Dealing with a workers’ compensation claim in Buffalo can feel overwhelming, especially when you’re unsure about the process and the timeline. If you’re reading this, it’s likely that you’re feeling uncertain or worried about navigating your case. It’s completely understandable. When you’re injured at work, the physical pain is tough enough, but the stress of what comes next can make it even harder. At Cole, Sorrentino, Hurley, Hewner & Gambino, P.C., we’re here to assure you that you’re not alone. We understand your concerns and are ready to guide you through every step of your workers’ compensation claim, helping you get the best possible outcome.
Richard H. Cole
Partner
Thomas F. Hewner
Partner
Donna L. Haslinger
Partner
Vivian P. Roche'
Partner
Keith R. Rosso
Attorney
Tasha D. Frazie
Attorney
Tyler I. Wood
Attorney
Marc A. Cangé
Attorney
Teresa M. Cappiello
Attorney
The timeline of a workers’ comp claim can vary based on the details of each case, but understanding what to expect can help ease some of the stress you’re feeling. Below, we’ve broken down the process and timeline, so you can have a clearer idea of what lies ahead and how we can assist you.
Filing the Claim
The first step in the workers’ compensation process is to file your claim. If you’ve been injured at work, you must inform your employer as soon as possible. In New York, you are legally required to notify your employer within 30 days of the injury. While this might seem like a simple task, it’s essential to report your injury thoroughly to ensure it’s properly documented. The sooner you file your claim, the better for your case. Delays could lead to complications or even result in your claim being denied.
After notifying your employer, they will give you the necessary form to file your workers’ compensation claim. Once completed, your employer will submit the form to their insurance provider, who will begin reviewing your case. It’s important to stay proactive during this stage by following up with both your employer and the insurance company to make sure your paperwork is correctly submitted and processed.
The Investigation Process
Once your claim is filed, the insurance company will begin their investigation. This phase can take several weeks. They will review your medical records, the circumstances surrounding the injury, and any other evidence you’ve provided. By New York State law, the insurance company is required to approve or deny your claim within 18 days of receiving your completed paperwork. While this timeline is mandated by law, there could be delays if additional information is needed or if there are any disputes regarding your injury.
During this time, it’s common to feel uncertain, especially if the insurance company requests further medical evaluations or denies your claim. However, you don’t have to navigate this alone. Having an attorney by your side during this stage is crucial to protect your rights. We can help ensure the insurance company follows the proper procedures and holds them accountable for any delays or errors.
Workers Comp Claim Timeline What if My Claim is Denied? Related Videos
Approval or Denial of the Claim
Once the investigation is complete, the insurance company will make a decision. They may either approve or deny your claim. If your claim is approved, you’ll begin receiving workers’ compensation benefits, which could include wage replacement and coverage for medical expenses. If your claim is denied, don’t be discouraged—it’s not the end of the road. You have the right to appeal the decision, and we are here to help you through that process.
If your claim is denied, the next step is filing a Request for Board Panel Review with the New York State Workers’ Compensation Board. This formal process allows you and your attorney to present evidence to challenge the denial. While this step can take several months, proper legal representation increases your chances of a successful appeal.
Receiving Workers’ Compensation Benefits
If your claim is approved, you will start receiving benefits. In Buffalo, the amount and duration of these benefits depend on the severity of your injury and your ability to return to work. If your injury results in temporary disability, you will receive wage replacement benefits, typically two-thirds of your average weekly wage, up to a state maximum. These benefits are meant to cover your lost wages and medical expenses as you recover.
The duration of benefits varies based on the nature of your injury. For temporary injuries, benefits may continue until you’re able to return to work. For permanent injuries, benefits can be extended. If you return to work in a modified role or with limitations, your benefits may be adjusted accordingly. At this point, you may also undergo medical evaluations to assess your progress and determine if further treatment is needed or if you’re fit to return to work.
Finalizing the Case
The final phase of a workers’ compensation claim involves closing the case and possibly receiving a settlement. If your injury results in permanent disability, you might be eligible for a lump-sum settlement, which compensates you for future wage loss and medical expenses. This settlement process can be lengthy and requires careful thought, as it can impact your long-term financial stability.
It’s essential to have an attorney who understands the complexities of workers’ compensation settlements. The insurance company’s initial settlement offer may not fully reflect the extent of your injury, and we’re here to help ensure you receive a fair and just settlement for your injuries.
Ongoing Medical Care and Evaluations
Throughout your workers’ compensation claim, your medical care is a critical component. Depending on the nature of your injury, you may need ongoing treatments, physical therapy, or additional medical evaluations. It’s important to attend all appointments and follow your doctor’s advice to ensure the best possible recovery.
In some cases, the insurance company may require periodic medical reviews to assess your recovery progress. These evaluations can impact your benefits, so it’s important to be prepared and ensure that all medical documentation is updated and accurate. Our team can help you understand what to expect from these evaluations and advocate for your interests if any disputes arise.
How We Can Help You
Navigating a workers’ compensation claim in Buffalo is undoubtedly challenging, but you don’t have to face it alone. Our firm is committed to guiding you through the entire process. Whether you’re dealing with a denied claim, an appeal, or negotiating a settlement, we’ll ensure that you get the compensation you deserve.
If you’re currently dealing with a workers’ compensation claim, reach out to us for a consultation. We’ll review your case, answer your questions, and explain the steps you need to take for a successful resolution. Our team at Cole, Sorrentino, Hurley, Hewner & Gambino, P.C. has the experience and dedication to help you through this tough time.