To get started on your workers' compensation claim, you must first notify your employer about your work-related injury or illness within 30 days of its recognition. Additionally, get prompt medical attention and make your doctor aware that your condition is linked to your employment. If you don’t already have a doctor, your employer’s healthcare provider may suggest one for you.
Next, you’ll need to fill out and submit Form C-3 to the New York State Workers' Compensation Board within two years of sustaining the injury or identifying the job-related illness. It’s best to do this as soon as possible to fast-track your benefits.
The information you’ll need to provide on Form C-3 includes:
- Your name, address, social security number
- A description of your work accident, injury, or occupational health condition
- The time, date, and location of your work accident
- Witness names and contact information (if there are any)
- Information about your employer and your employment at the time of injury or occupational illness
Your employer will need to submit Form C-2F to the Workers' Compensation Board no later than 10 days after being informed of your condition.
Additionally, your doctor is required to send an initial medical report (Form C-4) to the Workers' Compensation Board's district office. A copy of the completed Form C-4 should also be provided to you, your employer, and their insurance company.
Once the required forms are submitted to the board, your employer’s insurance company will assess your claim's legitimacy. They will then determine your eligibility for workers' compensation benefits. If your claim is approved, you’ll begin receiving benefits within 18 days of your claim being filed.
Depending on the nature of your injury or illness, this may include medical costs, lost wages, disability benefits, and vocational retraining services. If you lost a loved one due to a work accident or illness, you may be eligible for death benefits.
What if my claim is disputed or denied?
If your workers' compensation claim is disputed or denied in New York, there are specific steps you can take to challenge the decision and pursue your claim. Review the denial letter from the insurance company to understand why your claim was denied. There could have been a procedural error in filing the claim that you may not be aware of.
You can then file an appeal with the New York State Workers' Compensation Board within 30 days of the denial. Your appeal will likely lead to a hearing before a Workers' Compensation Law Judge. Your attorney will have the opportunity to present evidence, such as medical records or witness testimony, to support your claim.
If the judge doesn’t rule in your favor, you have the right to appeal the judge's decision to a three-member panel of the Workers' Compensation Board. This must be done within 30 days of the date the decision was filed. If you don’t get anywhere with the panel, you can take your case to the New York State Supreme Court, Appellate Division, and potentially, the New York State Court of Appeals.
To make this process as easy as possible, it’s best to speak to a New York workers’ compensation lawyer. This ensures you are well informed about your rights and the process for obtaining compensation.