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Personal Injury - Pyrros & Serres, LLP

New York Workers’ Compensation Attorneys

Workers’ Comp. Overview

In New York, as in other states, workers who are hurt on the job, have a right to pursue workers’ compensation benefits, provided they worked in a capacity and for an employer mandated to have workers’ compensation coverage under New York law.

Workers’ compensation laws benefit both workers and employers. Blame for the incident or condition causing the injury is not placed on the employee or the employer. In return for workers’ comp benefits, the injured worker cannot file a lawsuit against his employer.

New York workers’ compensation law establishes fixed weekly cash benefits and medical care, which the employer’s insurance carrier pays based on type of injury. However, a worker loses his/her right to workers’ compensation if the injury results solely from his or her intoxication from drugs or alcohol or from the intent to injure him/herself or someone else.

In many instances, however, employers and their workers’ compensation insurance companies make it difficult for injured workers to obtain the benefits they deserve. If you have been hurt on the job, an experienced workers’ compensation attorney can make the difference in the outcome of your claim.

Workers’ Comp Hearing Process

If you have been hurt on the job in New York, you may have a right to pursue workers’ compensation benefits to cover lost wages and medical care. During the claims process, a hearing may be scheduled with a workers’ compensation judge or referee.
Clients frequently ask why hearings are scheduled and what happens at a workers’ compensation claim hearing.

New York Workers’ Compensation Hearings

Under the best-case scenario, your workers’ compensation claim will be approved without a hearing and you will start receiving benefits within days or weeks of your application. However, a hearing may be scheduled for a variety of reasons:

  • Your employer may challenge your claim, alleging that the injury did not occur on the job or contending that your injury should not prevent you from working
  • The workers’ compensation insurance provider may challenge your claim, contesting the type of injury you have incurred or its impact on your ability to work

The insurance company’s decision to challenge your claim may be due to a variety of reasons such as:

  • Lack of sufficient medical information
  • Inaccurate information
  • A conflicting opinion from a doctor the insurance company has retained to examine you
  • Lack of wage information to determine the correct amount of your claim

A Judge Weighs the Evidence

At the hearing, the workers’ compensation judge will consider evidence from both sides and listen to testimony to determine whether you are entitled to an award and, if so, how much.

Workers’ comp hearings tend to move very quickly and the administrative judges don’t have time to explain the law to participants. Consequently, you may not understand what you need to do to protect your legal rights — one of the principal reasons why it is important to have an attorney represent you.

Your employer and/or the workers’ compensation insurance company will have legal counsel at the hearing, therefore, it’s critical that you also have a knowledgeable and experienced attorney to act as your advocate.

At the hearing, your attorney will introduce evidence to establish your pre-accident wages, so that you can receive the maximum benefit to which you are entitled under the law. Your attorney will also make certain that:

  • Your case is structured to cover all of the parts of your body that have been injured
  • All necessary treatment is authorized, including surgery, if required
  • You receive the amount to which the workers’ compensation law entitles you

Returning to Work

How Workers’ Comp Benefits are Affected

After a workplace injury, one of the most difficult questions concerns when you are ready to return to work and what will happen if you do return.

When you have suffered a workplace injury and you are receiving workers’ comp benefits, you may reach a point where you would like to try to go back to work, to see if you can physically handle the responsibilities of your job. Before you do anything, though, you should return to your doctor and get medical clearance. You may feel much better than you did, but your doctor may have concerns that you have not fully healed and that attempting to return may aggravate your injury or interfere with a full recovery. Don’t ever try to go back to work without obtaining a medical clearance.

If you do return to work, you must notify the workers’ compensation insurance company that you are back on the job. If you receive any workers’ compensation checks for any period after you return to work, do not cash the checks. Return them  to the insurance company.

After you return to work, you may continue to receive medical treatment for your injury. However, you should keep a journal or diary, noting any additional days that you miss work for reasons related to your injury. Missed days will be part of your claim for additional benefits.

In the event, pain becomes too much and you realize that you cannot work because of the injury, you will need to return to your doctor and get a medical report to determine your level of disability. In fact, you may be entitled to some level of workers’ compensation, even if you don’t stop working because of work-related injuries.

 

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