Tag Archives: claims

Facebook Postings Hurt Workers’ Compensation Claims

Today’s post comes from guest author Thomas Domer, from The Domer Law Firm.

While Facebook is extremely popular and used by over a billion people every day, no Facebook posting has ever helped an injured worker in a workers’ compensation claim. On the contrary, use of a Facebook page poses real dangers for injured workers pursuing workers’ compensation benefits.

Since Facebook is a public site, anything posted can be used by respondent insurance companies in claims denial. Even the most benign postings (birthday parties, family gatherings, etc.) can pose problems. For example, a grandparent lifting a 30 pound grandchild when doctors have imposed a 10 pound lifting limit could damage a claim. Additionally, nothing prevents an Administrative Law Judge from looking at a Facebook page.  Even innocent posts may be subject to misinterpretation. A picture of the worker riding a motorcycle or fishing taken prior to the injury but posted afterward could place the seed of doubt in an ALJ’s mind that the worker is not as limited as he claims. The best advice is to be extremely careful about what is posted because “friends” are not the only one who can access your Facebook page.

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How To Prepare For Your Workers’ Compensation Hearing

If you have a serious injury on the job and file a claim for workers’ compensation benefits you will most likely at some point in time have to attend a hearing before the Workers’ Compensation Board. The hearing process can be daunting to many first time attendees. They don’t know what to expect; what to bring or in many cases even what to wear. Those who have attended hearings are upset about the fact that they have to wait for a long period of time in a huge waiting room only to be rushed in and out of the hearing courtroom or “part” in a matter of minutes. They complain that while sitting inside a hearing “part”, the parties all seem to be speaking in codes and abbreviations and they don’t seem to really understand what has occurred. 

I am hoping that by providing information to you the hearing process does will not be as overwhelming and as confusing as it seems. When I first started in the practice, the board regularly scheduled hearings for any and all outstanding issues including need for treatment and or surgery. Most injured workers had numerous hearings before the workers’ compensation board with the same judge presiding and in many times the same insurance representative. Hearings were scheduled every 3-4 months untill the case was resolved which could take about 2 years.  

Today however things are radically different. Most times medical requests are dealt with in-house. The medical treatment guidelines lay out specifically what is pre authorized if certain medical conditions apply. If the treating doctor wishes to pursue treatment outside the scope of the treatment guidelines he must request it and this may be authorized or denied. These requests and denials are all done through paperwork and the injured worker unfortunately has very little to say in the matter.

The amount of hearings has declined tremendously so if you are not represented by an attorney you need to be prepared. 

  • Put together a file. 
  • Make sure any administrative decisions have established all sites of injury you are claiming. If not, you need to tell the judge that you have a claim for other sites and you will be directed to produce medical where appropriate. 
  • While your treating physician should be submitting regular medical reports to the workers’ compensation board and insurance carrier, you should always have your own copies of your medical records including diagnostic studies. 
  • You are entitled to reimbursement for mileage and prescriptions related to your claim. Bring copies of bills and mileage requests if the carrier has failed to reimburse you for these expenses. 
  • You should bring copies of all pertinent paperwork with you to proceed with your claim. 
  • Do not ever come late to a hearing but bring reading material as many cases rarely start at the time indicated. However if you are late the judge will probably not recall your case and now you must wait for a rehearing. 
  • You should be dressed appropriately and while a suit is not required, be mindful of the fact that you are appearing in a court room. 

The key to being your own successful advocate is to be prepared, be polite and be patient. 

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FEMA Extends Deadline For Hurricane Sandy-Related Claims To April 28

I recently had the pleasure of attending the New Hamilton Beach Civic Association, where I was scheduled to discuss Workers’ Compensation benefits, Social Security Disability, and give updates on Superstorm Sandy. While waiting to speak, I was privileged to hear a number of public officials speak who attended this meeting, including Congressman Hakeem Jeffries, State Senator Joe Addabbo, State Assemblyman Phillip Goldfeder and New York City Councilman Eric Ulrich.  

