NY Workers’ Comp – The Injured WorkerOn September 30, 2019 by Raul Dinwiddie
Although work injuries are common, we don’t need to overthink a pulled muscle, scrape or bruise. It would be silly to report every bump and ache immediately, every time. But, if the injury is severe enough that you can’t do your job safely, or if the discomfort or dysfunction lasts for more than a week, you should let your employer know. In New York, you have 30 days to tell your employer that you were injured. Your employer has to report the injury to the New York Workers’ Compensation Board and the insurance carrier within 10 days. The carrier has two weeks to give you a written list of your rights under the law. You, the injured worker, must be seen by a physician at least every six weeks. The New York Workers’ Compensation Board has written medical treatment guidelines that you, the carrier and your physician must follow depending on the part of the body that’s injured. For example, there are treatment guidelines for neck injuries, shoulder injuries and mid and low back injuries. These guidelines contain lists of medications, MRI and other diagnostic studies, physical therapy, chiropractic and other treatments that are pre-approved. In other words, the insurance carrier is obligated to provide them, no questions asked, no pre-authorization needed so long as they are needed for your work injury. But New York Workers’ Compensation insurance is like liability insurance for your car, not comprehensive insurance. Your doctor is allowed to order tests and provide appropriate treatment, but he or she is obligated to write work restrictions unless your symptoms are so severe that you can’t do anything, like being paralyzed. Your employer has only paid for liability insurance, and the carrier is only responsible for the percentage of disability related to your work injury. Your employer has an opportunity to provide light duty if they can, and you have an obligation to go back to work if your doctor agrees with the restricted duty that’s available. But if your employer can’t afford to offer restricted duty, they usually have an obligation to provide unemployment benefits to make up the difference between what your insurance carrier is responsible for and what you are losing by not being able to work. Your employer might mistakenly think it’s okay to ask your doctor to take you completely out of work and say you’re totally or 100% disabled. But doing that would be unfair to the carrier. So unless you can’t move, we have to provide restrictions and an estimated percentage of disability. Getting injured at work is not fun, but everyone involved – you, your doctor, your employer and the carrier wants you to get better as soon as possible. No one is intentionally trying to make it hard for you, so it’s important to stay focused and optimistic.