us stand by your side every step of the way.