Injured Middletown employees face significant financial uncertainty from medical bills and lost income when they’re too injured to work. This can happen to Middletown employees in almost any industry, from physically demanding jobs to white-collar office work. That’s why all employers in New York State are legally required to purchase workers’ compensation insurance, which provides benefits to cover the injured employee’s medical costs and a portion of their lost wages.
While workers receive these benefits under the law, the complicated filing process can result in many disputed or denied valid claims.
At Finkelstein & Partners, our Middletown workers’ compensation lawyers know that dealing with administrative roadblocks is incredibly frustrating for injured workers that depend on these benefits to cope with the difficulties of an on-the-job injury. Our team of Middletown workers’ compensation lawyers at Finkelstein & Partners has spent decades helping injured workers navigate the legal process and obtain the benefits they deserve.
Table of Contents
- Middletown Workers Compensation Attorneys You Can Trust
- Understanding the Workers’ Compensation Benefits in New York State
- Why Can Workers’ Compensation Reduce Or Deny Claims?
- How A Middletown Workers’ Compensation Lawyer Can Help
- How Much Does It Cost to Hire a Worker’s Disability Attorney?
Middletown Workers Compensation Attorneys You Can Trust
Workers’ compensation is technically a government program, but employers and insurers want to save costs, if necessary, at the expense of injured workers. If workers’ compensation denied your benefits, you’re experiencing abnormal delays, or you need help preparing your claim, the team at Finkelstein & Partners can help you.
Our workers’ compensation attorneys know the wide range of obstacles injured workers face while applying for benefits. We also understand the devastating toll that on-the-job injuries can take on workers and their families, especially when your application for workers’ compensation benefits doesn’t go as smoothly as expected.
Contact the New York Workers’ Comp attorneys at Finkelstein & Partners for a free evaluation of your case and expert guidance on how to strengthen your claim. A skilled workers’ compensation lawyer can provide support during every step of the process to help injured employees level the playing field and make sure their legal rights are protected.
Understanding the Workers’ Compensation Benefits in New York State
The most important thing to know about workers’ compensation benefits in New York State is that it’s a no-fault program where negligence is not a factor in whether injured employees receive coverage. That means recovering benefits won’t depend on proving that the employer created the conditions for an unsafe workplace.
It also doesn’t matter whether the employee did anything wrong unless their injuries were caused by extreme recklessness, like being intoxicated at work. An insurance policy paid by the employer provides workers’ compensation benefits to employees injured while working, regardless of the circumstances.
Types of Injuries Covered by Workers’ Compensation Benefits
All employees have some injury risk in their workplace, whether they’re construction workers, restaurant staff, delivery drivers, or office clerks.
Work-related injuries can include:
- Repetitive stress injuries, like carpal tunnel syndrome, tendinitis, or tennis elbow
- Lifting injuries that cause shoulder, knees, or back problems
- Burn injuries
- Injuries that cause hearing or vision loss
- Falling injuries, like concussions or traumatic brain damage
- Injuries from exposure to toxic substances, such as mesothelioma caused by asbestos
- Injuries from accidents with heavy machinery
- Overexertion injuries, like torn ligaments, torn rotator cuffs, or herniated discs
- Motor vehicle accidents
Eligibility Requirements for Workers’ Compensation Benefits
While virtually all workers enjoy these benefits, they must meet some approval criteria.
- The employee works for a company mandated to have workers’ compensation coverage.
- The employee suffered an injury or illness due to work-related tasks and obtained a medical report that states so.
- The employee gave their employer written notice of their injury within 30 days.
Benefits Provided by Workers’ Compensation
Workers’ compensation covers all the economic losses employees suffer when they get injured on the job.
The benefits available in New York State include:
- Medical costs: The employer’s insurance covers all medical expenses related to on-the-job injuries with no co-pays or other out-of-pocket expenses. This includes hospital bills, physical therapy, any adaptive medical devices the employee may need, and even reimbursement for the fuel and parking costs of going to medical appointments.
- Short or long-term disability benefits: Most injured employees need time off from work while they recover. Workers’ compensation benefits can cover up to 75 percent of their income during their recovery.
- Funeral expenses: Workers’ compensation benefits will help the employee’s family cover funeral and burial expenses when workplace injuries prove fatal. Their dependents or close relatives may also receive death benefits, which are a percentage of their deceased loved one’s income.
Why Can Workers’ Compensation Reduce Or Deny Claims?
Injured workers facing substantial medical expenses need prompt approval for workers’ compensation benefits. Unfortunately, valid claims get disputed, leaving employees with either no compensation or an amount that doesn’t adequately cover the full extent of their losses.
Ultimately, employers and insurers deny or reduce claims whenever possible. Employers want to keep their insurance premium costs down, which insurers base on the number of injured employees who receive benefits. For insurance companies, it’s all about saving money by looking for reasons to undermine claims and pay less in compensation.
