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New York Workers’ Compensation FAQs

by | Jan 21, 2016 | Workers' Compensation

Were you injured on the job? Or, have you developed an occupational disease? If so, there’s a strong possibility that you are covered under workers’ compensation. What exactly is workers’ compensation?

Workers’ compensation is a type of insurance that was developed to protect injured workers. Most New York employers must maintain workers’ compensation insurance for employees who become injured or ill as a result of their jobs.

With workers’ compensation, you can receive medical care, and a percentage of your lost wages because your ability to work is affected. You pay nothing for this insurance because your employer is responsible for 100% of the costs.

You receive your benefits from an insurance carrier, or by your employer if they choose to insure themselves.

Common Questions About Workers’ Comp

Q. What does workers’ compensation law cover?
A. It addresses work-related injuries and occupational diseases.

Q. What happens if I don’t file a claim?
A. You could lose your right to much-needed benefits for your medical care and lost wages.

Q. Should I file any paperwork?
A. In addition to notifying your employer right away, you should file a C-3, which reports your injury or illness, even though your employer’s insurer is required to notify the Board when it accepts or disputes your claim.

Q. Can I receive medical care, even if I don’t lose any time from work?
A. Yes. You can receive medical care for your condition, even if you didn’t lose any time from work.

Q. Do I need to wait for medical care?
A. No you don’t, however, your treating physicians must request authorization in order to perform a procedure that costs more than $1,000. This figure applies to each procedure, not the total cost of treatment.

Q. Can a doctor treat me, even if they insurer has not answered their request for approval?
A. Yes. Since insurers have 30 days to reply to an authorization request, if an insurer fails to reply within 30 days, the provider can go ahead and perform the services.

Q. My prescriptions are expensive, are they covered?
A. Yes. Once your claim is established, the pharmacy can bill the insurer directly. If your insurer has a pharmacy network, you will be required to use those pharmacies, with the exception of an emergency. In that case, you may have to pay the pharmacy before your claim is in the system, but the carrier will have to reimburse you.

If you have further questions regarding workers’ compensation in New York, contact Katz, Leidman, Freund & Hermanto schedule a free consultation!