Timeline for a Workers' Compensation Case

Posted By Katz Leidman Grossman Wolfe & Freund || 23-Mar-2016

Were you injured in a workplace accident, or have you fallen ill because of an occupational disease? If so, you should be covered under your employer’s workers’ compensation insurance.

Workers’ compensation provides medical care and a portion of a worker’s lost wages because their ability to work has been impacted. Most New York employers are required to carry this critical insurance.

You do not need to worry about fault to file a claim for benefits, since workers’ compensation is a “no-fault” system. Meaning, your claim will not be denied because you were at fault, nor will you receive less benefits if you were careless.

What is the timeline for a workers’ comp case?

The timeline for a New York workers’ compensation case is as follows:

1. Seek medical treatment
As soon as you are injured, seek medical treatment, whether this means going to the emergency room, calling 911, or seeing your primary care physician.

2. Notify your employer
As soon as possible, notify your supervisor or boss about the accident and tell them how it happened. Also, you are required to give your employer written notice of the accident within 30 days.

3. Within two days of receiving treatment
Within two days of your initial medical treatment, your doctor will file a medical report with the New York Workers’ Compensation Board. Copies will also be sent to you, your employer or their insurance carrier, and your attorney.

4. Within two weeks of learning about the accident
Once the insurance company has learned about the accident, they send you a written statement explaining your legal rights within 14 days, or they must provide this notice with your first check, whichever occurs sooner.

If your employer’s insurer requires that you use doctors in their provider network, then the insurer must provide you with that information.

5. Notice of a dispute within 18 days
The insurer must accept your claim within 18 days, or it must explain to you, your attorney and the Board why it is disputing it. If you did not notify your employer immediately after the accident, then the insurer has 10 days to act after learning about the accident.

6. Benefits are paid every two weeks
If your claim is approved, the insurer will pay the healthcare providers directly, and it will pay your lost wage benefits every two weeks. If the insurer modifies or decides to stop paying your benefits, it must notify the Board of any such changes.

7. Continuing medical treatment
Be sure to continue receiving the medical treatment as directed by your medical provider. Your doctor will be submitting progress reports to the insurance company and the Board.

Contact Katz, Leidman, Grossman, Wolfe & Freund to file a claim for workers’ compensation.

Categories: Workers' Compensation