Filing a New York workers’ compensation claim involves specific steps and deadlines that are crucial for ensuring you receive benefits. A basic understanding of the procedures can significantly reduce the stress involved. A New York workers’ compensation lawyer can provide guidance and help you understand your rights and options.
Reporting and documenting your work injury or illness
The moments following a workplace accident or discovering a work-related illness are critical. Your first priority should be to seek medical attention and inform your supervisor about the incident within 30 days. When seeking medical attention, make sure to inform your doctor that your injury or illness is work-related.
When notifying your employer, you must do so in writing and include the following information:
- Date and time of the injury
- Location where the injury occurred
- Description of how the injury happened
- Type of injury sustained
- Names of any witnesses
- Immediate symptoms or effects of the injury
- Any immediate medical treatment received
Your employer has 10 days from learning about your condition to report it to the Workers' Compensation Board and their insurance company using the Employer’s Report of Work-Related Injury/Illness (Form C-2).
Additionally, your attending doctor should fill out and submit a Doctor’s Initial Report (Form C-4). They should send it to the District Office and provide copies to your employer, their insurer, and yourself.
Filing your claim
Complete and submit the Employee Claim (Form C-3) to the State Workers’ Compensation Board within two years of your injury or illness. This form officially starts the claim process, but the sooner you file, the faster you can receive benefits. When completing Form C-3, you’ll be asked to provide the following information:
- Personal information (name, address, phone number, social security number)
- Employer information (name, address, phone number)
- Date and time of the accident
- Location where the accident occurred
- Description of the accident
- Description of the injury or illness
- First date of injury-related absence from work
- Healthcare provider information
- Witness information (if applicable)
- Whether you have returned to work
- Earnings information
Waiting for approval
Expect a written statement outlining your rights under the law within 14 days after the board receives the Employer’s Report. If eligible, you should start receiving benefit payments within 18 days after the insurance carrier gets the Employer's Report, provided the claim wasn't denied within the first seven days.
Upon approval, you will receive bi-weekly payments from the insurance carrier. This includes benefits for medical care, lost wages, disability, and vocational rehabilitation and retraining services.
Managing claim disputes and denials
If your claim gets disputed or denied, immediately consult with your workers’ compensation lawyer to understand your options. You can file an appeal with the Workers' Compensation Board, which will be reviewed by an administrative law judge.
If the judge's decision isn’t in your favor, you can make a further appeal to the Workers' Compensation Board’s three-member panel. If the panel’s decision still doesn’t resolve your claim favorably, you have the right to appeal to the Appellate Division of the Supreme Court, Third Department.
Filing a workers’ compensation claim is more than just paperwork; it's about ensuring your rights are protected and that you receive the support you need during your recovery. To avoid having your benefits delayed or denied, consult with an experienced New York workers’ compensation lawyer.
