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Author: Michael Serres, ESQ.

Do You Know What Workers’ Compensation Benefits Will Cover?

Knowing What Workers’ Compensation Will Cover

Queens | NYC | Brooklyn | Bronx Workers’ Compensation Attorneys

When you suffer a serious injury on the job, such as a broken bone, torn ligament or herniated disc, you can be pretty certain that any losses associated with that injury will be covered by a workers’ compensation claim. But what about seemingly minor injuries? What if you crack a tooth in a slip and fall on the job? What if a work-related mishap causes you permanent scarring or disfigurement?

The answer is that workers’ compensation is responsible to pay for all types of losses, provided the loss was sustained in a job-related accident or incident. Here’s the important caveat, though—you must have all necessary medical records and documentation to support your claim:

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What If You Have Been Found to Be Permanently Partially Disabled?

Experienced NYC | Brooklyn | Queens | Bronx Workers’ Compensation Attorneys

What If You Have Been Found to Be Permanently Partially Disabled?

In the aftermath of a work-related injury, when you file a workers’ compensation claim, certain determinations will be made regarding the nature of your disability. Is it temporary or permanent? Is it total or partial? The benefits you received will differ based on these findings.

With a finding that you are permanently partially disabled, the workers’ compensation judge has concluded that your injury does not necessarily keep you from working at all, but that your medical condition is not expected to get any better, at least with respect to the injury you suffered. Because your disability is considered to be permanent, there’s a requirement under New York law that you continue to receive some level of workers’ compensation benefits.

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What to Do at a Workers’ Compensation Insurance Company Medical Examination

You’ve been injured at work, notified your employer and filed a workers’ compensation claim. You’ve received notice that you must submit to a physical examination by a doctor chosen by the workers’ compensation insurance company or by your employer. What’s the best strategy for how to handle this exam?

First and foremost, it’s important to be as honest as possible. Don’t exaggerate or minimize the impact of the injury. Be specific about what limitations the injury places on you. If you are still able to perform many of the daily tasks in your life, admit that. If you overstate the impact of your injury and the workers’ compensation insurance company sends out a private investigator who videotapes you doing things you said you couldn’t do, your claim will likely be completely rejected.

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New York City | Queens | Brooklyn | Bronx Workers’ Compensation Lawyers

Your Rights During a Workers’ Compensation Insurance Company Medical Exam

When you’ve been hurt on the job and you file a claim for workers’ compensation, one of the first steps you’ll have to take is to submit to a medical examination by a company-selected doctor. Based on that physician’s findings, your claim will generally be approved or rejected. So what are your rights with respect to such an exam?

Can You Refuse to Be Examined by a Company Doctor?

It’s a requirement that you be checked out by a doctor chosen by the insurance company or by your employer. That does not mean, however, that you cannot go to your own doctor or that you cannot get a second opinion. If the findings of the company doctor differ from those of your doctor, the workers’ compensation judge will have to make a decision regarding what evidence is most credible and may even have you obtain a third opinion.

Can You Videotape the Exam?

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Queens | NYC | Brooklyn | Bronx Workers’ Compensation Attorneys

Beware of Insurance Company Investigators!

When you file for workers’ compensation, it’s not unusual for the workers’ compensation insurance company to send out a private investigator to videotape you without your knowledge. They’ll try to show you doing things that you shouldn’t be able to do with the injury you are claiming, including working on other jobs. It’s not uncommon for these investigators to confront you, ask you questions on camera and try to make it look like your claim is fraudulent.

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New York City | Queens | Brooklyn | Bronx Workers’ Compensation Lawyers

Don’t Think That Your Injury is Too Insignificant for a Workers’ Compensation Claim

There’s a tendency, when you are injured on the job, to believe that your injury must be serious and catastrophic before you should contact a workers’ compensation lawyer or file a claim. That’s not necessarily true. You may have minor injuries that don’t keep you from doing your job that simply heal and go away. But there are also what are known as consequential injuries—injuries that do not occur at the time of the accident, but arise because of some injury you suffered at work. If those consequential injuries prevent you from doing your job or limit what you can do, you have a right to workers’ compensation benefits. Let’s look at an interesting case we handled.

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Workers’ Compensation Attorneys in Queens, NYC, Brooklyn and the Bronx

The Lengths to Which Workers’ Compensation Insurance Companies Will Go to Deny a Claim

It often seems like a workers’ compensation claim should be simple—you were hurt at work, you have witnesses, you even have a medical opinion. But here’s what you need to understand–workers’ compensation insurance companies have a vested interest in paying as little as possible to settle your claim—so does your employer.

Workers’ compensation insurance companies make their money by maximizing premiums and minimizing payouts—it’s that simple. So they’ll look for any opportunity to deny your claim and they’ll use their size and financial resources to make you keep fighting. Your employer’s workers’ compensation premiums are based, in part, on the number of claims the insurance company has to pay on their behalf. The more claims, the higher the premium, so you can see the incentive to reject your claim.

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Can Your Employer Deny Your Claim by Calling You an Independent Contractor?

Experienced NYC | Brooklyn | Queens | Bronx Workers’ Compensation Attorneys

Can Your Employer Deny Your Claim by Calling You an Independent Contractor?

One of the classic ways in which an employer or a workers’ compensation insurance company will attempt to deny coverage for an injury is to allege that you weren’t really an employee, you were an independent contractor. They’ll allege that you were your own boss, that you had your own business, that their coverage is only for employees and that you should have had your own policy of workers’ compensation insurance.

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Queens |NYC| Brooklyn |Bronx Workers’ Compensation Attorneys

Don’t Give Up a Claim Just Because It Doesn’t Appear to Be Work-Related

One of the requirements for filing for and obtaining workers’ compensation benefits is that you must show that the injury was caused by something on the job. When you are injured in a traumatic accident—a machine breaks down or you slip and fall on a wet floor—it’s pretty easy to show that the injury is work-related. But what if you have a back injury that’s developed over time? What if you have a stroke or heart attack caused, at least in part, by stress from your job? In those types of cases, it can be extremely difficult to establish the necessary causal link, but our attorneys have the skill, experience and fight to do so. Here’s an example.

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If I Return to Work Making Less Money, Am I Still Entitled to Workers’ Compensation Benefits?

New York City | Queens | Brooklyn | Bronx Workers’ Compensation Lawyers

So you’ve been hurt at work and you can’t perform your old job. What happens if you go back to work at a different position, making less money than you were before your injury? Are you still entitled to seek workers’ compensation benefits for what you have lost? The answer is yes!

Under the New York workers’ compensation laws, an injured worker can make what is known as a “reduced earnings award.” In fact, you can be compensated up to 2/3 of the difference between the statutory maximum and what you are making after your injury.

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