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Workers' Compensation and Disability Benefits

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New York State Workers’ Compensation Board
Common Forms
Social Services and Rehabilitation
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Anybody can get injured at work and may remain disabled for a period of time. Workers’ compensation is an insurance that provides cash benefits and/or medical care for workers who are injured or become ill as a direct result of their job.

The New York State Workers’ Compensation Board is a state agency that processes the claims and determines, through a judicial proceeding, whether a worker will receive benefits and/or medical care, and how much he/she will receive. In a worker’s compensation case no one party is held accountable for the injury caused. The amount that the injured worker receives is not decreased by his/her carelessness, nor is it increased by the employer’s fault. However a worker loses his/her worker’s compensation if the accident is caused mainly by the worker by either intoxicating himself/herself by drinking or taking some kind of drugs or with an intention to harm oneself or somebody at work.

A claim is paid if the employer or insurance carrier agrees that the injury or illness is work-related. If a worker is not receiving benefits because the employer or insurance carrier is arguing that the injury is not job-related, he/she may be eligible for Disability Benefits in the meantime. Any payments made under the Disability Program, however, will be subtracted from future workers’ compensation awards.

This is very important for every individual to know how this systems works.

You have been injured — What do you do, immediately...

"Failure to file a claim or give the employer notice may result in the loss of rights to compensation."

The worker obtains the necessary medical treatment and notifies his/her supervisor about the accident and how it occurred.

The employee notifies the employer of the accident in writing, as soon as possible within 30 days.

The employee files a claim with the Board (New York State Workers’ Compensation Board) on Form C-3 (Employee's Claim for Compensation) by filing the form with the appropriate District office. This must be done within two years of the accident, or within two years after the employee knew or should have known, that the injury was related to employment.

After you have been rushed to the Hospital you make sure that the doctor completes a preliminary medical report on Form C-4 (Attending Doctor's Report) and mails it to the appropriate District Office within 48 hours of the accident. A copy of the Form C-4 should also be sent out to the employer or its insurance carrier, the injured worker, and his/her representative, if any.

Within 10 days of notification of the accident the employer reports the injury to the Board and the insurance company on Form C-2 (Employer's Report of Accident). The insurer provides the injured worker with a written statement of his/her rights under the law. This must be done within 14 days after receipt of the form C-2 from the employer or with the first, whichever is earlier.

Then the Doctor completes a 15 day report of the injury and treatment of Form C-4 and mails it to the appropriate District Office, within 15 days of initial treatment.

Within 18 days after the first day of disability or 10 days after the employer first has knowledge of the alleged accident or within 10 days after the carrier receives Form C2, (which ever is greater), the insurer begins the payment of benefits if lost time exceeds seven days.

If the claim is being disputed, the insurer must inform the Worker’s Compensation Board, the claimant and his/her representative if any. The insurer files Form C-669 (Notice to Chair of Carrier's Action on Claim for Benefits) or Form C-7 (Notice That Right to Compensation is Controverted) with the Board indicating either that payment has begun or the reasons why payments are not being made.

If the employee does not notify the employer timely, this notice may be filed within 10 days of learning of the accident. A copy of each form must be transmitted to the claimant and his/her attorney or licensed representative, if any, simultaneously with the filing with the Board.

When the Board notifies an employer or its insurance carrier that a workers compensation case has been indexed against the employer, and the employer or insurance carrier decides to controvert the claim, a notice of controversy Form C-7 shall be filed with the Board within 25 days from the date of mailing of the notice of indexing. Failure to file the notice of controversy within the prescribed 25-day time limit could bar the employer and its carrier from pleading certain defenses to the claim.

If the rights to compensation is not controversial but payments has not begun because no compensation is presently due, prescribed Form C-699 shall be filed with the Board no later than 25 days after the Board has transmitted a notice of indexing a case to the employer or its insurance carrier.

Every two weeks the insurer continues to make payments of benefits to the injured employee (if there are no disputes). The carrier must notify the Board on Form C-8 (Notice That Payment of Compensation Has Been Stopped or Modified) when compensation is stopped or modified.

Every 45 days the doctor submits progress reports on Form C-4 to the Board.

After eight weeks, the insurer considers the necessity of rehabilitation treatment for the injured employee.

Failure to file a claim or give the employer notice may result in the loss of rights to compensation.

Common Questions That Arise During a Worker’s Compensation Claim

Q. Are all disabilities covered under Worker’s Compensation Law?

A. No. Only those disabilities that are causally related to an accidental injury “arising out of and in the course of the employment” or to occupational disease, are compensable.

Q. What if the worker fails to file a claim for worker’s compensation?

A. The worker may lose his/her rights to benefits and medical care.

Q. Is it necessary for a worker to retain an attorney?

A. No. Worker’s Compensation Law Judges may assist a worker not represented by an attorney. If the case is complicated it is better to have an attorney represent you.

Q. How expensive is it to hire an attorney?

A. Attorney’s fees are deducted from the claimant’s award as determined by a Worker’s Compensation Law Judge. A claimant must not pay an attorney directly.

Q. Are prescription drugs and medications covered under the law?

A. Yes. The claimant should send a receipted bill and letter from the attending physician to the insurance carrier, stating that the purchase was necessary and in accordance with the physician’s direction.

Q. Should an injured worker be subjected to a medical examination when requested to do so by the employer or the insurance carrier?

A. Yes. The employer or the insurance carrier is entitled to have worker examined by a qualified physician. Refusal by the worker may affect the claim. Any person who willfully misrepresents the circumstances surrounding his or her case in order to obtain benefits is guilty of a felony and may result in jail time and may be fined.

Important Telephone Numbers to Service Centers

Workers' Compensation Benefits

Brooklyn District (New York City)
Counties Serviced: Kings, Richmond
Edward M. Joyce, Jr., District Administrator
Tom Agostino, District Manager
1-800-877-1373 FAX-718-802-6642
111 Livingston Street Brooklyn, NY 11201

Manhattan District
Counties Serviced: Bronx, New York
Frank Vernuccio, District Administrator
Joann Shelton, District Manager
1 - 800-877-1373
215 W. 125th Street New York, NY 10027

Queens District
Counties Serviced: Queens
Wayne D. Allen, District Administrator
Carl Gabbidon, District Manager
1 -800 - 877 -1373 FAX - 718 291-7248
168-46 91st Avenue, Jamaica, NY 11432