Tag Archives: Benefits

What To Do When You Get Hurt At Work

As an attorney who has practiced in the field of Workers’ Compensation for more than 28 years, I have seen many changes in how the system treats injured workers.  During this age of progressiveness in New York, when the minimum wage has increased and the requirement for paid sick leave has been implemented, it only stands to reason that injured workers would be treated with dignity during their quest to obtain monetary benefits for their lost time and obtain the medical treatment necessary during their recovery. 

Unfortunately, however, there has been a nationwide focus on Workers’ Compensation reform with the emphasis on cost savings, often at the expense of the injured worker.  New York State has followed along in this national trend; therefore, it is even more imperative to know what to do in the event of a work-related injury or illness.  Injured workers must notify their employer immediately – preferably in writing if possible – within 30 days and file their claim with the New York State Workers’ Compensation Board within two years of the date of an accident or onset of an illness.     

Additionally, finding the right doctor is one of the most important decisions you can make during this particularly rough time. After you are injured, you obviously must seek immediate medical attention before you do anything else. Don’t wait or assume your injury is going to heal, because if you are unable to work, benefits will not be payable until the date of the first medical treatment. You might need to go to the hospital if your injury is an emergency or life threatening, but in most cases you should be able to visit your physician. Either way, be sure you notify the medical professional that you are being treated for a work-related injury as any treatment should be billed through Workers’ Compensation.  It is important that your treating physician be coded to practice before the New York State Workers’ Compensation Board because of the medical evidence necessary to proceed with a claim, the myriad of forms they are required to file, and the possibility of their testimony in the future.  

The New York State Workers’ Compensation Board has implemented medical treatment guidelines for injuries to the back, neck, shoulder, knees, and bilateral carpal tunnel syndrome. Medical providers must comply with these guidelines in their treatment of injured workers, which have a number of treatments or tests that are preauthorized based upon certain findings. If the modality of treatment is not included in the guidelines, a variance may be requested. There are different forms for different requests and different timelines in which to file. A doctor not coded in Workers’ Compensation or inexperienced in this procedure could prevent you from receiving proper or timely treatment. 

Payments made for lost time are based upon the earnings of the injured worker, as well as the overall degree of disability. The degree of disability is based upon the medical evidence submitted by the injured worker’s treating doctor, as well as the opinion of the insurance company’s consultant. Many times these opinions are at odds and medical testimony is necessary so the law judge can make an informed decision. Doctors who are coded understand the procedure and the necessity of being available to testify on your behalf at these medical depositions. The insurance carrier will question the doctor on whether he or she is coded, which may impact the judge’s perception as to a doctor’s credibility regarding treatment guidelines, degree of disability, or earning capacity. Ultimately, the length of time and the amount of weekly benefits an injured worker is entitled to receive benefits once permanency is determined by a law judge is based on a finding of loss of earning capacity. In many cases, there can be a difference in years. 

Nothing is better than finding a doctor who is competent, empathetic, and an expert in his area of specialty, but finding one with all of these qualities who is also knowledgeable in Workers’ Compensation is invaluable. 

 

Catherine M. Stanton is a senior partner in the law firm of Pasternack Tilker Ziegler Walsh Stanton & Romano, LLP. She focuses on the area of Workers’ Compensation, having helped thousands of injured workers navigate a highly complex system and obtain all the benefits to which they were entitled. Ms. Stanton has been honored as a New York Super Lawyer, is the past president of the New York Workers’ Compensation Bar Association, the immediate past president of the Workers’ Injury Law and Advocacy Group, and is an officer in several organizations dedicated to injured workers and their families. She can be reached at 800.692.3717.

 

  

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Benefits Alert – Workers’ Compensation Rates Increased on July 1, 2018

Senior Partner Jordan A. Ziegler

Last year’s solar eclipse brought about fun and excitement for Americans of all ages, but did you know it also brought about several Workers’ Compensation claims?

