Getting hurt on the job is more than just painful; it can throw your entire life off balance. Suddenly, you’re facing medical bills, missed paychecks, and uncertainty about when, or even if, you’ll start receiving workers’ compensation benefits. The good news? New York’s workers’ compensation system is designed to cover medical costs and replace a portion of lost wages while you recover. The catch? There’s a process, and payments don’t always start right away.
Here is everything you need to know about when lost wage payments kick in, how much you can expect, and what to do to keep the process moving smoothly.
How does New York’s waiting period affect my lost wages?
In New York, workers’ compensation includes a mandatory 7-day waiting period before lost wage benefits begin. This means you won’t receive wage replacement for the first seven days you miss work unless your disability extends beyond 14 days. The rationale behind this waiting period is to prevent short-term absences from triggering compensation claims. This way, benefits get reserved for more serious injuries.
If you’re unable to return for more than 14 consecutive days, you may receive retroactive benefits covering the first week. For severe injuries that lead to hospitalization or long-term disability, you might qualify for expedited processing or exceptions. However, most cases follow the standard waiting period unless specific medical evidence supports an exemption. Proper documentation and timely claim submission can help avoid unnecessary delays.
How are lost wages calculated?
Workers’ compensation in New York calculates lost wage benefits based on your average weekly wage (AWW) over the previous 52 weeks before the injury. The formula considers gross earnings, including overtime and bonuses, to determine fair compensation. If you have not been employed for a full year, an adjusted calculation based on available earnings applies.
New York pays two-thirds (66.67%) of a worker’s AWW, subject to state-mandated limits. As of recent updates, the maximum weekly benefit adjusts annually based on statewide average wages, while a minimum benefit ensures injured workers receive at least a baseline amount. These limits prevent excessive claims while maintaining financial support.
When exactly will lost wage payments begin?
Injured workers in New York should receive their first workers’ compensation lost wage payment within 18 days after their disability begins, provided their claim is properly filed and approved. The 7-day waiting period applies first, meaning benefits don’t start until the eighth day of missed work. If the worker remains out for more than 14 consecutive days, they receive retroactive payment for that first week.
For example, if you suffer a back injury on March 1st and can’t work, your waiting period runs from March 2nd to March 8th. If you’re still unable to work by March 9th, your first payment should arrive by March 26th, following the 18-day rule, assuming no delays in claim processing. If you miss more than 14 days, you receive back pay for the waiting period.
Once payments start, you typically receive benefits every two weeks, though some insurance providers issue them weekly. Payments are usually issued by check, though some insurers offer direct deposit. Regular payments continue as long as you remain eligible and submit the required medical documentation.
What are retroactive workers’ compensation benefits in New York?
If your work-related injury prevents you from working for more than 14 consecutive days, you become eligible for retroactive workers’ compensation benefits covering the initial seven days of lost wages. This ensures you don’t lose pay for that first week if your recovery extends beyond two weeks.
To receive these retroactive benefits, you must file a Form C-3 (Employee Claim) with the New York State Workers’ Compensation Board. Additionally, your healthcare provider needs to submit medical reports confirming that your injury prevents you from working for at least 15 days. It’s also crucial to ensure your employer accurately reports your injury and the days you’ve missed work.
Once your claim is approved, the retroactive benefits are typically included in your subsequent workers’ compensation payments.
What if my lost wage payments get delayed or denied?
Several factors can delay or disrupt payments. Missing paperwork often slows down claims, especially if the worker fails to provide a C-3 claim form or the doctor doesn’t submit a timely medical report.
Employer delays also cause problems, particularly if your employer disputes the claim or fails to report the injury. Insurance carriers may deny or stall payments due to disputes over your injury’s severity or your job status.
To avoid delays, you should file your claim as quickly as possible, follow up on documentation, and maintain communication with your employer and doctor. Double-check your claim before submitting it to avoid unnecessary setbacks.
Your employer also plays a role. They must report your injury promptly and verify details for the insurance company involved. If they delay or dispute your claim, it can slow down payments. Additionally, your doctor’s reports must confirm your disability or the insurance company may challenge your claim.
When should I hire a New York workers’ compensation lawyer?
The workers’ compensation claims process in New York is complicated. If you were injured on the job, the best time to contact a workers’ compensation lawyer is right away, before mistakes, delays, or denials put your benefits at risk. One missed deadline or incorrect form can jeopardize your claim.
Insurance companies look for ways to deny or reduce benefits, and without legal representation, you may struggle to get the compensation you need. That’s where the New York workers’ compensation lawyers at Pasternack Tilker Ziegler Walsh Stanton & Romano LLP come in. For over 90 years, we’ve fought for injured workers in New York.
We can help you file your claim correctly, challenge employer or insurance disputes, and get the best possible outcome for your case. You focus on your recovery and adhering to medical and legal advice.
To get started on your claim, contact us online or call one of our New York law offices today for a free case evaluation. We serve clients in NYC and throughout New York State.
“Great legal team. Clients are kept informed of every step. … Highly recommend.” – P.C., ⭐⭐⭐⭐⭐
Prior results do not guarantee outcomes.
Attorney Advertising.