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Connect with Our Garden City Workers’ Compensation Lawyers
Getting back on your feet after a workplace accident may seem like a daunting task, but it is not one that is insurmountable. Most injured workers in New York are eligible to claim workers’ compensation benefits, which can significantly ease the burden of recovering from an injury while you are out of work. However, claiming workers’ compensation benefits is often easier said than done, and there are many pitfalls lurking for the unwary. Your best bet for obtaining the full amount of workers’ compensation benefits you are entitled to is with the assistance of our Garden City workers’ compensation lawyers.
Qualifying for Workers’ Compensation Benefits
Almost all workers in Garden City and elsewhere in New York are required by law to be covered by workers’ compensation insurance through their employers. That includes:
- Employees of for-profit businesses, including full-time, part-time, temporary, seasonal, leased, and borrowed employees
- Casual and day laborers
- Farm workers
- Domestic employees
- New York state employees
- Municipal employees who perform hazardous work
There are only a few categories of workers who are not required to be covered by workers’ compensation insurance. Major exceptions include:
- Volunteers
- Independent contractors
- Clergy and members of religious orders
- Sole proprietors who do not have employees
- Partnerships, LLCs, and LLPs that do not have employees
- New York City police officers, fire fighters, sanitation workers, and public school teachers
- Private school teachers
Workers who do not qualify for workers’ compensation may nonetheless qualify for benefits through other programs if they suffer an injury on the job (e.g., New York City police officers). Our Garden City workers’ compensation lawyers can discuss these alternative programs with you.
Work-Related Accidents vs. Non-Work-Related Accidents
As its name indicates, workers’ compensation benefits are available only for accidents and injuries that are work-related. What this means is that the injury must have arisen out of the injured worker’s duties or in the course of performing such duties. To illustrate, assume that a chef severely injures his finger by cutting it with a knife while slicing vegetables. That injury is work-related, as it arose in the course of his duties. Non-work-related injuries are those suffered while the worker was not engaged in the performance of his or her work duties, as well as injuries suffered while under the influence of drugs and alcohol and injuries suffered while engaging in prohibited horseplay. Commuting injuries are not considered to be work-related in most cases, although there are certain exceptions that our Garden City workers’ compensation lawyers can discuss with you.
The Three Types of Workers Compensation Benefits
Workers’ compensation benefits come in three flavors. The two most common are medical benefits and cash benefits. If an injured worker dies of their injuries, their survivors receive survivor benefits.
Medical Benefits
Medical benefits cover the full cost of treatment that is medically necessary for the worker to recover from their injuries. It includes emergency medical treatment, doctors’ appointments and follow-up visits, dental care, optometric care, surgeries, x-rays, prescription drugs, physical therapy, and medical devices. With the exception of certain emergency cases, the healthcare provider who provides the services must be authorized by the New York State Workers’ Compensation Board. Workers can find an authorized provider by using the Board’s Health Care Provider and IME Search.
Cash Benefits
Cash benefits (also known as lost wage benefits) are designed to partially compensate injured workers for their lost income while they are out of work recuperating from their injuries. The amount an injured worker receives depends upon the degree of their disability and their average weekly wage for the year preceding the injury, but follows the formula 2/3 x (average weekly wage) x (% of disability). So, for example, if a worker’s average weekly wage is $1,000 and they are 60% disabled, their weekly cash benefit would be about $400.
Survivor Benefits
In the unfortunate event that a worker does not survive their injuries, worker’s compensation provides survivor benefits (also known as death benefits) to the decedent’s surviving spouse, minor children, and certain other dependents. The deceased worker’s survivors are entitled to two-thirds of the decedent’s average weekly wage for the 52 weeks preceding the accident, as well as costs for funeral expenses. In Garden City, funeral expenses are capped at $12,500.
Common Reasons Why Workers’ Compensation Claims Are Denied
Claiming workers’ compensation benefits is not always smooth sailing. A Garden City workers’ compensation lawyer can help ease the process, but injured workers can still make mistakes that can jeopardize their claims. The following are some of the most common reasons why workers’ compensation claims are denied.
- You did not report your injury when it occurred. Injured workers are required to report their injuries to their supervisors as soon as possible, but in no event later than 30 days.
- You failed to seek medical treatment. Failing to seek medical treatment for your injuries or failing to follow your doctor’s orders can exacerbate your injuries and form the basis of a claim denial or reduction in benefits.
- You have a preexisting condition. Employers and their insurance companies frequently (but unjustly) deny claims in which the injured worker has a preexisting condition by arguing that the injury is not work-related, but instead is due to the preexisting condition.
- Your employer disputes the accident. If your employer disagrees with your version of your events and you do not have sufficient evidence to back up your side of the story, your claim may be denied.
- You were under the influence of drugs or alcohol when the injury occurred. While being under the influence of drugs or alcohol is not an absolute bar to receiving benefits, it can significantly complicate a workers’ compensation claim.
Get the Benefits You Are Entitled to With Help From Our Garden City Workers’ Compensation Lawyers
If you have suffered an injury that is keeping you out of work, you should consider speaking to an attorney who can help you claim the benefits you deserve. To get started, please contact the Garden City workers’ compensation lawyers at Turley, Redmond & Rosasco by using our online form or by calling us at 516-745-5666.