The rare total solar eclipse was the first time it occurred in the United States since 1979. The August 21 eclipse was the most watched and photographed eclipse in history. With all the excitement surrounding the day, many employers planned solar eclipse office viewing parties. What they might not have known, however, was that in the case of a mandatory employer-sponsored event, safety precautions must be taken. In this case, employers were responsible for providing safety glasses. Employees who were injured while eclipse-viewing on the job were able to file Workers’ Compensation claims if their boss did not provide adequate eye protection.

In fact, an article about workplace safety concerns related to the eclipse was the third most read Workers’ Compensation story on Business Insurance’s website in 2017. This substantiates the proof that Workers’ Comp is a complicated matter and one that workers should not play guessing games with.

Jordan Ziegler, Esq. Senior Partner in the law firm Pasternack Tilker Ziegler Walsh Stanton & Romano LLP, said the New York State Workers’ Compensation system is a no-fault system that was created to aid injured workers with wage replacement and medical benefits. However, navigating through the Workers’ Comp maze requires much more than chasing a dangling carrot. You need to know and understand the rules in order to follow the rules. And that’s no easy task.

The effects of even a small injury can last a lifetime, so make the most of each step toward healing and the compensation to which you are entitled. Effective July 1, 2018, the new maximum weekly benefit for Workers’ Compensation claims increased to $904.74 from the previous year’s $870.61.

If you are injured on the job, or think you might have a work-related injury, here are some important steps to follow:

  • Let your employer know the circumstances that resulted in your injury. You only have 30 days to report the incident. Next, inform the Workers’ Compensation Board (WCB) so everyone is on the same page. It may be difficult to contact them but don’t worry, you’ve got two years to let them know.
  • Even if you don’t lose time from work, you should still file a claim. Someone has to pay the medical bills and it’s typically the WCB’s insurance company’s responsibility.
  • Remember to document any phone records and emails that follow. Written communication is the best way to later prove your side of the story. In fact, the law requires you to give written notice of your injury to your employer. Make sure you note the supervisors and staff you communicate with and the date your notification took place. Make copies of everything! And save all emails.
  • When seeking medical attention, either in the nearest emergency room or a doctor’s office, ask for detailed records of your injury and prescribed treatment.

Ziegler said the path to benefits is highly detailed. You may not even realize that beside medical benefits, you might also qualify for indemnity benefits — money you receive each week that you’re unable to work. With a permanent injury, you might be eligible for such benefits even if you return to your job.

Just as employers have attorneys to represent the interests of their companies, YOU must gather the right team to navigate the detailed — and often confusing — laws of Workers’ Compensation.

“Workers’ Comp goes a long way toward helping ease the financial burden that comes with not being able to fully return to work,” Ziegler said. “There are so many complicated ins and outs of filing, however, that all too often injured workers will give up rather than fight for what they are entitled do. That’s where we are able to step in and help but we can’t do that if we don’t know about the injury.”

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Veterans Can Be Eligible For Full Or Partial Disability Benefits

(U.S. Air Force photo/Staff Sgt. Desiree N. Palacios)

Veteran’s disability is a monetary benefit that is paid to veterans who have disabilities incurred or aggravated during active service in the military. Benefits may also be awarded for post-service disabilities if the disability is deemed related or secondary to disabilities occurring during active service.

This tax-free benefit is paid monthly if the veteran is deemed to be at least 10% disabled. The amount of compensation is determined by the degree of disability from 10% to 100%.

Other eligibility requirements include the status of your discharge, duration of service, as well as the degree of your disability.

If you believe that yourself or a loved one should be entitled to Veterans Compensation Benefits, or if you believe you are more disabled than Veterans Affairs has previously determined, contact Pasternack, Tilker Ziegler, Walsh, Stanton & Romano, LLP for a free consultation.

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Don’t Go It Alone

An injured worker walked through my door the other day frustrated beyond belief. He had been representing himself on his compensation claim for his back injury. He thought he did not need a lawyer and could handle it himself.

The insurance company accepted the claim and paid this worker only a fraction of what he was actually entitled to, though that was not the issue the client wanted to discuss. He did not even realize that he had been short changed.

What he wanted to discuss was getting back surgery. His doctor requested a laminectomy, but the insurance company told the doctor and the injured worker that they were not going to authorize it or pay for it. This man had been suffering terrible back pain for nearly six months and his surgery was never scheduled.

