FAQs

1. What must I do if I am injured at work or believe my work activities have caused a condition affecting my health?

2. What must my doctor do?

3. What must I pay for treatment?

4. What about my weekly pay?

5. Why did the insurance company cut my weekly benefits?

6. When should I return to work?

7. What happens if I return to work?

8. What if I still need treatment after I return to work?

9. What if I need a specialist or surgery?

10. Who attends hearings at the Workers' Compensation Board?

11. Do I need a lawyer?

12. Does my lawyer attend hearings with me?

13. Am I eligible for Social Security Disability benefits?

14. What is the definition of "disabled" ?

15. Are my family members entitled to any benefits?

16. How much will I get?

17. How much work experience do I need before I am eligible to receive Social Security Disability benefits?

18. How long can I get Social Security benefits?

19. When should I file for Social Security benefits?

20. How can I apply for Social Security benefits?

21. Can I get Medicare too?

22. Will I lose my benefits if I find work?

23. Who decides whether I am disabled?

24. I applied but was denied. What should I do?

25. Can I apply or appear for a hearing without an attorney?

26. Can I receive Social Security Disability and Workers' Compensation benefits at the same time?

1. What must I do if I am injured at work or believe my work activities have caused a condition affecting my health?

As soon as an incident occurs or you believe your work activities have caused some condition affecting your health you must notify your employer, preferably in writing. The law requests that you give your employer notice within 30 days of your accident.

You also have two years from the date of the accident to file a claim with the NYS Wokers' Compensation Board.

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2. What must my doctor do?

Under the NYS Workers' Compensation Law, the doctor is required to submit reports to the NYS Workers' Compensation Board, and your employer's workers' compensation insurance company. It is essential that the doctor's report reflect the history of the work activities you describe as well as contain a statement that the injury was the result of an accident at work or your work activities.

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3. What must I pay for treatment?

You pay nothing for your treatment under the NYS Worker's Compensation Law. In fact, the workers' compensation insurance company must reimburse you for your transportation costs to and from treatment.

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4. What about my weekly pay?

The law provides that you may receive up to 2/3 of your weekly salary, capped at the maximum depending on the date of accident or date of disablement. It ranges from $400 to $739.83.

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5. Why did the insurance company cut my weekly benefits?

If you were examined by a doctor selected by the insurance company, it may be that his report indicates you have a partial disability or none.

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6. When should I return to work?

Your return to work and your ability to perform your duties at work is a decision to be made between you and your doctor.

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7. What happens if I return to work?

If you return to work earning equal to your previous salary, you are not entitled to further compensation benefits.

If you return to work earning less, you may be entitled to reduced earnings of compensation. In either case, notify the insurance carrier and your attorney. CRIMINAL PROSECUTION CAN RESULT FROM RECEIVING COMPENSATION WHILE WORKING.

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8. What if I still need treatment after I return to work?

The Workers' Compensation Law Judge can authorize continuing treatment even after you have returned to work.


9. What if I need a specialist or surgery?

Your treatment physician can request specialist consultations, diagnostic tests, and/or surgery in his reports for the Workers' Compensation Law Judge to consider.

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10. Who attends hearings at the Workers' Compensation Board?

You should attend all hearings scheduled on your claim. The Workers' Compensation Law Judge and a hearing reporter are provided by the Workers' Compensation Board because the hearing is a judicial proceeding.

The insurance company will be represented by a licensed professional or an attorney.

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11. Do I need a lawyer?

You should, at least, consult an attorney experienced in Workers' Compensation. There is no charge or fee for such a consultation.


12. Does my lawyer attend hearings with me?

Yes, if you retain a lawyer to represent you. The lawyer can assist you with completing claims forms for Workers' Compensation benefits. The lawyer can also negotiate with the insurance company to assist your doctor in obtaining authorization for treatment.

There may be many hearings over the course of your claim involving both medical and legal issues including the taking of testimony from doctors.

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13. Am I eligible for Social Security Disability benefits?

If you have worked long enough at a job and have become disabled, you maybe be eligible to receive Social Security Disability benefits.

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14. What is the definition of "disabled" ?

Disability is based on your inability to do any kind of work. The physical or mental condition which provides you from being able to work must either be expected to last for more than a year or result in your death.

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15. Are my family members entitled to any benefits?

Most dependent children under eighteen are entitled to benefits.


16. How much will I get?

The amount of monthly benefits you get depends upon how much you were earning when you were able to work.

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17. How much work experience do I need before I am eligible to receive Social Security Disability benefits?

Generally, before you can receive Social Security Disability benefits, you must show that you worked a total of ten years and that you worked five years out of the last ten before applying. Younger workers applying for Social Security Disability benefits need fewer years.

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18. How long can I get Social Security benefits?

As long as you remain disabled, you are eligible to receive benefits until you return to work or reach retirement age.

19. When should I file for Social Security benefits?

Since the application process can take more than a year, the sooner you start the better. In most cases, monthly benefits will start in the sixth full month of your disability. By filling early, all paperwork may be processed before your first benefits are due.

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20. How can I apply for Social Security benefits?

The application process can be initiated by calling Social Security toll-free at 1-800-772-1213. You can also obtain information and application documents from your local neighborhood Social Security office.

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21. Can I get Medicare too?

Automatically, two years after you are eligible for Social Security Disability benefits, you will be enrolled in Medicare.

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22. Will I lose my benefits if I find work?

People receiving Social Security Disability benefits may attempt to trial work period of up to 9 months during which they can earn income without limit. Eligibility may be extended three years, during which you may receive benefits in any month your income falls below $740. Medicare coverage may be extended for three years beyond the trial work period; and disability-related work expenses are deducted when computing your income.


23. Who decides whether I am disabled?

In order to get Social Security benefits, you must have a physical and/or emotional disability severe enough to prevent you from working, which is supported by acceptable medical findings. Initially, at the application phase, the determination is made by a responsible state agency.

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24. I applied but was denied. What should I do?

The most important thing to do is to meet the deadline for the next step so that your case is not closed. You have a right to request a hearing before an Administration Law Judge. This request may be filled within 60 days of the date of the denial letter.

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25. Can I apply or appear for a hearing without an attorney?

Yes. But statistics show that claimants without legal representation are far less likely to get benefits than claimants applying with professional help.

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26. Can I receive Social Security Disability and Workers' Compensation benefits at the same time?

Yes. However, Social Security Disability benefits may be reduced in part by the amount of Workers' Compensation benefits. An experienced attorney can assist you in estimating and calculating maximum benefit payments to avoid a Social Security offset reduction.

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