FAQ: Workers' Compensation

Frequently Asked Questions About New York Workers' Comp Claims

FREE Consultation For Injured Workers · 800-671-4927
We can help at any stage of your New York workers' compensation case. The work injury attorneys of Turley Redmond Rosasco & Rosasco, L.L.P., have handled thousands of claims for clients in New York, Queens and Long Island. We are here to answer your questions.


Why should I hire the law firm of Turley, Redmond, Rosasco & Rosasco for my workers' compensation claim?

New York workers' compensation claims are complicated legal proceedings. You will have to fight both the insurance company ( and their lawyers) for both medical treatment and compensation. Let us fight the insurance company while you concentrate on your health!

Eventually, you will want to appear at a formal hearing before a Workers Compensation Law Judge to preserve your rights to medical care in the future. At this hearing, the insurance company will have their attorney present to fight your workers compensation claim. Our experienced workers' compensation lawyers will be by your side at your formal hearing to fight for all the benefits you deserve. Our 11 attorneys, many with decades of individual experience in this specialty, are well prepared to protect all of your rights.

When we are not representing you at administrative hearings, we will be answering your questions and phone calls on a timely basis. Our law firm's goal is to return all client phone calls within 24 hours. Unlike other law firms, our attorneys return their own phone calls. Our experienced paralegals ( some of whom have been with us nearly 20 years!) spend most of each day solving client problems, such as obtaining authorizations for medical testing, treatment and prescriptions. They also keep in close contact with both the Workers' Compensation Board and insurance companies to resolve problems without a fight so you can get your treatment faster.

Despite what insurance companies might tell you, you must personally file a claim on a C-3 form with the New York State Workers' Compensation Board. The filing of an "accident report" with your employer is NOT good enough. The experienced lawyers at Turley, Redmond, Rosasco & Rosasco can make sure you get everything you deserve. Call us today toll free at 800-671-4927 for a free consultation with one of our attorneys.


What is a "Schedule Loss of Use" Workers' Comp Award (SLU)?

This is an award that is issued by a Workers' Compensation Law Judge that determines the amount of loss of use or permanent restriction you have to an injured body part (usually arms, shoulders, elbows, wrists, hands, fingers, hips, legs, knees, ankles, feet, toes). These injuries can involve fractures, sprains, muscle tears, amputations or related surgeries. These awards do not require the claimant to lose time from work but they do require what the Workers' Compensation Board considers a permanent injury. The final award includes a finding of a "percentage loss of use" of the injured body part based upon the Workers' Compensation Board Medical Guidelines.

This percentage is determined by opinion medical evidence from your treating doctor or an insurance company doctor. The amount of cash payable in these awards is often the result of negotiations between your attorney and the insurance company attorney. If a settlement cannot be worked out between the attorneys, the judge will set a trial date for the testimony of doctors.

This award is paid at your total disability rate depending on your "average weekly wage" for the 52 weeks prior to your accident. This award is set forth in a Board decision, listing amounts as if they were lost wages, whether you have actually lost time or not.

If you have injured your shoulders, arms, hands, hips, legs, knees, ankles or feet on the job, call one of our experienced workers compensation lawyers today at 800-671-4927 for a free consultation to discuss a cash award, even if you lost little or no time from work. You will be glad you did!


What is a "Section 32 Settlement" at the New York Workers' Compensation Board?

A "Section 32 Settlement" is usually an agreement between you and the insurance company to waive all or part of your workers' compensation claim in return for a one-time lump sum cash payment. Section 32 Agreements are the result of negotiations between the attorneys for the claimant and the attorneys for the insurance company.

The actual waiver agreement is often multiple pages long and contains important legal language which in many ways mirrors a formal legal contract. Your workers' compensation lawyer should sit down with you to fully explain the benefits and ramifications of this important document. This document is so important that you cannot enter into a Section 32 Waiver Agreement without having a formal hearing before a Workers' Compensation Law Judge. At the hearing, the judge will make sure you fully understand your rights before he/she approves the agreement. Once a judge approves your agreement, you should receive your cash award 10 days after the judge's decision is filed.

