New York workers’ compensation pays benefits to employees who are injured on the job. Workers may receive medical treatment, compensation for wage loss, and other financial assistance. To collect benefits, you must meet certain requirements—including reporting your injury to your employer and making a timely claim for benefits.
In New York, most employers must have workers’ compensation coverage—either by:
In general, only large, financially stable employers will qualify to self-insure. The New York Board of Workers’ Compensation oversees all workers’ comp claims in the state.
Like all other states, New York has a no-fault workers’ compensation system. You do not need to show that your employer acted carelessly in order to receive benefits. As long as your injury happened on the job or was caused by your work activities, you will typically be eligible for benefits. Available benefits include:
Notifying your employer is the first step to starting a workers’ compensation claim. In New York, you must promptly notify your employer of a work-related injury in writing. If you do not notify your employer of the injury within 30 days, you may lose some or all of your benefits.
However, employees should provide notice and request medical treatment as quickly as possible. Employers and insurance companies are skeptical of delayed claims and tend to deny them. Giving notice and getting treatment early on will reduce the likelihood of a claim denial.
When giving written notice, include the following:
Once you report an injury, your employer should allow you to seek medical treatment with a Board-authorized doctor. It is important to provide the doctor with accurate information about the cause of your injuries and the severity of your symptoms. Insurance companies rely heavily on medical records of initial treatment when they evaluate claims. Either downplaying or exaggerating your symptoms may result in a denial of benefits.
Reporting a work injury does not automatically start a New York workers’ compensation claim. You must file a claim with the Board in order to receive benefits. There are several ways to file an Employee Claim (Form C-3):
You must file your workers’ compensation claim within two years of your workplace injury. If an injury or illness develops over time, you must file a claim within two years of discovering its relationship to your work. If you fail to file a workers’ compensation claim, you will lose your right to benefits.
Within ten days of receiving notice, your employer must also report your injury to its insurance company and the Board. Then, the insurance company will determine your eligibility for benefits. Its investigation may involve:
Under New York law, the insurance company must either approve or deny your workers’ compensation benefits within 18 days of receiving your claim. If your claim is approved, you will start receiving wage loss payments and other benefits. If the insurance company disputes your claim, the Board will schedule a hearing to determine your eligibility for benefits.
If your workers’ compensation benefits are denied, the Board will refer your claim to a workers’ comp judge and schedule a hearing. At the hearing, you will have an opportunity to present testimony and other evidence in support of your claim. If the judge denies your claim after a hearing, you have the right to appeal this decision. On appeal, a panel of judges will review your claim and issue another decision. Appeals must be filed within 30 days of a denial of benefits.
Unless your claim is very simple, you should consider hiring a workers’ compensation lawyer. The insurance company will have a lawyer, and you may be at a disadvantage if you proceed without an attorney. New York also offers an Advocate for Injured Workers Program that assists injured workers with their claims. (To learn more, see Should I Hire a Workers' Comp Attorney or Can I Handle My Own Case?)