The workers' compensation system in New York is designed to help you recover from a work-related injury or illness by providing medical care, paying you for some of your lost earnings, and helping you get back to work. This article explains the types of workers' comp benefits available in the state, as well as how they're calculated. (To get these benefits, you must promptly report your injury to your employer and file a workers' compensation claim.)
Can You Get Workers' Comp Benefits in New York for COVID-19?
COVID-19 might be covered by workers' comp as an occupational disease if you can show that you were exposed to the coronavirus because of the particular nature of your job. As the New York Workers' Compensation Board (WCB) has explained in a Q&A on COVID-19, you're more likely to get benefits if the risk of exposure is "significantly higher" at your workplace. Healthcare workers and first responders are the most obvious examples of employees at higher risk, but the WCB also noted that workers in other occupations—including transportation and food service—interact closely with the public in places where there has been documented exposure to the coronavirus.
Even if you couldn't meet the standard for an occupational disease, you might get workers' comp benefits for COVID-19 if you could prove there was a particular exposure event, such as an interaction with a sick coworker or an outbreak at your workplace. In the past, New York courts have treated infectious illnesses as accidental injuries under certain limited circumstances—such as when a correctional officer got tuberculosis after repeated contact with a TB-infected inmate, or when a teacher contracted mumps during a school-wide epidemic of the illness. (Matter of Middleton v. Coxsacki, 341 N.E.2d 527 (N.Y. 1975); Matter of McDonough v. Whitney Point Cent. School, 15 A.D.2d 191 (N.Y. App. Div. 1961).) However, it's not clear how those cases would apply in the context of a pandemic, where the disease is widespread in the community.
Workers' comp pays for all reasonable and necessary medical treatment related to a work injury, as long as the health care provider is authorized. (Learn how to get medical treatment through workers' comp.)
When it's appropriate, you may also receive mileage reimbursement for travel to and from doctors' appointments.
If you need to take more than seven days off work to recover from your work-related injury, you may receive cash benefits intended to replace part of your lost wages. You won't receive these benefits for the first seven days, unless you ultimately are off work more than 14 days.
The amount of temporary disability benefits depends on your average weekly earnings during the year before your injury, as well as the extent of your temporary disability. Your treating doctor will assign you a disability percentage, ranging from 0% to 100%.
If your doctor says that you're 100% disabled on a temporary basis, your temporary disability benefits will be two-thirds of your average weekly wage, up to a maximum amount. The legal maximum depends on the date of your injury. For injuries that happened between July 1, 2020 and June 30, 2021, the maximum is $966.78 per week. (For other injury dates, the New York Workers' Compensation Board (WCB) keeps an updated list of the maximums on its website.)
If you aren't able to return to your full pre-injury job (and the wages that come with that) but can do some level of work while you're recovering from your injury, you will be entitled to partial temporary disability benefits. These benefits will amount to two-thirds of the difference between your average weekly wage and your current earning capacity (up to the same cap mentioned above).
For this purpose, your earning capacity is generally measured by what you're actually making. For example, if your average weekly wage was $900, but you're working a light-duty job earning $300 per week, you could receive two-thirds of the difference ($600), or $400 per week.
However, if you aren't working at all—for instance, because your employer hasn't offered you a light-duty position that accommodates your partial disability—the WCB may assign you a level of earning capacity that's reasonable under the circumstances (but no more than 75% of your pre-injury wages).
Once your medical condition has stabilized to the point where it wouldn't improve even with further treatment (a stage known as "maximum medical improvement"), your doctor will evaluate you to decide if your injury has left you with permanent limitations. If the doctor says that you're 100% disabled, you'll receive two-thirds of your average weekly wage as long as you continue to be disabled.
Generally, permanent total disability means that you can't work at all because of your limitations, but injured employees with certain types of disabilities (such as the loss of both eyes, legs, or arms) may be able to earn a limited amount of money without losing their disability benefits.
New York has three different ways of awarding benefits for permanent partial disability, depending on the parts of the body that are affected.
New York law includes a schedule to determine permanent partial disability benefits for injured employees who've lost the ability to use certain parts of their body (eyes, ears, and parts of the upper and lower limbs). If you've permanently lost some use of one of these body parts, you'll receive two-thirds of your average weekly wage (up to the legal maximum) for the number of weeks listed in the schedule, multiplied by the percentage of your lost use. For example, the schedule lists a total loss of use of a hand at 244 weeks. If you have only 50% lost use, you would receive 122 weeks of payments.
You may request a lump-sum payout instead of weekly payments. Cash benefits that you have already received are deducted from your award.
If you have a permanent disability to your spine, head, organs, or another part of the body not listed on the schedule, you may receive permanent partial disability benefits. The amount of the payments will be two-thirds of the difference between your pre-injury average weekly wage and your current earning capacity (as determined based on your specific disability and state guidelines). The maximum number of weeks you'll receive these benefits will depend on the percentage of your lost earning capacity, according to a formula in New York law. For example, you'll receive benefits for no more than 500 weeks if you've lost 91% of your earning capacity, while a 15% loss of earning capacity will result in benefits for no more than 225 weeks.
You may be able to receive an additional award of up to $20,000 if your injury has left you with a permanent, serious disfigurement to your face, head, or neck, or if a workers' comp judge has decided that disfigurement to certain other parts of your body could hurt your earning capacity.
New York workers' compensation also provides additional benefits, including:
You can see by now that you won't receive compensation for all of your losses through workers' compensation. This may seem unfair, but it's part of the workers' comp trade-off: You can receive benefits relatively quickly without having to prove that your employer was at fault for the injury. At the same time, you generally aren't allowed to sue your employer in an effort to receive the full value of your lost earnings, as well as damages like pain and suffering.
However, there are limited circumstances when you may be able to sue outside of the workers' comp system for a workplace injury. If you believe your case may qualify for one of these exceptions, or you're having trouble collecting workers' comp benefits, consider speaking with a workers' comp lawyer. An attorney who's experienced in this area can explain how the law applies to your situation and make sure you get the compensation you deserve.