If you have questions about whether a Section 32 Waiver Agreement is right for you in your individual situation, call one of our experienced workers compensation attorneys today for a free consultation at 800-671-4927. We would be glad to advise you properly on this important decision.


If I am out of work due to a work related injury, can I be fired or can my employer take away my regular medical insurance?

Unfortunately, nothing in the New York State Workers' Compensation Law protects your job or health insurance while you are out of work due to an on-the-job accident. However, there are some other federal and state laws, such as the Family and Medical Leave Act, COBRA and the Affordable Care Act ("Obamacare") that may provide protections and benefits. Call our office to discuss these potential benefits at 800-671-4927 to discuss these protections with one of our attorneys.


What exactly is Workers' Compensation?

Workers' compensation is simply insurance, 100 percent paid for by your employer, that provides cash benefits and medical care for workers who are injured on the job . Making a claim for workers' compensation should not affect your employment in any way. Filing a claim may seem simple, but obtaining benefits from an adversarial insurance company is often difficult.

Many times workers do not have to lose any time from work in order to get a substantial cash award from workers' compensation. You should contact us today at 800-671-4927 for a FREE CONSULTATION to see if your injury qualifies for a cash award, even if you do not lose time from work.


How much does New York Workers' Compensation pay?

The amount of weekly benefits you receive during your period of lost time from work is based on the gross "average weekly wage" you were earning at the time of your injury. Initially, you should receive approximately 2/3 of your weekly wages, not to exceed the New York State maximum of $808.65 per week, if you were injured after 7/01/14, while you are out of work. For example, if you are injured and you earned on average $750 per week, you would be entitled to up to $500 per week (tax free) in weekly workers' compensation benefits.

However, the insurance company will quickly send you to one of "their doctors" and try to cut your benefits below this level. When this happens, you should contact our law firm to request an emergency court hearing to get you your fair level of benefits. If your weekly workers' compensation benefits have been cut by an insurance company or employer, call us Today toll free at 800-671-4927 for a free consultation to discuss how you can regain your lost benefits.

Finally, keep in mind that it is possible for injured workers to get large cash awards for injuries to certain body parts, even if they have not lost any time from work. These are called "Schedule Loss of Use" awards and frequently involve injuries to extremities, such as arms, hands, hips, legs, knees and feet. If you have a work-related injury to one of these body parts, call us today for a free consultation to discuss how much your case may be worth.


When will my weekly workers' compensation benefits begin if I am out of work?

If you are out of work for 14 days or more, cash benefits are payable from the first day you are out of work. Unfortunately, insurance companies frequently delay the first payment while the claim is "under investigation." This is a typical insurance company delaying tactic. Claimants often times hire our firm to expedite their payments when insurance companies unfairly delay payments. If you have been out of work more than two weeks and have not received your first weekly workers' compensation check, call us today at 800-671-4927 so we can expedite your payments. You have bills to pay! We can help!


Who will pay my medical bills for my job accident injury?

The employer's workers' comp insurance company is responsible for 100 percent of all reasonable and necessary medical charges connected with your work injury. There are no deductibles or co-pays, and you do not pay any of the medical costs — ever. This includes hospitals, physicians, ambulance charges, X-rays, crutches, physical therapy and prescription charges. All of your medical expenses are paid if the care is reasonable, necessary, associated with your injury and within the applicable Workers' Compensation Board Medical Guidelines.

No medical provider can request direct payment from the injured worker and no medical provider can request that you use your regular medical insurance once you tell them the injury is work-related. Do not let any medical provider intimidate you into not putting your medical care under workers' comp if you think your injury is truly work-related. A Judge at the New York Workers' Compensation Board will decide if your injury is work related. While not every medical provider in New York has to take workers' compensation insurance, most do and you can often go to the top hospitals in your area for treatment for workers' compensation injuries. If you have questions about workers' compensation medical treatment or treatment denials, call us today at 800-671-4927 for a free consultation.


Should I talk to insurance company "nurse case managers," claims examiners or investigators about my workers' compensation claim?

