WORKERS’ COMPENSATION

Workers’ Compensation (Comp) is no-fault insurance for employees with job-caused injuries or illnesses. It pays for all medical expenses, up to two-thirds of loss wages, and retraining, if necessary. It does not, however, pay for pain and suffering.

Persons who are injured on, or become ill because of, a job should immediately notify their employer. They should also immediately see a doctor letting him/her know their injury or illness is job-related. They should also file their report with the employer’s compensation insurer (carrier) and the Workers’ Compensation Board (Board), which has an office in Saranac Lake with forms.

If the employer does not “contest” the claim, benefits should start immediately. If it does, then a hearing will be held before a referee. The employee must then prove s/he had an Accident about which the employer got immediate Notice and the employee’s injury or illness is Causally Related to his/her employment (ANCR). If the referee finds ANCR, the claim is “established”, but subject to the carrier’s appeal to the Board in Albany and vice versa.

The carrier can also demand that its own doctor examine the employee. If the injury is to an eye or limb, there is a limit to the number of weeks that the employee will receive lost wages according to a statutory schedule. If the injury is not on the schedule (e.g. back), the employee will receive a percentage of his or her lost wages based on “degree of disability”.

“Total” (100%) disability results in the employee receiving two-thirds of his or her average weekly wage (AWW); “Marked “ (75%) - 50%; “moderate” (50%) - 33% and “mild” (25%) - 17%. The maximum weekly benefit is currently $400.00. If an employee with a non-schedule injury is partially employed, s/he will received two-thirds the difference between his/her current gross weekly wage and his/her pre-injury AWW.

As you can see, Comp is a tricky area with its own jargon. You should consult an experienced compensation lawyer or licensed practitioner if the Comp carrier contests your claim. However, his or her fee will be deducted from your award.

This article is my incomplete opinion only. While I have handled Comp cases, I am a general practitioner who does not specialize in Workers’ Comp. You should consult an experienced compensation attorney or licensed practitioner.

DO NOT RELY ON THIS ARTICLE. SEE AN ATTORNEY.

E-mail Paul Herrmann: pauljosephherrmann@yahoo.com