The most basic explanation of workers’ comp is that it consists of both cash benefits and medical care. New York law specifies the time period under which the workers’ comp insurer must begin your benefit payments.
To start the process, you must notify your employer as soon as possible after the injury. You also should file the Employee Claim (C-3) as close to your accident date as possible. You have up to two years from the injury or discovery of the injury of the injury to file this document, but to ensure prompt payment of your benefits, notify your employer of the injury and file the form as soon as you are able.
Cash Benefits
Cash benefits are paid to employees who can’t work due to a partial or total disability. You will receive cash benefits after the first seven days of your disability have passed. Thus, you will receive disability payments from the eighth day of disability forward. If the injury lasts more than 14 days, then you will receive cash benefits for those first seven days.
The insurer should begin payment within 18 days of receiving the Employer’s Report of Work-Related Injury/Illness (C-2). You should receive your benefits about every two weeks until you are able to return to work, or your Schedule Loss of Use award for a permanent partial injury is over – this is dependent on the number of weeks assigned your particular injured body part and your impairment rating. If you have a Non-Schedule Loss of Use award for a permanent partial injury, the number of weeks you receive benefits depends on your loss of earning capacity.
Filing a Medical Claim
Many workers are unsure about how to find a doctor and who pays the doctor after a visit or treatment. If you sustain non-life-threatening injuries, you must select a doctor approved by the Workers’ Compensation Board. If you require emergency care, approval by the Workers’ Compensation Board is not required for the emergency care.
While you may select your physician, the insurer may require you obtain diagnostic testing with certain facilities. Further, some insurers may require workers seek care with certain doctors but workers can opt out of this and seek their own doctor after 30 days.
Regardless of who treats you, your doctor may submit the bill directly to the workers’ compensation insurer. It may not charge you for care if the injury occurred at work.
However, if the insurer disputes that your injury is work-related, and the Workers’ Compensation Board agrees, you or your health insurance carrier may be responsible for your medical bills. Your healthcare provider may ask you to sign an A-9 form, which informs you that you are responsible for medical bills if the Workers’ Compensation Board disallows your claim.
At Markhoff and Mittman, P.C., we help New Yorkers get the workers’ compensation help they need. Call 1-855-614-4351 to set up an appointment with an attorney who can review your case and ensure you receive the benefits to which you are entitled on time.
