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Explaining Workers Comp

A look at who qualifies for workers comp, its importance and who pays when you are hurt

Richard J. Brandenstein's picture
Oct 12, 2017

In New York State, employers are required to have Workers Compensation insurance coverage to protect an employee injured on the job. Workers Compensation benefits include medical care, prescription coverage and wage replacement for time lost from work. It is important to remember that filing a Workers Compensation claim is not a lawsuit against your employer, nor are you suing them. All of your benefits are paid for by the employer's insurance company, which is why your employer carries this type of insurance. In fact, by having a Workers Compensation insurance policy, the employer is protected in that employees are forbidden to bring a formal law suit.

There are different ways an employee can get injured on the job. Whether the incident results from an accident or an occupational or repetitive stress claim, the benefits are the same. Injuries resulting from accidents must be reported to the employer within 30 days of the accident and a claim must be filed within 2 years of the accident date.

Another common type of injury is an occupational or repetitive stress injury. This is an injury that develops over time as a direct result of a certain activity that your job duty requires. An occupational or repetitive stress injury can include carpal tunnel syndrome, trigger finger, chronic neck or back conditions, joint conditions that develop over time and many others. For example, if an employee is a carpenter for 15 years involved in daily heavy lifting, and as a result of this constant heavy duty work, the employee develops a back and shoulder injury, then they may qualify as having an occupational and/or repetitive stress injury and be entitled to Workers Compensation benefits. An employee may also develop respiratory or cardiac conditions as a result of occupational hazards such as asbestos and other harmful materials. Employees should notify the employer as soon as they become aware the injury is work-related. Claims must be filed either 2 years from the date the employee knew or should have known that the injury was work-related, or 2 years from the date you became disabled.

There are also claims for occupational hearing loss. The work-related hearing loss may occur from job-related noise exposure, such as heavy machinery, trains, engine sounds to name a few. Prior to filing a claim, you must be removed from the noise exposure for 90 days. Because of the 90 day requirement, many employees file their claims after retirement, but the claim must be filed within 2 years and 90 days of the last exposure to the noise.

If you have missed more than 7 days of work, the insurance company should begin paying you weekly wage reimbursement. The employer may even restore your personal time that was initially used as a result of the accident. The amount of money you receive each week for weekly wage replacement is determined by a percentage of your weekly wage.  As of July 1, 2017, the current maximum rate you may receive weekly is $870.61.

It is important to notify your supervisor at the time of a work-related accident and seek medical attention. The next step is to consult with an attorney about your case and make sure you are receiving all the benefits that you are entitled to.  Our firm, Fusco, Brandenstein & Rada, P.C. can assist you with all aspects of your claim.

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