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How Does Workers’ Compensation Work In New York?

When you suffer an illness or injury that resulted from your job duties, your employer’s workers’ compensation insurance policy can cover the cost of medical bills, lost wages and other related expenses. In New York, companies must have insurance to cover all full-time and part-time employees or risk hundreds of thousands of dollars in fines.

If you or a family member had an accident at work, review the process of filing a workers’ comp claim.

Seek medical treatment

In an emergency situation, you can see any doctor for immediate care. Otherwise, you must see a health care provider with authorization through the state Workers’ Compensation Board. Some employers participate in an alternative dispute resolution or preferred provider organization network; these programs allow employees to see their own doctors after a workplace illness or injury.

Provide official notice

You should let your manager know about the accident as soon as possible. Failure to provide written notice of an injury within 30 days of the incident can result in loss of benefits. Employers must then notify their insurance company within 10 days of finding out about the injury or illness.

You must also notify the state board by sending in Form Employee Claim C-3 within two years of the accident. Your doctor must submit Form C-4 to the state board, the employer and the insurance company. If you develop an illness because of workplace exposure, you have two years to file after you learn that the disease resulted from your employment.

Receive benefits

You will receive a statement of your legal rights from the workers’ comp insurance provider within 14 days. This statement includes information about the network where you must seek diagnostic tests if applicable.

If the insurer approves your claim, your benefits will begin within 18 days. Your doctor must submit a progress report on your condition every 45 days. If the insurer disputes your claim, you must receive written notice of the decision within this time frame so that you can exercise your right to appeal.

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