How to File a Workers’ Comp Claim in Queens

Information from a Reliable Workers’ Comp Law Firm

Filing a workers’ compensation claim in New York can be a bit difficult if you do not know much about the legal process, as most workers in the state do not. To try to make things a little easier for you, head to the Harris Firm, LLC in Queens. Our workers’ compensation lawyers can assist you from start to finish with any claim or case, starting with sharing some basic information you should know about how to file a claim.

For counsel from our firm now, dial (718) 487-8669. We have two offices located in the Bronx and Queens. We can travel if necessary.

New York Workers' Compensation Laws

Workers' compensation laws in New York, like in many other states, are designed to provide financial and medical benefits to employees who are injured or become ill due to work-related activities. These laws are intended to protect both workers and employers by providing a no-fault system, which means that employees generally do not have to prove that their employer was at fault for their injuries in order to receive benefits.

Most employers in New York are required to provide workers' compensation insurance coverage for their employees. This includes full-time and part-time employees, as well as some seasonal and casual workers.

Workers' compensation benefits in New York can include the following benefits:

• Medical Care: Injured employees are entitled to necessary medical treatment for their work-related injuries or illnesses. This includes doctor visits, hospitalization, surgeries, prescription medications, and other medically necessary services.
• Wage Replacement: Workers who are unable to work due to a work-related injury or illness may be eligible for wage replacement benefits. These benefits are typically a percentage of the employee's average weekly wage, subject to a maximum limit.
• Disability Benefits: Workers' compensation provides disability benefits for temporary or permanent disabilities. These benefits may be classified as temporary total disability, temporary partial disability, permanent total disability, or permanent partial disability, depending on the circumstances.

Basic Steps to File a Workers’ Compensation Claim

In any workers’ compensation claim in New York, there are five things that must happen:

1. Qualify for workers’ comp: Not all workers are eligible for workers’ compensation coverage. Specifically, you need to be a qualifying employee, not an independent contractor in most cases. Also, you have to be hurt while completing a job-related duty.
2. Report your injury to your employer: You need to inform your employer that you were injured at work or while completing a job-related duty. Your report should be given within the hour or the same day at the latest. Legally, you must inform your employer within 30 days, or your right to get workers’ compensation can be removed.
3. Gather information about your accident and injury: Workers’ compensation is a no-fault system, but that does not mean that evidence is not useful. Gather information about our accident, how and why it happened, and what injuries it caused you to suffer. When you file your claim, this information will help you back your statements in case there is any doubt.
4. Complete a C-3 employee claim form: In New York, workers’ compensation insurance claims begin with a C-3 employee claim form. You can retrieve this form offline from the New York Workers’ Compensation Board, or you should be able to get one from your employer. Either way, it should be free. Fill it out as much as possible.
5. Submit it to your employer: The last step is to submit the completed form to your employer, so they can use it to forward the claim to their workers’ compensation insurance provider.

At any point in this process, if you feel confused or worried, then you should pause and get a workers’ compensation attorney on your side. We would be happy to explain your rights and options in full detail, so you can feel confident about your future again.

What Happens If My Workers' Comp Claim Is Denied?

If your workers' compensation claim is denied in New York, it can be frustrating and stressful. However, you have the right to challenge the denial and seek a reconsideration or appeal.

Here are the steps to take if your workers' compensation claim is denied:

