Workers Compensation Claims Process

What is the workers’ compensation claims process like in New York?

If you’ve sustained an illness or injury due to your activities at work in the state of New York, you should be entitled to workers’ compensation payments to replace lost income and other expenses. Unfortunately, however, the process involved in applying for these benefits is not always as straightforward as it should be.

If you encounter issues when applying for workers’ compensation, you’ll need to work with an attorney who knows how to protect your interests.

How a Workers’ Compensation Attorney From Tucker Lawyers Can Help You

At Tucker Lawyers, we help sick and injured New Yorkers to navigate every step of the workers’ compensation application process, from understanding whether a given health complaint will qualify for benefits, to filing initial applications, to challenging wrongful claim denials. Our workers’ compensation attorneys understand that the process can be challenging and frustrating, particularly given the high stakes involved. When you come to us, you can be sure we’ll do everything in our power to get you the payments you need to get your life back on track.

Broadly speaking, we can assist you by:

• Helping you understand your entitlements: If you’re not sure whether your condition will entitle you to workers’ compensation, you should report your injury and see a doctor anyway. The sooner you report your injury, the better; making your workplace aware of it within 30 days of the accident (or the initial occurrence of symptoms) is ideal.
• Drafting claims: Many people choose to speak with a New York workers’ compensation attorney prior to filing an initial claim for benefits. An attorney can help you to complete the application properly. It’s a highly complex and technical process, and the consequences for getting it wrong are potentially very serious.
• Representation in disputes: As is the case with all forms of insurance, workers’ compensation coverage premiums increase after claims are paid out. This means your employer, along with its insurer, has a financial incentive to see your claim fail; this, in turn, means that claim disputes are very common. Our attorneys can represent you in such disputes, whether they involve your employer or its insurance carrier.
• Ongoing support: We offer ongoing support and communication throughout the entire process, keeping you informed and involved at every step.

Though it’s not technically necessary to hire a lawyer to help with the workers’ compensation claim process, expert legal help will be very valuable to you if you encounter any issues along the way.

The Workers’ Compensation Application Procedure in New York

The first thing you should do after sustaining a workplace-related illness or injury is seek medical attention. However, it’s important to realize that you can only use healthcare providers with approval from the state Workers’ Compensation Board, unless your situation is an emergency. You must ensure that your doctor knows your condition is work-related and that they record it as such.

Your employer should have a system in place to accept accident report filings. You should complete this process within 30 days of your accident or of the onset of your condition. Your employer will then have to pass on details of your case to its workers’ compensation insurance company within 10 days of your report. It’s crucial that you’re as detailed as possible when reporting the nature of your injury and the reasons it came about. If possible, take photos of the accident scene, and ask any witnesses for their contact details so they can corroborate your story later on.

Once you’ve officially notified the company in this way, you’ll need to fill out Workers’ Compensation Board forms, which your lawyer will be able to help you with. The most important of these is the Form C-3, which must be submitted within two years of your injury.

At this point, the Workers’ Compensation Board holds a hearing wherein they either approve or decline your claim. You’re entitled to have an attorney with you during this hearing, and having one will greatly increase your chances of securing benefits. At Tucker Lawyers, we have a wealth of experience in dealing with the board and the insurance companies that are most commonly involved.

If your claim is denied, we’ll get to work filing an appeal. The appeals process involves presenting your case again in front of a panel of three specialist judges.

How Long Does the New York Workers’ Compensation Application Process Take?

The entire workers’ compensation application process, from reporting the injury to receiving your first benefit payment, can take as little as a few weeks if everything runs smoothly. However, there are a number of factors that can cause complications and greatly increase the length of time you’ll have to wait to get paid. These include filing issues (such as a missing piece of information in the details submitted to the insurance company) or disputes over the validity of your claim.

As noted above, insurance companies often try to escape liability in relation to claims by issuing bad-faith denials. An initial denial doesn’t mean you won’t get paid, it just means you may have a legal dispute on your hands.  

What Challenges Arise in the Claims Process, and How Can They Be Navigated?

Denials of valid claims can happen for a number of reasons, including:

• Incomplete documentation: Inadequate or incorrect paperwork is a common reason for claim denial. Ensuring all documents are thoroughly and accurately completed is essential.
• Disputes over work-related injuries: Sometimes, employers or insurance carriers may dispute a claim’s validity, arguing that the injury is not work-related.
• Missed deadlines: Failing to meet the strict deadlines for reporting injuries and filing claims can result in denial.
• Lack of medical evidence: Claims may be denied if there is insufficient medical evidence to support the injury or illness claim.

Contact Tucker Lawyers Today

When you’ve fully recovered and are ready to return to work, you’ll be able to move on with your life without the aid of workers’ comp payments. However, the period before this can be financially devastating for many people, so it’s vital that you secure these benefits if you need them.

Call us at Tucker Lawyers PC, where initial consultations are always free. You can reach us at (516) 399-2364, or via our online contact form. If we’re unable to win your claim, we won’t charge you anything.