Claims can get flagged for many reasons, mainly because workers do not provide enough substantiating evidence.
Some of the main justifications for getting a rejection can include:
- “You weren’t injured on the job”: These denials are more likely to happen if the insurer thinks there’s not enough of a connection between the worker’s job duties and their injuries or if a poorly documented incident caused them.
- “You’re exaggerating your injuries and you can still work”: Insurers can invalidate claims that don’t provide enough proof that the worker required medical treatment and suffered from the lasting effects of an injury. This reason is also more likely to be given to injuries that are harder to measure or verify, like lower back pain and carpal tunnel syndrome.
- “Your injuries were pre-existing and not related to your job”: Injured employees with pre-existing conditions can deal with stumbling blocks when trying to recover compensation for a workplace injury related to their original issue. However, like any other denial, a lawyer can overcome these obstacles by providing more and better substantiating evidence.
- “There are administrative mistakes with your claim”: Applying for workers’ compensation benefits includes multiple steps, filling out lots of paperwork, meeting deadlines, providing precise information, and going to appointments, such as the Independent Medical Examination that insurers often require. It’s common for any small mistakes made along the way to result in a denial, causing some discouraged workers with valid claims to give up and forfeit their rights to compensation.
While having your workers’ compensation claim receive an initial denial is very stressful, it’s not the end of the line. New York State workers can appeal rejected or reduced compensation claims. The appeals process can include trying to negotiate directly with the insurance company, but the Workers’ Compensation Board also provides an official appeals process.
Injured employees can request a hearing with an administrative law judge, a formal proceeding similar to a civil court trial. The judge will review the victim’s medical records and other types of evidence, like witness statements. If the judge refuses to deny the claim, workers can escalate their case to the Appellate Division and then to the New York Court of Appeals.
Appealing a denied claim involves complicated legal procedures that the average person might find intimidating. Having an experienced workers’ compensation lawyer handle your appeal can boost your chances of a favorable outcome.
How A Middletown Workers’ Compensation Lawyer Can Help
There’s a lot on the line when injured employees apply for the workers’ compensation benefits they’re entitled to receive under the law. Suppose the insurer disputes the merits of your claim, or you need help navigating the process. In that case, a skilled workers’ compensation attorney can prepare a stronger case and improve your odds of recovering fair compensation.
- Handle all paperwork and meet every deadline: Many workers’ compensation claims will get held up due to technical errors like not filling out forms correctly or not providing the right information. A lawyer can keep track of important details and avoid wasting precious time due to these basic mistakes.
- Gather the medical evidence needed for a strong claim: Insurers carefully scrutinize the medical records of injured employees when evaluating their claims. Insufficient medical evidence is the most likely reason for getting a rejection. A workers’ compensation attorney is familiar with the proof needed to accurately show the extent of the employee’s injuries and any limitations that can keep them from performing job duties. They can substantiate your case by arranging specific diagnostic tests or treatments, gathering compelling testimony from medical experts, and helping you prepare for an Independent Medical Examination, which a doctor chosen by the insurer performs.
- Negotiate a settlement with the insurance company: Workers’ compensation lawyers have the expertise to estimate how much the injured worker is entitled to receive as compensation for their medical expenses, lost wages, and other losses. If you’ve received an offer that doesn’t cover the full extent of your damages from getting injured, your attorney can sit down at the negotiation table with your insurer to reach an agreement that works in your favor.
- Represent you in an administrative hearing: If the insurer denies your claim and the appeal advances to a formal hearing with an administrative law judge, your workers’ compensation lawyer can represent your best interests throughout the proceedings. This includes opening and closing arguments, interviewing witnesses, and making any necessary objections. Along with making this process less intimidating, having an attorney at your hearing protects your legal rights.
How Much Does It Cost to Hire a Worker’s Disability Attorney?
Many injured workers want an attorney to improve the chances of getting their claim approved but worry it’s too expensive. In New York State, workers’ compensation attorneys cannot collect any payments upfront. The Workers’ Compensation Board must review and approve their legal fees, typically about 15 percent of what the injured employee recovers in a successful claim.
Judges will consider several different factors when approving the lawyer’s proposed legal fees, including the injured worker’s financial status, the complexity of the case, and the amount of time the attorney spent providing legal services for this client. These measures provide injured workers access to skilled legal representation without paying anything upfront.
Skilled Legal Services For Injured Workers In Middletown, NY
Accidents in the workplace are common and potentially very serious, with many injured employees dealing with crippling medical bills and a significant amount without working. The NY personal injury lawyers at Finkelstein & Partners understand the stress and uncertainty of applying for benefits, especially if you received an initial denial.
We have decades of experience guiding injured workers throughout Middletown through every step of their application. We’ve handled just about any scenario that can affect injured workers filing a claim for benefits, from pre-existing conditions to permanent disabilities that prevent the employee from ever returning to work. Contact us at (845) 344-4855 for your free evaluation and learn more about your best options for receiving the benefits you deserve.