The injured worker was shocked when I told him that the insurance company did not have to give authorization — this surgery was already authorized under the Board’s Medical Treatment Guidelines. The insurance company knew this of course, but seemingly played ignorant to avoid paying for the needed surgery.

When I then told him that he could not only have his surgery, but also had been paid less than half of the indemnity payments to which he was entitled, the gentleman shook his head in frustration and said, “I shouldn’t have done this alone.”

How right he was. The New York Workers Compensation system is extremely complicated. Insurance companies know the system well and often do not tell unrepresented injured workers details that matter, often while telling the injured worker that they are acting in their best interest.

Do not go it alone.  At Pasternack, Tilker, Ziegler, Walsh, Stanton, and Romano, with more than eight decades of experience in defending the rights of New Yorkers, we help clients get the justice they deserve.

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Injured Volunteer Firefighters And Ambulance Workers May Be Eligible For Benefits

New York workers are generally covered by the Workers’ Compensation Law, but there are special laws which cover volunteer first responders – firefighters and ambulance workers.

Closely aligned with the Workers’ Compensation Law are the Volunteer Firefighter Benefits Law (VFBL) and the Volunteer Ambulance Workers Benefit Law (VAWBL). As their titles suggest, these two laws protect people who volunteer in the potentially hazardous duties of fighting fires, responding to motor vehicle accidents and tending to those injured in a variety of circumstances. While not all firefighters and ambulance workers are unpaid, many areas outside the five boroughs of New York City and other smaller cities maintain volunteer forces to provide these indispensable services. Given the inherent danger involved, volunteers often suffer injury when “on duty”.

In the event of an injury, both laws provide wage replacement benefits and medical coverage. Also, there is a “built in” presumption of an earning capacity for volunteers; therefore, even if a volunteer is not otherwise employed, she or he may be entitled to benefits. In addition to physical injury, the laws cover such events as exposure to noxious fumes, smoke or chemicals and post-traumatic stress disorder.

The list of what entails an “injury in the line of firematic or ambulance worker duty” is extensive. These events include maintaining vehicles and participation in certain department-sanctioned events. We take pride in representing those who volunteer their efforts in the service of others, especially when those efforts can be fraught with danger.

In order to best insure that your rights are protected, be sure to contact our office for a no-cost consultation. And thank you for volunteering!

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Outrage Over Proposed Benefit Cuts Dominates Public Comment Period – How To Keep Pressure On Lawmakers

As you may recall, the issue of Workers’ Compensation benefits for injured workers was used as a bargaining chip in Albany during this year’s budget negotiations. A compromise was reached that would update the current medical treatment guidelines to reduce costs to employers while still protecting the rights of injured workers. October 23, 2017, was the final day interested parties could comment regarding the proposed changes. 

In order to reach this goal, the New York State Workers’ Compensation Board was directed to put together a task force with input from labor, the insurance industry, medical providers, and the Business Council to revise the impairment guidelines to reflect “advances in modern medicine that enhance healing and result in better outcomes.” On the Friday of a holiday weekend, in order to diminish media coverage of the results, the final draft was released. This was not a revision, but rather a full-scale re-write of the guidelines. Labor groups, injured workers’ advocates, and member s of the State Legislature were justifiably outraged.

One of the provisions would allow insurance company doctors to question injured workers without their lawyer present, which could negatively impact future legal proceedings. If an injured worker refused to answer a question, the insurance company doctor could deem the injured worker as “uncooperative,” which could result in a suspension of benefits. Even worse, the end results of these proposed guidelines would slash benefits in some cases up to 97%, and for others, there would be none. 

As a result of the controversy, the New York State Assembly Labor Committee held a public hearing at which representatives of the New York State Workers’ Compensation Board testified first about the procedure used to formulate their revisions. They testified that they had a number of meetings with the Orthopedic Society, as well as discussions with the AFL-CIO and the insurance industry.  A number of additional witnesses testified, including members of the task force, and it became abundantly clear that the New York State Workers’ Compensation Board started their own re-write to these guidelines more than two years prior to any direction to do so. It was also clear that the end result had little resemblance to the recommendations made by the AFL-CIO or the Orthopedic Society.