• Review the Denial Notice: Carefully read the denial notice from the New York State Workers' Compensation Board. This notice should specify the reasons for the denial.
• Contact Your Employer: Discuss the denial with your employer and their workers' compensation insurance carrier. Sometimes, the denial may be due to administrative errors that can be corrected without the need for formal appeals.
• Request a Hearing: If you believe the denial is unjust, you have the right to request a hearing before a workers' compensation law judge. This request is made by completing a C-3 form (Employee Claim) and submitting it to the Workers' Compensation Board.
• Gather Evidence: To support your case at the hearing, collect all relevant medical records, witness statements, and other documents related to your injury or illness. This evidence will help establish the work-related nature of your condition and the need for compensation.
• Attend the Hearing: Attend the scheduled hearing and present your case. The judge will consider the evidence and make a decision.
• Request a Review by the Workers' Compensation Board: If you disagree with the judge's decision, you can request a review by the Workers' Compensation Board's Appeal Board. This request is made using a C-108 form (Application for Board Review). You typically have 30 days to request this review.
• Consider Further Legal Action: If the Board's Appeal Board upholds the denial, you may still have legal recourse. You can consult with an attorney and consider filing a formal lawsuit in a New York state court. This is a more complex and time-consuming step, but it is an option for challenging a denial.
• Keep Records: Throughout the process, maintain copies of all documents, correspondence, and records related to your workers' compensation claim. These documents may be important if you need to prove your case during appeals or legal proceedings.
• Be Timely: It's crucial to adhere to all deadlines and timelines associated with the appeals process. Failing to meet these deadlines can jeopardize your ability to challenge the denial.
• Seek Legal Advice: Consult with an experienced workers' compensation attorney. An attorney can guide you through the process, help you build a strong case, and represent your interests at hearings and during the appeal.

How Often Are Benefits Paid?

In a typical workers’ compensation case, benefits are paid to the claimant once every two weeks. Once the first receipt of the injured worker’s medical treatment is submitted, the insurance company has up to 18 days to get the first payment to the claimant. Assuming you qualified for wage replacement benefits, the bi-weekly payments will include two-thirds of your average pre-injury wages and any repayments you are owed for necessary medical treatment costs if any.

Get More Help Today – Call Now

The Harris Firm, LLC, can provide valuable assistance and support throughout the workers' compensation claims process in New York.

Here's how our firm can help you navigate this process effectively:

• Claim Evaluation: We start by assessing the specifics of your case, including the circumstances of your work-related injury or illness, medical documentation, and other relevant details. This initial evaluation helps us determine the strength of your claim and identify any potential challenges.
• Filing the Claim: We assist you in completing and submitting all necessary paperwork, ensuring that your claim is filed correctly and within the prescribed deadlines. This includes preparing the C-3 form, gathering medical records, and submitting the claim to the Workers' Compensation Board.
• Negotiating with Insurers: Our firm can engage with the workers' compensation insurance carrier on your behalf. We negotiate for the maximum benefits you are entitled to under New York's workers' compensation laws, such as medical care, wage replacement, and disability benefits.
• Appeals and Dispute Resolution: If your claim is initially denied or disputed, we represent your interests at hearings before workers' compensation law judges. We gather and present evidence to support your case, question witnesses, and argue on your behalf.
• Board Reviews and Further Appeals: If necessary, we can request a review by the Workers' Compensation Board's Appeal Board and present additional evidence to support your claim. Our aim is to ensure that your rights are protected and that you receive the benefits you deserve.
• Legal Representation: Throughout the entire process, we provide legal representation and advocacy. We help you understand your rights, answer your questions, and provide guidance on the best course of action.
• Communication and Documentation: We handle all communications with the workers' compensation board, the insurance carrier, and other parties involved in your case. Our team ensures that all necessary documentation is filed correctly and on time.
• Protection from Retaliation: In some cases, employees may fear retaliation from their employers for filing a workers' compensation claim. We can help protect your rights and interests, ensuring you are not subjected to unfair treatment or termination due to the claim.
• Settlement Negotiations: If a settlement offer is made, we can evaluate it to ensure it is fair and in your best interest. We negotiate on your behalf to secure an equitable settlement, taking into account the long-term implications of your injuries.
• Peace of Mind: Engaging our firm provides you with peace of mind, knowing that experienced legal professionals are advocating for your rights. We strive to alleviate the stress and complexities of the workers' compensation process, allowing you to focus on your recovery.

We hope this quick rundown of New York’s workers’ compensation filing process is helpful. But it is completely understandable if you still think you need legal counsel.

Get our Queens attorneys on the phone now by dialing (718) 487-8669, tell us what happened, and we can discuss what should happen next. Remember: All initial consultations are free!