The Process of Applying for Workers’ Comp

The Process of Applying for Workers' CompIf you’ve suffered a work-related injury or illness, you may be entitled to workers’ comp benefits, including medical care and part of your lost wages while you’re off work during your recovery, and permanent disability benefits if the injury left you with long-lasting limitations.

Be sure and research Workers’ Compensation Attorneys in NYC before moving ahead. An experiences Workers’ Comp Attorney is practically a necessity if you expect to be fairly compensated for your injury at your workplace.

Inform your employer about your injury.

Your workers’ compensation claim could be canceled if you do not notify your employer within 30 days of becoming aware that you have sustained a job-related accident. This is a mandatory step that you must take. You should check to see if there is a specific procedure for reporting workplace injuries.

Temporary or permanent disability can be covered by lost wage benefits.

These include:

Temporary Total Disabilities

These benefits last until the worker is back at work or achieves maximum medical improvement (MMI). When a treating physician concludes that an injury/illness has fully healed, MMI is the result. This could be a partial or full recovery.

Temporary Partial Disabilities Benefits

These are benefits that are paid to workers who (1) have returned to work under duty restrictions, but not yet reached MMI, and (2) who earn less than 80 percent of their pre-injury wages. These benefits can be claimed for up to 104 weeks (two years) or until the MMI is established.

Permanent Impairment benefits – Workers may be eligible for these benefits after an injury or illness that causes physical, psychological, or functional loss. These benefits will continue even after MMI. A doctor will give a permanent impairment rating. This is expressed in percentage of the total disability.

Permanent Total Disabilities

These benefits are available to workers who have been permanently disabled by injuries and are unable to work for any money. An employee must prove that he/she is unable to work within 50 miles of their home, or that they have suffered severe traumatic brain injuries (TBI), such as paralysis, loss of an arm or leg, or severe traumatic brain injuries (TBI).

Before you file the Petition, try to resolve the dispute.

You should have received from your employer a copy of your employer’s First Report of Injury/Illness, along with a brochure outlining your rights.

You should have received bi-weekly checks (every other week) 21 days after your injury to be eligible for benefits.

If you haven’t received correspondence or checks from the insurer or if there is a dispute regarding your workers’ comp benefits, you should first discuss it with your employer. New York law requires that you make this “good faith attempt” to resolve any dispute.

You may also need to file a petition if you are unhappy with the medical benefits you receive, such as if the carrier refuses treatment by a specialist.

The grievance process begins with the filing of a written grievance form provided by workers’ compensation carrier.

Before you file a petition, contact an attorney. If you have failed to resolve the dispute, you can file a Petition. can be viewed as a Petition.

An attorney is unnecessary to assist you with the filing of the Petition and to represent you during the claims process. You will be greatly benefited if you do so.

Complete the Petition

You are required to provide extensive information in your petition, including:

  • Contact information for your employer, its workers’ compensation carrier, and you
  • A summary of your job responsibilities, and what you were doing at the time your injury occurred.
  • A detailed description of the accident with a list of all body parts that were injured
  • List all benefits, such as medical and lost-wage, that you claim are “due ripe and due”, including rates and dates of denial.
  • Claim for interest/penalties for unpaid benefits, and a claim to attorney fees and costs

Your claim may be denied if you don’t provide the required information. You may miss an important deadline, even though you can still file another petition. The deadline for filing the Petition is two years after your injury.

It is important to work with a lawyer who can properly file a petition.

Filing and serving the Petition

The Petition must be filed with the OJCC Clerk’s Office. If you have a lawyer representing you, they will file the Petition via the OJCC electronic filing system.

You must also send a certified copy of the Petition via mail to your employer and the employer’s workers’ compensation carrier (and, if possible, the attorney for the employer/carrier).

Prepare to undergo mediation and, if necessary, a hearing.

You can expect mediation to be held within 130 days of filing the Petition. In some cases, mediation may not be ordered, and the case will proceed to a final hearing.

Mediation is an informal process. It’s a process that aims to reach an agreement between you and your employer (or its workers’ compensation insurance).

Your case will be heard in a pre-trial hearing if mediation fails to reach an agreement. Next, you will be heard by a Judge of Compensation Claims.

You should prepare to give evidence at the hearing about your injury, its nature and extent, and the impact it has had on your ability to work (or the same job that you did before). Your employer/carrier and you may both present medical experts as witnesses.

You can appeal if you disagree with the decision.

The JCC will issue a final decision within 30 days. You and your lawyer can appeal this decision to the First District Court of Appeal within thirty days.

The JCC decision will be confirmed by the appellate court. It can then be reversed or sent back to the JCC for further proceedings.

Once your claim has been approved, you will start receiving benefits. You have the right to appeal if your claim is denied, which often happens. You should consult a lawyer immediately if your claim is denied. 0

There are many reasons you might be denied, including missed deadlines and disputes about whether your medical condition is related work-related.

Appeal procedures are complicated and have strict deadlines. A skilled workers’ compensation attorney can assist you in many ways. They can gather evidence to support your claim, negotiate with the insurance company, or represent you at hearings.

A lawyer will usually not cost you anything upfront. Workers’ compensation attorneys in almost every state charge a percentage of the benefits you receive if your case is successful, and nothing if it fails.

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