what percentage does workers' comp pay in ny

3 min read 23-12-2024

what percentage does workers' comp pay in ny

Workers' compensation in New York aims to protect employees injured on the job. But what percentage of your wages will you actually receive? Understanding the intricacies of New York's workers' compensation benefits is crucial for injured workers. This guide clarifies the payment structure and factors influencing the percentage you receive.

Understanding New York's Workers' Compensation Benefits

New York's workers' compensation system provides medical benefits and wage replacement for employees injured at work, regardless of fault. The system is designed to ensure injured workers receive the care they need while preventing lawsuits against employers. This means your employer's insurance pays your benefits, not your own health insurance. The percentage you receive isn't a flat rate, however. It depends on several variables.

Lost Wage Benefits: The Percentage Breakdown

The amount of your weekly wage replacement, often called lost wage benefits, depends on your average weekly wage (AWW) before the injury. New York calculates your AWW based on your earnings over a specific period.

Two-Thirds of Your Average Weekly Wage: Generally, workers' compensation in NY will pay two-thirds (66.67%) of your average weekly wage. This is the standard percentage for lost wage benefits. This amount is subject to maximum and minimum weekly benefit limits set by the state.

Example: If your average weekly wage was $1,000, your weekly workers' compensation benefit would be approximately $666.67.

Maximum and Minimum Weekly Benefit Amounts

New York sets maximum and minimum weekly benefit amounts. These limits change periodically, so it's crucial to consult the most up-to-date information from the New York State Workers' Compensation Board (WCB) or a qualified legal professional. These limits affect the actual dollar amount you receive, even if 66.67% of your AWW would exceed the maximum.

Factors Affecting Your Benefit Percentage

Several factors can influence the percentage of your wages you receive:

Pre-existing Conditions: If you had a pre-existing condition that contributed to your injury, the WCB may adjust your benefits. They might apportion the benefits based on the extent to which the pre-existing condition impacted your current injury.
Contributory Negligence: If your actions significantly contributed to your injury, your benefits could be reduced or denied. This is less common, but it’s important to be aware of the possibility.
Your Employer's Insurance Coverage: While highly unlikely in New York, extremely rare circumstances could involve insufficient insurance coverage. However, this is generally not a concern.

Medical Benefits: Coverage Beyond Lost Wages

Beyond lost wage benefits, New York workers' compensation covers reasonable and necessary medical expenses related to your work injury. This includes doctor visits, surgeries, physical therapy, medications, and other related treatments. There's typically no percentage limit on the medical benefits you're entitled to receive, provided they're deemed necessary by your physician and approved by the workers’ compensation insurance carrier.

Navigating the Workers' Compensation System in NY

Navigating the New York workers' compensation system can be complex. The process involves filing a claim, undergoing medical evaluations, and potentially attending hearings. It is highly recommended to seek legal counsel from a workers’ compensation attorney. They can help you understand your rights, ensure you receive the benefits you are entitled to, and represent you in any disputes with the insurance company.

What to Do if Your Claim is Denied or Disputed

If your claim is denied or your benefits are less than you believe you're entitled to, you can appeal the decision. An experienced lawyer can guide you through the appeals process, which can often involve hearings and legal arguments.

Conclusion

While New York workers' compensation generally pays two-thirds of your average weekly wage, the actual percentage you receive can vary based on several factors. It's crucial to understand your rights, diligently gather necessary documentation, and, if needed, seek legal assistance to navigate this system and ensure you receive the full compensation you deserve. Remember, the information provided here is for informational purposes only and should not be considered legal advice. Consult with a qualified professional for personalized guidance based on your specific situation.