Financial factors and common challenges in the NY work injury claim process
When a worker is injured on the job in Brooklyn, they may find themselves unsure how to cover bills while they recover. While New York’s workers’ compensation system provides lost wage benefits to help replace a portion of income, navigating the claims process can be complex and challenging – especially if the injury was severe. In Brooklyn, some of the most severe incidents involved the construction, demolition, warehousing, and hazardous material removal industries. Common sources of on-the-job injuries in the borough include:
- Falls from scaffolding, roofs, and windows
- Car, boat, and truck accidents
- Electrocution
- Machinery and equipment malfunctions
- Forklift accidents
- Caught by, struck by, and crushed by objects, materials, or machinery events
Having an experienced Brooklyn workers’ compensation lawyer can make a significant difference in ensuring the worker receives the benefits they’re entitled to without unnecessary delays or complications. Here’s how the system works.
What are workers’ compensation lost wage benefits?
Workers’ compensation lost wage benefits provide a safety net when an injury or illness on the job keeps a worker from working. In New York, injured workers can receive up to two-thirds of their average weekly wage, though this amount varies based on the injury’s severity and the time off work. Workers’ compensation also covers rehabilitation programs, such as physical and occupational therapy, vocational rehabilitation, job placement, and social services.
Since New York operates under a no-fault system, even if the injury was partially the worker’s fault, they’re still entitled to benefits as long as the injury happened on the job. However, to qualify for lost wage benefits, certain criteria must be met:
- Work-related injury. The injury or illness must have happened while performing job duties. This can range from physical injuries like a fall to occupational illnesses from toxic exposure.
- Medical verification. A doctor needs to confirm that the injury or illness prevents the worker from doing their job.
- Notification and filing. The worker must notify their employer within 30 days of the injury and file a formal claim with the Workers’ Compensation Board within two years. In Brooklyn, the workers’ comp board office serves Kings County and Richmond County and is located on the 5th floor of One Pierrepont Plaza.
Workers’ compensation benefits in Brooklyn aren’t paid for the first 7 days of disability unless the disability lasts more than 14 days. If it extends beyond 14 days, benefits are paid retroactively from the first day of missed work. Payments should start within 18 days of the injury or 10 days after the employer learns about the injury, whichever comes later.
Temporary vs. permanent lost wage benefits
Workers’ compensation benefits can be temporary or permanent. Which one a worker qualifies for depends on the injury and recovery prospects.
- Temporary lost wage benefits. These kick in when an injury keeps the worker off the job for a short period. Benefits cover two-thirds of the worker’s average weekly wage, but there’s a cap on the maximum amount, which is updated regularly. If a doctor clears the worker for light duty but not their usual role, partial benefits may still be available.
- Permanent lost wage benefits. When an injury results in permanent impairment, the worker may receive benefits for life. There are two types: Permanent Partial Disability (PPD), which may be available when the worker can still work, but not as they once did; and Permanent Total Disability (PTD), which may be available if an injury is severe enough to prevent any kind of work.
The duration of benefits depends on the injury’s severity and how long recovery takes. Temporary benefits last until the worker returns to the job or reaches maximum medical improvement (MMI). Permanent disability benefits may last for a set number of weeks or, in extreme cases, for the worker’s lifetime. Keeping up with medical appointments and staying in touch with the Workers’ Compensation Board helps ensure the worker receives the benefits they deserve.
Calculating NY workers’ comp lost wage benefits
Workers’ compensation lost wage benefits are calculated based on two main factors: the worker’s Average Weekly Wage (AWW) and their disability percentage. This approach ensures that lost wage benefits are tied to both the worker’s prior income and how significantly the injury impacts their ability to work.
- The AWW is determined by averaging the worker’s earnings over the past year, including regular wages, overtime, and bonuses. This figure represents what the worker typically made each week before the injury occurred.
- The disability percentage indicates how much the injury affects the worker’s ability to perform their job. A 100% disability means the worker cannot work at all, while a lower percentage (such as 50%) reflects partial ability to work in a limited role.
Workers’ compensation pays roughly two-thirds of the worker’s AWW. If the disability is 100%, the worker receives the full two-thirds. For partial disability, the benefits are reduced according to the disability percentage. For instance, if a worker has an AWW of $900 and a 50% disability rating, they would receive about $300 per week — half of the two-thirds amount.
Common challenges with lost wage benefits in Brooklyn
While workers’ compensation benefits are there to help, the process can be tricky. Some common issues include:
- Claim delays or denials. Sometimes, claims are delayed or denied due to paperwork issues, disputes with employers, or missing medical documents. If this happens, the worker has the right to appeal through the Workers’ Compensation Board.
- Disability rating disputes. The amount of lost wage benefits hinges on the disability rating, which can spark disagreements between the worker’s doctor and the insurance company’s doctor. If this happens, the worker may need an independent medical exam or a hearing to settle the issue.
- Pressure to return to work. Some employers push injured workers to return before they’re ready. If this happens, a second opinion from a trusted medical professional can help protect the worker’s health and long-term recovery.
If benefits are delayed or denied, workers should act fast. They can file a complaint with the Workers’ Compensation Board or request a hearing. If the insurer disputes the claim, a judge will review the case and direct the insurer to pay. While waiting for a decision, the worker can receive disability benefits. Getting legal help from a Brooklyn workers’ compensation lawyer is the best way to resolve complicated cases or appeals.
Legal help for injured Brooklyn workers
Navigating the New York workers’ compensation system can be a challenge, but lost wage benefits provide crucial financial support for injured workers. Whether a worker is dealing with a temporary setback or a permanent disability, understanding the process helps ensure they receive the benefits they’re entitled to during recovery.
If you’re facing challenges with your NY workers’ compensation claim or need help securing the lost wage benefits you deserve, a Brooklyn workers’ compensation lawyer can provide the guidance you need. Schedule a free consultation today to discuss your case and explore your options for maximizing your lost wage and medical benefits.
