Having to go on workers’ comp is never a great thing; after all, no matter how beneficial it is to your recovery and compensation for the harm, you still suffered the harm and need to recover from it. Some people may be confused as to what workers’ comp entails, however, especially if they had not been properly educated on workers’ comp and their benefits. Different states have different ways of handling workers’ comp, so for New Yorkers, it is important to know how their specific state handles things.
What benefits are available under workers’ comp in New York?
One of the key benefits available under workers’ comp is, well, the ability to not have to worry about where money is going to come from while you are recovering from your injury or illness. For as long as is required, New York’s workers’ comp laws will help you focus on your recovery without risking financial stability. In terms of financial stability, another benefit that comes from workers’ comp is the fact that it covers the costs for every medically necessary check-up and procedure related to the injury or illness you sustained while on the job. So if, for instance, if you broke a tooth while at work, you should be able to get the costs to have this break addressed cover by workers’ comp. The same is true for medications you are required to take as part of the recovery process for any injury or illness sustained while on the workplace. You are also entitled to have the hospital stay costs covered in the event that your injury or illness causes you to have to be hospitalized. Other types of medical care that is covered by workers’ comp in New York include surgery, x-rays, lab tests, psychological care, and more.
As far as providers go, you do have options, but the providers you can choose from are based on what the Workers’ Compensation Board (WCB) in New York have authorized to give medical care. If you want to get a list of such providers, you can visit the WCB’s website for it. However, just because a doctor is considered approved by the WBC, it does not mean that you are going to get the medical costs you incur covered. Rather than charging you directly, your doctor will likely not charge you directly, instead sending the charge to the New York State Insurance Fund (NYSIF). Not everyone is going to be on the same page as to what is considered medically necessary, so there is a chance that the NYSIF is going to dispute your request for compensation. As a result of this, your doctor may then require that you sign a form guaranteeing that if the payment does not come from compensation provided through workers’ comp, that it will come from you instead. You should ensure that whatever physician you decide to work with is under your health insurance plan. In doing so, this significantly reduces the risk of having a hefty health insurance bill on your shoulders if the compensation should prove to be inapplicable under your workers’ comp agreement.
Medical benefits are not the only kind of benefits available to you, however. Another type of benefit comes in the form of wage replacement, which itself is determined by the negotiated agreement that is applicable to you. One of the types of wage replacements is called statutory benefits, which provides you a weekly payment. This payment is calculated based on your average weekly wage for the previous year, where they cut it by 2/3. After that, they multiply it by the percentage of disability or temporary impairment. The maximum amount that is payable through this wage replacement is determined by the New York State Average Weekly Wage (NYSAAW). While this is the standard wage replacement program, there are other options, depending on contractual agreements with your employer. For instance, you can have a Supplemental Pay Program. This program helps supplement your statutory benefits for up to nine months, ensuring that the total wage replacement for the pre-disability gross wages is 60 percent. Less commonly seen are contracts where an employee suffering from an illness or injury may, on top of the statutory benefits, seek compensation in the form of six months of leave, with full pay for the entirety of those six months. There are different factors that may go into this, such as the severity of the disability.
One of the big issues with workers’ comp that a lot of New Yorkers struggle with is the wait to receiving the above-mentioned benefits. It is nothing particularly exceptional about dealing with workers’ comp, mind you; it is just inevitable that you will have to wait some period of time while they look into the workers’ comp claim. If you are eligible for wage replacement, for instance, the law forbids you from receiving any of this wage replacement until after the first seven days of your disability. However, there are exceptions to this, such as if the disability goes beyond 14 days. If the disability lasts from eight to 14 days, you may be able to receive compensation for the second week of disability, however. As far as it goes with respect to receiving your first check, excepting for a dispute from the NYSIF over the claim, your first compensation should be received no later than 18 days after you first became disabled from the injury or illness. If you are not being paid by your agency, the first payment comes in within 10 calendar days after the injury or illness is first reported.If, for whatever reason, the NYSIF or your employer attempts to deny you compensation for your injury or illness, the best approach is to get in touch with an NYC Workers’ Comp Lawyer. Not only can they help you figure out whether your medical expenses or other types of compensations should be covered, their mere presence can make it very clear to your employer and/or NYCIS that you mean business.