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 need to report your injury to your employer and file a claim within the legal deadlines; learn more about filing a workers' comp claim in New York.)
Workers’ comp pays for all reasonable and necessary medical treatment related to a work injury, as long as the health care provider is authorized. (For more information, see our article on 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 injury dates between July 2018 and June 2019, the maximum is $904.74 per week. As of July 1, 2017, the maximum benefit is $870.61 per week. (For other injury dates, the New York Workers’ Compensation Board keeps an updated list of the maximums on its website.)
There are two possible ways of determining the cash benefits for partial temporary disability:
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 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 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 500 weeks’ worth of benefits if you’ve lost 91% of your earning capacity, while a 15% loss of earning capacity will result in 225 weeks of benefits.
If your injury has left you with a permanent, serious disfigurement to your face, head, or neck, and a workers’ comp judge has decided that it might limit your earning capacity, you may be able to receive an additional award up to $20,000.
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.