Understanding the workers' compensation claims process in New York

The claims process for workers' compensation in the state of New York features responsibilities for workers, employers, doctors and insurers.

Sustaining a workplace injury can be a challenging experience. The physical recovery process itself may be difficult enough. Stress from mounting medical bills and lost wages only makes things worse. On top of all this, navigating the workers' compensation process can be overwhelming. For this reason, understanding how this process works may be welcome to injured workers. Specifically, understanding how the claims process works may be helpful.

Filing a claim

The first step for New York workers who are injured on the job is to obtain whatever medical care is necessary to treat the workplace injury. The worker's supervisor should also be notified of the injury at this time. However, even after notifying the supervisor, the employer must be notified, in writing, regarding the specifics of the injury. This must be done within 30 days of the injury. The next immediate step is to complete what is called the Employee Claim (C-3) as soon as possible. This form comes from the New York State Workers' Compensation Board. Completing the C-3 form is required within two years of the accident that produced the injury.

Doctor and employer responsibilities

Within 48 hours of the accident, the doctor from whom medical care was sought must complete a preliminary medical report. This specific form is called the Form Doctor's Initial Report (C-4). The C-4 must be distributed to the Board, as well as the employer or its insurer. Within ten days of receiving notification of the accident, the employer must also report the workplace injury to the Board and its insurer.

Insurer responsibilities

The next step is for the employer's insurer to communicate with the injured worker. Specifically, the insurer is required to provide the worker with a written statement of his or her rights under New York state law. The deadline for this requirement is fourteen days after receiving the employer's report or with the first payment check, whichever occurs earlier. Soon afterwards (eighteen days after receiving the employer's report), the insurer is to begin payments of benefits. Along with this step, the insurer must notify the Board that payments have commenced or, if not, what the reasons are for delay or denial.

Legal representation is available

It is important to remember that successfully filing a claim is a competitive process. Employers and their insurers are financially motivated to avoid paying claims that injured workers file. They may also possess significant resources to legally resist distributing benefits. In order to make the process fair, injured workers also need to be legally represented. For this reason, injured workers may wish to consult with a Staten Island workers' compensation attorney.

Keywords: workers' compensation, job, injury