It is now more than 45 days since the proposed re-write was put out for public comment, and the list of those who are opposed is tremendous. On October 18, worker advocates showed up at a number of Workers’ Compensation Board locations across the state for Days of Action including at Hauppauge, Brooklyn, and Buffalo. More than 100,000 postcards objecting to the proposed changes were delivered.  Members of the Retail Wholesale and Department Store Union, the AFL-CIO, NYCOSH, New York City District Council of Carpenters, DC37, and countless more have all publicly railed against these changes.  Members of the Legislature have called out the Workers’ Compensation Board for overstepping their authority and for proposing changes that would vastly favor the Business Council over the injured worker. 

While the comment period is finished, you can still voice your outrage by contacting your State Senator and Assembly member and telling them that injured workers don’t deserve to lose any more benefits.  Sometimes after an injury, Workers’ Compensation is what prevents a worker from losing everything.

 

Catherine M. Stanton is a senior partner in the law firm of Pasternack Tilker Ziegler Walsh Stanton & Romano, LLP. She focuses on the area of Workers’ Compensation, having helped thousands of injured workers navigate a highly complex system and obtain all the benefits to which they were entitled. Ms. Stanton has been honored as a New York Super Lawyer, is the past president of the New York Workers’ Compensation Bar Association, the immediate past president of the Workers’ Injury Law and Advocacy Group, and is an officer in several organizations dedicated to injured workers and their families. She can be reached at 800.692.3717.

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New York State Workers’ Compensation Board Proposes Broad Anti-Worker Changes

There is a phrase in politics known as Friday News Dump or Take out the Trash Day. In other words, the act of releasing certain news items at the end of the work week in an attempt to avoid media scrutiny. In the case of the New York State Workers’ Compensation Board, the public servants that they are, the News Dump occurred at 11:00 pm on the Friday of Labor Day Weekend. As you may recall in April as part of the horse trade known as the New York State Budget, injured workers’ benefits were used as  bargaining chips. The Business Counsel had argued that schedule loss of use awards which are given to workers’ for permanent injuries to the extremities were suddenly unfair to the employer. The original guidelines they argue were outdated and did not take into consideration new advances in medicine. One of the Budget provisions directed the Board to “consult” with a group stacked with pro-business and insurance interests to re evaluate the current guidelines. Well at 11:00 before the holiday weekend they issued their proposed changes and like the impact of Hurricane Harvey and Irma, no one could have foreseen the complete and utter destruction these proposals would have on injured workers benefits. Rather than addressing how advances in modern medicine enhances healing or create better outcomes, the Board totally disregarded the legislation’s directive and instead simply rewrote the entirety of the guidelines to create a new evaluation process which would destroy previously awarded benefits for permanent injuries.

These changes are arbitrary and capricious and an abuse of discretion. The legislature had previously established a fixed period of compensation based upon a specific injury but the board has taken it upon themselves to reduce or eliminate many of the benefits previously awarded for an injury. Additionally the Board has proposed provisions which are punitive in nature against the injured worker, bordering on being downright insulting, which only provide more opportunities for insurance companies to deny benefits.

One of the amendments submitted allows the insurance carrier to go on a fishing expedition to obtain information that is privileged, irrelevant or against the injured workers’ interest and penalizes them for failing to comply. These “questionnaires” if not completed to the satisfaction of the insurance carrier can be negatively inferred against the injured worker. The carrier can deny benefits simply by stating that the injured worker was uncooperative. This new amendment seems to be in direct violation of HIPPA privacy laws. 

There are many who will be affected. Anyone who has been injured or knows someone who has been injured on the job should be appalled that their family and friends, when they are at their most vulnerable, would be attacked by the same State Agency that was established to protect them. Shocking as it is, these guidelines are being proposed by the Workers’ Compensation Board. The name itself implies it is for the benefit and protection of the Worker. Perhaps the name should be changed to the Business Council and Insurance Defense Agency as it appears their agenda has changed. Unions, particularly those that have workers who engage in any type of physical or hazardous activity should be outraged that their members will again be attacked financially when they are injured. The New York Daily News recently spoke to Mario Cilento, the President of the NY AFL-CIO, who commented that “the plan is an insult to all working men and women. Benefit cuts for injured workers are wholly unjustifiable.” 

