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Workers Compensation Benefits

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When an employee is injured on the job, or suffers an occupational disease, he or she may be eligible for compensation benefits. These benefits include payment of all medical expenses and reimbursement for a portion of wages lost due to disability caused by the injury. Additionally, if the worker suffers a permanent impairment of a body member, such as a leg or hand, a payment may be made for this loss even though the worker has not lost time or has returned to work. Awards are also made for loss of vision and loss of hearing. No payment is made for pain and suffering, mental anguish or other such elements of an injury. However, if a third party (other than the employer or a co-worker) is responsible for causing the injury, the injured worker may sue such other party for the full measure of damages, including pain and suffering. This is discussed more fully below.

The injured employee must report the accident to the employer within 30 days, and a claim for compensation must be filed with the NYS Workers' Compensation Board within two years. Medical doctors and other medical providers cannot charge the injured worker, but must submit the bills and reports to the employer or the employer's workers compensation insurance carrier. Employers are required to post the name and address of the workers compensation carrier in the workplace. After an accident, the employer must report the accident to the compensation insurance carrier. The attending physician must submit the medical bills and reports to the carrier. When the carrier gets the paperwork from the employer and doctor to show that the employee is out of work and disabled due to the job accident, the carrier must make payment to the disabled employee within 10 days.

There is no payment for the first five days of lost time, unless the lost time exceeds ten days, in which case payment is due from the beginning. Payment is based on the worker's average weekly wage in the 52 week period immediately preceding the accident. The rate of compensation depends on the degree of disability. For total disability, the rate is two-thirds of the average weekly wage. The rate for partial disability is reduced proportionately. For example, a fifty percent disability would be one-half of the two-thirds rate. The maximum disability payment is $400 per week, whether total or partial. Workers with high average wages may be paid the maximum $400 rate even though they are partially disabled. If a worker is permanently disabled, payments may be made for life.

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