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Who Is Eligible for Workers' Compensation Benefits in NYC?

If you were hurt on the job, you should get workers' comp

Whether they were injured by a forklift in a Bronx warehouse, a fall from a ladder on a construction site in Manhattan, exposed to toxic substances in a Queens machine shop, or another type of on-the-job hazard, many injured workers in New York City have questions about workers' compensation eligibility after a work accident.

Generally, in New York, all employees are eligible for workers' compensation. There are only very limited exceptions. If you were hurt at work, regardless of fault, you should get workers' compensation benefits.

Still, every case is different, and circumstances will determine whether a worker qualifies for benefits. The best way for an injured worker to find out their options is to contact a trusted NYC work injury law firm for a free case evaluation. Here's more information about how an experienced NYC workers' compensation lawyer can help victims of workplace accidents fight for maximum injury compensation.

What is workers' compensation?

Workers' compensation is a type of insurance mandated by the State of New York that protects employees injured on the job.

If you are hurt at work, workers' comp pays for the full cost of reasonable and necessary medical treatment for your work injury, as well as two-thirds of your average weekly wage (subject to a state maximum and minimum) while you are unable to work due to the injury. It also pays some additional benefits for certain permanent, disabling injuries, as well as death benefits for families who have lost loved ones in fatal work accidents.

Workers' comp is a "no-fault" system because, with very few exceptions, it doesn't matter how a workplace accident happened or who is at fault. If you were hurt at work, you can get benefits, even if your own carelessness caused the injury.

NYC Workers' Compensation eligibility requirements

Again, essentially all employees are covered by workers' compensation, regardless of the size of the employer. Every business in New York with at least one employee must carry workers' compensation insurance. Employees must be covered by workers' compensation insurance whether the worker is:

  • Part-time
  • Full-time
  • Temporary
  • Seasonal
  • Casual/Day Labor

There are only a few specific types of workers who are not covered by New York workers' compensation, mostly because they are covered by other programs. Such workers include:

  • New York City police, firefighters, uniformed sanitation workers, and public school teachers, who are covered by other compensation systems.
  • Federal employees, who are covered under the Federal Workers' Compensation Law.
  • Members of the clergy and certain employees of religious nonprofits.

Employees should know that there is no waiting period for workers' compensation benefits. You are eligible for workers' comp starting from your first day of employment – although some aspects of the process may be different if you have been employed for less than 52 weeks.

It's also important to know that your immigration status does not affect your eligibility for workers' comp in New York. All employees, including undocumented immigrants, are entitled to the same workers' compensation benefits.

Workers' comp does not protect independent contractors and other workers who are not employees. However, whether you are considered an "employee" for workers' compensation purposes is sometimes contentious. An attorney can sort this out.

Exceptions to workers' compensation eligibility

While essentially all employees are eligible for workers' compensation, there are specific scenarios in which a particular injury may not be covered by workers' comp. Some of these situations include:

  • You were under the influence of drugs or alcohol, and your intoxication was the sole cause of your injury.
  • You intentionally injured yourself.
  • You were injured in a fight that you started.

Again, only very limited situations can disqualify a worker from receiving benefits. Sometimes, employees are told they do not qualify for workers' comp when they really do deserve benefits. This highlights the importance of injured employees seeking guidance from experienced workers' compensation attorneys to fight back.

Why your workers' comp claim may be denied

While nearly all New York workers are covered by workers' compensation, that doesn't mean getting the benefits you are entitled to receive will be easy. More than 15,000 workers' compensation claims are "controverted" or disputed in New York every year. Some of the reasons a claim may be denied or disputed include:

  • You did not report the injury in a timely manner (30 days from the date of the injury, for accidents that happened at a specific moment in time).
  • You did not file the claim within 2 years of the injury.
  • The insurance company disputes whether the injury was sustained at work.
  • The insurance company disputes whether a particular medical treatment is "reasonable and necessary."
  • The insurance company disputes the extent of your disability.
  • The insurance company argues you are able to return to work, even though your treating doctor says you are not.

In short, just because eligibility is automatic doesn't mean benefits are automatic. Only an attorney who understands the workers' compensation system can put you in a position to receive the compensation you deserve for your work-related injuries.

An experienced attorney can help you pursue the benefits you deserve

In NYC, injured employees can easily determine their eligibility for benefits after a workplace accident by contacting a lawyer. Respected and experienced NYC workers' compensation lawyers offer free case evaluations, providing injured workers with an explanation of their eligibility, answers to their questions, and information about other potential sources of financial compensation. These lawyers also work on a contingency fee basis, so if they don't win the case, there's no payment required for their services.

At Pasternack Tilker Ziegler Walsh Stanton & Romano LLP, our experienced New York City workers' compensation lawyers and work injury attorneys are dedicated to helping injured employees and families affected by work accidents. If you've been injured on the job in NYC, reach out to us today for a free case consultation. We can assess your eligibility for workers' compensation and provide the knowledge and support needed to make informed decisions that protect your interests after a work accident.

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