NO! These people are not your friends. They are paid by the insurance company to reduce your benefits. In our experience, speaking and giving information to these people will come back to haunt you. Never speak to these people about your workers' compensation claim without talking to a workers' comp lawyer first! Call Turley, Redmond, Rosasco & Rosasco today at 800-671-4927 to discuss your options.


Can a "nurse case manager" from the insurance company come with me to see my own treating workers' comp doctor?

Only if you let them! You are entitled to medical privacy with your own doctor in a New York Workers' Compensation case. We never let nurse case managers go to the doctor's office, much less invade the examination room, with our clients. They should not be allowed to call your doctor directly or fax him/her forms intended to hurt your claim. Call us today at 800-671-4927 if the insurance company is harassing you or your doctor. We will put an end to it ASAP!


Must I sign medical releases requested by the workers' comp insurance company?

No. Tear them up and throw them in the garbage unless we tell you otherwise.


What kinds of jobs are covered by Workers' Compensation?

Almost every type of job in New York State is covered by the New York State Workers' Compensation Law. There are a few major exceptions, including New York City police officers, firefighters, sanitation workers and teachers, federal government employees and clergy. If you have any doubts about whether you are covered, you should call us today at 800-671-4927.


How long do I have to work for my employer to be covered by Workers Compensation?

You are covered the moment you begin your employment. There is no waiting period for coverage, like other health insurance sometimes.


How long do I have to file a Workers Compensation Claim?

You generally have two years from the date of the accident or knowledge of the injury to file your claim with the New York State Workers' Compensation Board. Simply notifying your employer is not sufficient. You should contact one of our attorneys today at 800-671-4927 to discuss the exceptions to this rule if you feel you have missed the two-year deadline.


Do I have to tell my boss about my job accident?

Yes. You should notify your supervisor immediately, or as soon as possible, after your accident. Generally, it should be no later than 30 days after the accident. The employer must then file an Accident Report with the insurance company and the Workers' Compensation Board. Failure to tell your supervisor or your employer timely after your accident may delay your first workers' compensation payment if you are out of work.


What kinds of injuries are covered by Workers' Compensation?

Almost any type of physical injury or mental illness caused by your work is covered. This includes all types of orthopedic injuries, including fractures, herniated discs and muscle strains. Some of the most common workers' compensation injuries include:

  • Back injuries
  • Neck injuries
  • Shoulder injuries
  • Fractured bones
  • Hand injuries
  • Crush injuries
  • Amputations
  • Knee injuries
  • Ankle injuries
  • Foot injuries
  • Carpal tunnel syndrome
  • Traumatic brain injuries (TBI)
  • Post-traumatic stress disorder (PTSD)
  • Reflex sympathetic dystrophy

Many times employees fail to realize that workers' compensation also covers other types of work-related injuries, loss of hearing/vision, lung injuries, heart attacks, strokes, hernias, disfiguring scars, and occupational diseases such as asbestosis. You should call one of our attorneys today at 800-671-4927 to see if your injury qualifies for New York State Workers' Compensation benefits.


What if I have a pre-existing injury?

An aggravation of a pre-existing injury is covered by workers' compensation. If you had no functional job restrictions due to your pre-existing injury prior to your new work-related accident, you are eligible for the same benefits as someone who was injured on the job for the first time. This is true even if the earlier injury was not work-related or if no workers' compensation claim was filed for the old injury. Because reporting aggravations to pre-existing conditions can be complicated, you should call one of our experienced workers' comp lawyers at 800-671-4927 as soon as possible after your accident.


What are workers' compensation death benefits?

If a loved one were to unfortunately die on the job, a spouse and dependent children are entitled to weekly compensation benefits of two-thirds of his prior gross weekly wages up to the current state maximum rate of $808.56, in addition to funeral expenses.

If your loved one had neither a spouse nor children, then his or her estate may be eligible for a lump sum payment of $50,000, plus the cost of funeral expenses. Call one of our experienced workers' comp lawyers at 800-671-4927 if a loved one was killed on the job. We will handle all the paperwork for you and your family in your time of grief.


