In New York, workers who suffer injuries or illnesses directly resulting from their job are generally eligible for workers’ compensation benefits. And in cases where the injury or illness is significant enough to keep you out of work for more than seven days, one of those benefits is partial replacement of your lost wages.
Lost wage benefits, sometimes called indemnity or cash benefits, help injured employees pay the bills while they are out of work recuperating from a work-related injury or illness. However, getting the full benefits you deserve can be a challenge. An employee can lose out on full compensation if their benefits are not properly negotiated or their claim is denied. Over 16,000 claims are disputed in New York every year.
To protect their health and finances, many injured workers hire experienced Queens workers’ compensation attorneys to collect evidence, handle the claim, and negotiate aggressively for maximum compensation.
Whether it was a fractured arm bone in an Elmhurst warehouse forklift accident, pain from repetitive motions like typing, packing, or sewing, a head injury due to a scaffolding collapse on Roosevelt Avenue, or another type of on-the-job accident, it’s important to understand how workers’ compensation wage benefits are calculated. Here’s what workers need to know about workers’ comp wage benefits in Queens, NY.
Who is eligible for wage loss benefits in New York?
Under New York law, all employees are eligible for workers’ compensation benefits. Unlike some other types of benefits, such as health insurance, there is no waiting period: you are eligible for workers’ compensation on your first day of work.
In Queens, some industries come with higher risks of work injury than others. Local sectors that typically file the most workers’ comp claims include:
- Public administration
- Health care and social assistance
- Transportation and warehousing
- Retail
- Manufacturing
- Construction
- Accommodations and food services
What is the wait time for wage loss benefits?
If an injured employee’s workers’ comp claim is accepted by the insurer, payments should begin within 18 days of the day they were injured, or within 10 days after the employer became aware of the injury, whichever is later. A report by the NYS Workers’ Compensation Board found that 9 out of 10 workers receive a “timely” first payment.
Wage loss benefits begin on the 8th day of disability – the first seven days typically are not paid. However, if the worker is out of work for more than 14 days, then they will be retroactively paid for the first seven days as well.
Of course, this assumes the process goes smoothly. If the workers’ comp insurance carrier disputes the claim, then there may be a significantly longer process to obtain wage loss benefits. This is one situation in which an experienced workers’ compensation lawyer can make a meaningful difference.
How much do wage loss benefits cover?
Typically, wage loss benefits pay two-thirds of the worker’s average weekly wage (AWW), which is based on their gross earnings for the 52 weeks prior to the injury. (If the injured worker has only been employed for a short time, the employer needs to provide salary information for another employee with the same or similar job to calculate the AWW.) This includes overtime pay, bonuses, and so on, not just the worker’s base salary.
If the injured worker has multiple jobs (concurrent employment) and is out of work at each job, then their income from those jobs is included in their AWW.
Wage loss benefits are also subject to a weekly minimum and maximum. In New York, the minimum benefit is $150 per week for all injuries that occurred after May 1, 2013. The maximum benefit is based on the state’s average weekly wage and is adjusted on July 1 of each year.
Note that the minimum and maximum benefits on the day of the injury apply to each claim; the injured worker can’t claim more if the state maximum amount is adjusted upward after the injury.
In cases where the injured worker only loses part of their income – for instance, they have to work reduced hours due to the injury, or have two jobs and can only work one of them due to the injury – then workers’ compensation pays for two-thirds of the difference between their pre-injury and post-injury wage.
How long do lost wage benefits last in New York?
There is no set end date for wage loss benefits in the New York workers’ compensation system. It depends on the nature and extent of the injury and if and when you are able to return to work.
Once you reach maximum medical improvement (MMI) – which means you have recovered as much as possible and further improvement is unlikely – your workers’ comp doctor will evaluate whether you have returned to your pre-injury level of health or still have some degree of disability. At this point, your claim transitions from temporary disability benefits to permanent disability benefits (if applicable). If you are permanently disabled, you can qualify for additional benefits, depending on the extent of the disability and the part or parts of the body affected.
How a Queens workers’ compensation attorney can help
Injured workers frequently face challenges in obtaining the full benefits they are entitled to. Employers or their insurance companies may dispute the extent of the injury or the employee’s eligibility for wage benefits.
An experienced Queens workers’ compensation lawyer can take on the complex and technical workers’ compensation system while their clients focus on healing. Having a workers’ comp attorney with a track record of success on their side puts injured workers in a stronger position to receive the benefits they deserve.
Strict timelines and deadlines apply to workers’ compensation claims, so if you’ve been injured on the job, don’t delay. Contact a workers’ compensation lawyer in your area for a free consultation today.
