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Workers’ Compensation Benefits Explained

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New York Workers’ Compensation Benefits Explained

Experienced Injury Lawyer Explains Details of NYC Workers’ Compensation Benefit Rights

Every employee in NYC has the right to workers’ compensation benefits that provide compensation for work accidents.  Workers’ compensation benefits are available both for work-related injuries and illnesses sustained because of conditions on the job.

At Proner & Proner, we believe that the first step to protecting your right to fair workers’ compensation benefits is understanding your rights under the law.  For over 50 years, our skilled labor lawyers have dedicated our practice to helping injured clients get fair compensation for their injuries. With over $400 million in compensation recovered for our clients to date, our leading NYC workers’ compensation lawyers have the tools to get the benefits you deserve.

The materials that follow provide an explanation of the workers’ compensation benefits you may be entitled to receive for work injuries or illness.  If you or a loved one were hurt in a work-related accident, call us today to schedule a free case review so that we can explain your right to NYC workers’ compensation benefits.

Explaining Your Right to NYC Workers’ Compensation Benefits

Workers’ compensation benefits provide compensation after you are hurt on the job and unable to return to work.  The system in NYC can also provide benefits when you are able to work, but your injury prevents you from earning the same amount that you did before the accident. 

The types of benefits that workers’ compensation may provide include:

  • Reimbursement for the cost of your medical care,
  • A portion of your lost wages while you recover,
  • Expenses incurred in vocational retraining if you are unable to return to the same line of work even once you recover,
  • Compensation for permanent injuries,
  • Death benefits to protect your family if your work injury results in death.

Except in emergencies, medical benefits are only provided to a medical provider that the workers’ compensation board has authorized.  In some cases, the insurance company may be authorized to direct you to a different provider. Remember, the payments will be made directly from the insurance carrier to the medical provider—even if you are asked for payment, you do not have to pay anything for your medical treatment.

The Lost Wages Element of NYC Workers’ Compensation Benefits

NYC workers’ compensation benefits cover all medical expenses required because of work accidents regardless of whether you have to miss work.  However, replacement wage benefits are subject to more complicated rules, as follows:

  • You will not receive cash wage replacement benefits the first seven days that you miss work,
  • Once you miss 14 days of work, you become eligible for wage replacement benefits,
  • After 14 days of missed work, you also become entitled to wage replacement benefits for the first seven days of missed work.

Clients are often surprised to learn that their workers’ compensation benefits will not cover the full amount of their lost wages during the recovery period.  Instead, your weekly wage replacement benefit is based upon:

  • Your average weekly wages, and
  • Your “percentage of disability”.

To calculate your weekly wage replacement benefit, you multiply your average weekly wage by your percentage of disability.  The resulting amount is then reduced by 1/3.

Example: Assume your average weekly wage is $400.  If you are completely unable to work, your “percentage of disability” is 100%.  100% of $400 is $400. Reducing that by 1/3, you will receive $266.67 each week.  If you were able to work part-time earning half as much as your average wage (i.e., 50% percentage of disability), your weekly wage replacement benefits would be reduced by 50% (to $133.34 per week).

Injured workers with a relatively high average weekly wage will also be subject to a cap, which changes based upon the date of your accident.  For example, the cap if you were totally disabled by the accident (and so cannot work) is:

  • $934.11 per week if the accident occurred between July 1, 2019 and June 30, 2020,
  • $904.74 per week if the accident occurred between July 1, 2018 and June 30, 2019,
  • $870.61 if the accident occurred between July 1, 2017 and June 30, 2018.

The cap increases slowly over time to account for cost-of-living increases, but your weekly maximum will remain the same even if you remain unable to work for more than one year—because the cap is based on the date of your accident.

If and when you are able to return to work, you may continue to be eligible for wage replacement benefits if you are earning less than you did before the injury.  Those benefits will be equal to about 2/3 of the difference between your pre-accident wages and your post-accident wages.

Schedule a Free Case Review for a Detailed Explanation of NYC Workers’ Compensation Benefits

Our top-rated labor lawyers provide a free case review if you would like a more individualized explanation of workers’ compensation benefits in your case.  To speak with us, call our office or contact us online today.

Frequently Asked Questions About New York Workers’ Compensation Benefits

FAQ: Why am I only receiving 2/3 of my average weekly wage for workers’ compensation in NYC?

One of the reasons benefits are limited to 2/3 of your wages is that the benefit amounts are not subject to tax. Because workers’ compensation benefits are only meant to reimburse you for what you’ve lost, the idea is that 2/3 of your wage should approximate your average take-home pay after taxes.

FAQ: What is a “Schedule Loss of Use” award?

A Schedule Loss of Use award, or SLU, is a form of workers’ compensation benefit you receive because you have lost the use of a body part permanently. The SLU is designed to compensate you for a reduction in earning power that is permanent because of your work injury. To be eligible, you must:

– Have recovered as much as possible,
– Obtained and submitted a medical report prepared by your doctor that meets certain guidelines and that states you have reached “maximum medical improvement”,
– Have suffered a permanent loss of function in an injured body part because of a work injury.

SLU awards can be granted based upon loss of a limb or some type of permanent nerve, bone or muscle damage to a body part. Hearing loss, vision loss and disfigurement also count. It is not necessary that you lose 100% function. Your doctor’s report will state the percentage of function that you have lost permanently, which will be used in computing your SLU benefit.

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