Are heart attacks and strokes covered by workers' compensation?

Yes. A heart attack or stroke caused by the physical or mental stress of employment is generally covered by workers' compensation. The heart attack or stroke generally must happen at work or soon thereafter. Even if you had a prior heart condition or other risk factors not related to your work, you may be entitled to workers' compensation benefits.

Heart attack and stroke claims are some of the most difficult claims to establish at the Workers' Compensation Board, so you should consult an experienced workers comp lawyer as soon as possible. Our firm has won many heart attack and stroke cases over the past 20 years. You or a family member should call one of our experienced workers' comp lawyers today at 800-671-4927 as soon as possible after your heart attack or stroke.


Can I choose my own doctor for my workers' comp claim?

Yes, as long as the doctor or other medical professional is authorized to treat Workers' Compensation patients by the New York State Workers' Compensation Board. Before making an appointment with a doctor, ask if they "accept workers' comp"? If they do, you can proceed to make the appointment without fear that you will ever be responsible for any medical bills.

A few employers in New York State offer a "managed care plan" for workers' compensation injuries, but the employee can always "opt out" of the plan after 30 days and choose a different doctor. Call our office at 800-671-4927 if you have any trouble finding a doctor or other medical provider to treat your workers' compensation injury. We can refer you to reputable doctors who take workers' compensation cases.


What if I need medical care in the future after my workers' comp claim is resolved?

If your workers' compensation claim is properly handled, your right to medical care in future years can be protected. The right of an injured worker to reasonable and necessary medical care may be the most valuable benefit provided by workers' compensation law.

Great caution should be exercised in entering into any agreement that requires you to give up this valuable right to medical care in the future. Be absolutely certain you are aware of all your rights before you consider signing a release or entering a final settlement, such as a Section 32 Settlement, which gives up your right to future medical care.

In addition, when you settle your workers' compensation pursuant to a Section 32 Agreement, you may not be able to put your future medical bills under Medicare or Medicaid. Your Section 32 settlement agreement may require a special provision called a "Medicare Set Aside Agreement" which protects Medicare's interests when you give your rights to workers' comp-related medical care. This is an area of the law where the advice of an attorney experienced in workers' compensation law is extremely important. Call one of our attorneys today before you sign away your right to future medical care. We may be able to negotiate either a higher "Section 32 Settlement" amount or a lower "Medicare Set Aside" amount to benefit your individual needs in the future. In many cases, we can also resolve only the cash payment portion of your claim but leave your right to lifetime workers' compensation medical benefits intact. Call one of our experienced workers' compensation attorneys today at 800-671-4927 to discuss you individual case.


Do I need a workers' compensation lawyer?

You are not required by law to have an attorney represent you. However, without a lawyer, you will have to negotiate on your own directly with an insurance company lawyer and a New York Workers' Compensation Law Judge.

The best way to be sure that you receive all the benefits you deserve is to have the help of attorneys like those at Turley, Redmond, Rosasco & Rosasco who have helped close to 10,000 claimants over the past 25 years navigate the compensation maze. Call one of our experienced workers' compensation attorneys today at 800-671-4927 to discuss you individual case.


How much does a workers' compensation attorney charge?

Attorney fees are always determined by a Workers Compensation Law Judge based upon what the judge thinks is fair and reasonable given the amount of work and time a lawyer spent on your case. There are no set percentage fees like the standard one-third in regular personal injury cases.

Workers' compensation attorneys get paid significantly less per case than regular personal injury attorneys. As a general rule, judges often approve lawyer fees in the 10 to 20 percent range of any extra benefits the lawyer obtains for you. These fees are deducted directly from your benefits and sent to your lawyer. You never have to pay an attorney directly. If you have questions about workers' comp attorney fees, call us today at 800-671-4927.


Will I have to go to the Workers' Compensation Board for a formal hearing?

Yes, in most serious injury cases which involve more than a few weeks of lost time from work or injuries to your arms, shoulders, hands, hips, knees, ankles or feet. Most likely you will have at least a few hearings before a judge at the New York State Workers' Compensation Board.