Legislators, in particular should be infuriated knowing that a governmental agency has usurped their authority in an attempt to dismantle a system that has been statutorily in place for over 100 years.     

When will these attacks end if ever?  Who is the driving force behind these attacks? One of the unfortunate consequences of a typical day is that some people go to work healthy one day and leave as a casualty of a work place injury the next. Some of us will be permanently injured or even killed. Regulating away benefits will not prevent injuries but will only result in someone else paying for benefits -usually tax payers.  The slashing and burning must end.  All of us must take a stand to protect those of our society who did nothing wrong except be one of the unfortunate victims of a workplace injury. How ironic that this bomb was dropped upon the working men and women of New York State on a holiday weekend dedicated to honoring the working people of this country.  

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The Road Ahead: Adjusting To Life After An Injury

As an attorney who has represented injured workers for more than 27 years, I see first hand what an injury can do to workers and their families. A number of years ago I represented an injured electrician, who as a result of an overextension injury sustained on the job, ended up having multiple surgeries. Almost immediately, this once athletic, high wage earner with a beautiful family and comfortable lifestyle saw an abrupt end to the life he knew.

My client faced a debilitating injury. He was no longer able to travel, his personal relationships suffered, and his once strong physique withered away. His financial situation was dire and he was unable to afford his home. Beside the extreme physical impairment, he ended up being treated for major depression. Both the insurance carrier’s medical providers, as well as the claimant’s treating doctors in this particular case, agreed that the claimant was totally disabled or incapable of performing any meaningful work activity – a standard not easy to meet.

Many of those injured on the job may not be able to return to their prior employment. Yet, according to the law, that does not mean they are totally disabled from any employment. If they are able to perform any work activity at all then they may be considered partially disabled. The amount of weekly payments an injured person receives and the length of time an injured worker receives these benefits is dependent upon a number of factors including degree of disability and loss of earning capacity. A partial disability can be considered mild, moderate, or marked.  These degrees are further broken down into when an injury is deemed permanent to a percentage loss of earning capacity. In some cases the difference of one percent loss of earning capacity can mean the difference of a full year of additional benefits. As you can imagine, much of my practice is consumed with litigation regarding the degree of disability and the loss of earning capacity.

The road for those who are partially disabled is not an easy one. Despite the Workers’ Compensation Board’s determination that an injured person has an ability to perform some work activity, it does not always translate into being able to obtain employment. In the case of serious injuries resulting in extensive lost time, the employer may have had to fill the position or the employer may not be able to accommodate the physical limitations. This puts injured workers in a position of having to look for alternate employment that they may not be trained for. The Board recommends a number of resources available to those seeking assistance, including one-stop career centers, as well as participating in vocational rehabilitation programs and continuing education such as SUNY Educational Opportunity centers adult career and continuing education. For more information go to www.wcb.ny.gov/labor-market-attachment

Many workers who are unable to obtain employment because of their injuries apply for Social Security Disability benefits. The standard for Social Security disability is different than Workers’ Compensation and relies more on the age and ability of the injured person to be retrained and to obtain relevant future employment. Social Security Disability benefits are payable for any illness or injury and do not have to be work related. All medical conditions are considered by the federal judge when making a determination as to eligibility, including physical or emotional impairments.

While an injury on the job can be life altering, there are resources available. You may never be able to return to your pre-injury status, but knowing your options allows you the ability to have some control over your future.

 

Catherine M. Stanton is a senior partner in the law firm of Pasternack Tilker Ziegler Walsh Stanton & Romano, LLP. She focuses on the area of Workers’ Compensation, having helped thousands of injured workers navigate a highly complex system and obtain all the benefits to which they were entitled. Ms. Stanton has been honored as a New York Super Lawyer, is the past president of the New York Workers’ Compensation Bar Association, the immediate past president of the Workers’ Injury Law and Advocacy Group, and is an officer in several organizations dedicated to injured workers and their families. She can be reached at 800.692.3717.

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