Rockaway Beach Workers’ Compensation Lawyer

After a job-related injury or illness, you may want to secure the insurance benefits your employer is required to provide. Worker’s compensation insurance can pay for your medical and rehabilitative care and supplement your wages. You are also entitled to permanent disability if you qualify, and a family could receive death benefits if an employee did not survive a workplace accident.

It sounds ideal not to have to worry about money after a job accident, but there are downsides. Many insurers deny claims on technicalities or because the less they pay out, the more their company profits. Some employers might argue that your claim did not happen at work or that you have a pre-existing condition. Some are afraid the insurance premiums will go up, so the fewer claims they report, the better. If you need help filing for benefits or fighting a denial, a Rockaway Beach workers’ compensation lawyer is standing by. Our dedicated personal injury attorneys could support your claim for benefits.

Filing a Workers’ Comp Claim

In New York, an injured person must notify your employer of a workers’ compensation claim within 30 days of the illness or injury. If 30 days pass and they have not done so, they might lose their rights to workers’ comp benefits.

As soon as possible, an injured person also needs to file an employee claim with the Workers’ Compensation Board in New York. To complete this form, you will need to provide:

  • Your employer’s name and address
  • The dollar amount of gross wages paid per pay period
  • The names and addresses of any other employers you worked for at the time of your injury or illness
  • The name and address of the doctor or hospital that provided your initial treatment

A lawyer in Rockaway Beach could ensure an employee files all claims necessary to secure workers’ compensation benefits.

Types of Employees Covered

Under state workers’ compensation law, most individuals providing services to a for-profit business will be considered employees of that business. An employee may be:

  • Part-time
  • Full-time
  • Temporary
  • Seasonal
  • Casual/day labor
  • Unpaid including volunteers and family members

All of these types of employees must be covered by an employer’s workers’ compensation insurance.

Employers with at least three employees, including part-time, must carry workers’ compensation insurance, which they purchase from private insurers that offer it. Benefits cover sudden accidents, like falls and chemical burns, and conditions that develop over time, like asbestos-related lung disease. The accident or illness must be work-related. Pre-existing conditions exacerbated by a second accident could be covered, but benefits will be affected.

Accidents must be reported to employers within 30 days. A physician who works within the workers’ compensation system must diagnose the patient and prescribe treatment, which is documented for the claims administrator. A workers’ compensation attorney could help an employee in Rockaway Beach understand their eligibility.

Getting Medical Treatment Under Workers’ Comp

When an employee gets ill or injured, they should immediately tell their employer or supervisor and seek medical treatment. The health care provider they choose must be authorized by the New York State Workers’ Compensation Board, except in an emergency situation.

For minor injuries, the employer can choose to pay for first-aid treatments directly. An injury is considered minor if:

  • It requires two or fewer treatments
  • The lost time at work amounts to less than one day

In the instance of minor injuries, the employer would complete a report on the injury but would not send it to the New York State Workers’ Compensation Board or their insurance company. Instead, the form would remain in their business files. The employer should plan on keeping these injury records for at least 18 years. The New York State Workers’ Compensation Board may review these files at any time.

All injuries other than minor injuries must be reported to the Workers’ Compensation Board and the business’s insurance carrier within 10 days. Failure to file within 10 days means the Board could impose a penalty of up to $2,500. A workers’ comp lawyer in Rockaway Beach could help an employee secure the medical care and reimbursement they need.

Temporary Total and Partial Disability

Temporary total disability payments are meant for injured workers who are unable to work after the accident. Benefits include two-thirds of a worker’s average wages and are paid until the worker can return to the job or up to 400 weeks. If the injury is catastrophic, there is no limit on benefits.

Temporary partial disability makes up a portion of the pay difference for those who can return to light duty or part-time work, earning less than before the accident. They are paid for up to 350 weeks at two-thirds the difference between pre- and post-accident wages.

Permanent Partial Disability and Death Benefits

When the treating physician determines an employee injured on the job is permanently disabled, a formula is used to gauge the percentage of disability, which is then used to calculate benefits.

If an employee does not survive the workplace accident, death benefits are paid to certain family members, including spouses and children. Legal counsel could help a family secure death benefits through workers’ compensation.

When a Workers’ Comp Claim is Denied

Claims administrators deny claims when documentation is incomplete or an investigation cannot confirm the injury was clearly job-related. A Rockaway Beach lawyer could appeal a denial through a court filing followed by a hearing before a workers’ compensation judge.

Navigate the Workers’ Compensation System With a Rockaway Beach Attorney

Employees count on an insurance system that pays them benefits if they are injured at work or become ill because of a workplace condition. Wages are replaced and medical bills are paid when a benefits claim is successful. Unfortunately, claims are not automatic. Documentation and an investigation precede granting them.

Sometimes, insurers and employers dispute a claim’s validity. Sometimes, claims are denied. The application process is specific, and if you are in the early stages of recovery from your accident and feel overwhelmed by the paperwork, call us. Whether you have just been seriously injured, or your claim has been denied, a Rockaway Beach workers’ compensation lawyer is available to assist you.

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