The meeting, run by Civic Association President Roger Gendron, made it extremely clear that those living in the community and serving the community are the best resources when it comes to information regarding the aftermath of the Storm. Everyone involved is to be commended for not only their actions, but the dissemination of valuable information to those still trying to pick up the pieces. While it is clear that much remains to be done, it is also clear that there are many dedicated citizens and officials who want to offer assistance. 

For those still suffering from the after effects of Superstorm Sandy, I will provide a little background information on FEMA’s flood program. Since standard homeowners’ insurance does not cover flooding, in 1968 Congress created the National Flood Insurance Program (NFIP), overseen by the Federal Emergency Management Agency (FEMA), to help homeowners. The NFIP offers flood insurance to homeowners, renters, and business owners if their community participates in the program. Participating communities agree to adopt and enforce ordinances that meet or exceed FEMA requirements to reduce the risk of flooding. Many of you who reside in South Queens were severely affected. If you have sustained damage, you need to file a claim with FEMA, as they have extended their filing deadline again, this time to April 28, 2014. Therefore, make sure you file a proof of loss before that time.     

Many homeowners who filed were not satisfied with their FEMA experience. Part of the problem was the sheer volume of claims. If you do not believe you were paid fairly and timely, or were unreasonably denied, you need to act now by filing a claim against your insurance carrier. There is a one-year statute of limitations to file against the insurance carrier when it denied payment or disbursed a final check.  The time to act is now. 

It is almost a year and a half since this monster storm caused unprecedented destruction and death.  There are residents still displaced and those still waiting for much-needed relief. Contact your public officials and your local boards and associations for assistance. Get proper legal advice. Speak to those who have been through similar disasters. Know what to do in a future emergency. While we all pray that Superstorm Sandy was a once-in-a-lifetime storm, we also need to be ready in case of a repeat scenario. While no amount of preparation can protect us against certain catastrophes, it is a comfort when we know what to do in the face of these obstacles.   

As we enter one of the holiest seasons for both Christians and Jews, I would like to quote Rabbi Mark Geller who said “we note that it is the season of renewal. Like babies, springtime is God’s inescapable message that life should go on.”  

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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Legally Speaking – Afraid To File A Claim?

As a 25-year attorney in the field of Workers’ Compensation, I have represented thousands of injured workers and heard all kinds of stories — many involving workers who didn’t file a Workers’ Comp claim for one reason or another. Some of the most frequent reasons I’ve heard from workers who get injured on the job and don’t file a claim include fear of getting fired, or intimidation by a system that seems cumbersome and hard to navigate.

First of all, it is against the law for an employer to fire you in retaliation for filing a Workers’ Compensation claim.  You should know that Workers’ Compensation is a no fault system. In exchange for timely payment of medical and indemnity benefits, workers gave up the right to sue their employer.   These laws went into effect in the early 20th Century as a result of social reform and tragedy.  While every state in the nation has some form of Workers’ Compensation laws, they all vary in scope and date of inception.  In New York, the pivotal event that culminated in the passage of Workers’ Compensation legislation occurred in 1911 after the horror of the Triangle Shirtwaist Factory fire, where 146 individuals perished — some burned to death while others leapt to their deaths when they tried to escape the fire and found the emergency exits locked.  This was a preventable tragedy caused by unsafe work conditions and was a catalyst for…

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World Trade Center Registry Reopened and New Protections Accorded to Workers

On November 13, 2013, Governor Andrew M. Cuomo signed significant protections for World Trade Center workers into the Workers’ Compensation Law under Article 8-A. The legislation extends and enhances workers’ compensation eligibility and benefits for World Trade Center workers. Most notably, the legislation reopens the World Trade Center Registry; extends the deadline period for filing Form WTC-12, Registration of Participation in World Trade Center Rescue, Recovery and/or Clean-up Operations, with a deadline to September 11, 2014; reopens previously time-barred World Trade Center claims and considers them timely; and adds qualifying conditions to the law.

Reopening of Registry and Extension of Filing Period for Form WTC-12

The World Trade Center Registry, which preserves workers’ compensation rights for those who performed rescue, recovery, and clean-up operations after the World Trade Centerattacks, is now reopened and will remain open until September 11, 2014. Previously, any claims for which the associated Form WTC-12 was received after September 13, 2010 were time-barred. Those workers were not entitled to benefits. These claims will now be reopened and considered timely.

Workers who participated in the rescue, recovery, and clean-up operations of the World Trade Center between September 11, 2001 and September 11, 2002, should promptly register their service participation with the NYS Workers’ Compensation Board (Board). This registration will preserve workers’ rights to future benefits, should they ever be needed. Employed and volunteer workers should file a notarized Form WTC-12 prior to September 11, 2014, whether they were injured or not. Eligible work includes duty at Ground Zero, the Fresh Kills Landfill, duty on the barges and piers, and the morgues. Paid workers and volunteers covered under the New York State workers’ compensation system are eligible. The filing of the registration Form WTC-12 does NOT constitute the filing of a claim. The filing of the sworn statement does, however, extend the time to preserve the workers’ right to file a claim. Instructions are provided on the Form WTC-12 regarding the filing of a claim. Specifically, when the time comes to file a claim, an injured worker or volunteer should submit Form C-3, Employee Claim, for compensation or Form WTCVol-3, World Trade Center Volunteer’s Claim for Compensation, to the Board.

A completed Form WTC-12 can be submitted to any Board office. Completed forms must be received at any Board office by September 11, 2014. A postmark by this date is not sufficient. Workers can obtain Form WTC-12 from any Board office or from the NYS Workers’ Compensation Board website.

These changes are included in Workers’ Compensation Law § 162.

Previously Time-barred World Trade Center Claims

As stated earlier, any Form WTC-12 filings that were received after the previous original September 13, 2010 deadline are now considered timely. (The deadline was stated in Article 8-A as September 11, 2010, a Saturday;, however, the Board accepted filings that arrived on Monday, September 13, 2010, as timely.)

The Board will review its files to locate any World Trade Center claims previously disallowed asuntimely under Workers’ Compensation Law §§ 18 or 28, or from failure to file a timely Form WTC-12. The Board will, under its own initiative, now allow those particular World Trade Center claims and consider them timely. Workers whose Form WTC-12 were previously deemed untimely will be notified that their cases are no longer time-barred and instructed on how to obtain benefits should they become injured or ill. While the Board will be pro-actively checking its own files and providing notice to claimants, claimants should feel free to contact the Board, so that the Board may provide specific information regarding the reconsideration process. All parties will be notified that their cases are being reopened as their cases are brought forward for consideration. While it is not necessary for claimants to file reopen or hearing requests, the Board wishes to make workers aware that this process is now being initiated.

These changes are in Workers’ Compensation Law §§ 165 and 168.

Qualifying Conditions

Article 8-A now contains a new list of qualifying health conditions resulting from hazardous exposure for World Trade Center workers who participated in rescue, recovery, or clean-up operations. The categories are:

  • Diseases of the upper respiratory tract and mucosae, including conditions such as conjunctivitis, rhinitis, sinusitis, pharyngitis, laryngitis, vocal cord disease, upper airway hyper-reactivity, and tracheo-bronchitis, or a combination;
  • Diseases of the lower respiratory tract, including but not limited to, bronchitis, asthma, reactive airway dysfunction syndrome, and different types of pneumonitis, such as hypersensitivity, granulomatous, or eosinophilic;
  • Diseases of the gastroesophageal tract, including esophagitis and reflux disease, either acute or chronic, caused by exposure or aggravated by exposure;
  • any combination of such conditions; and
  • New onset diseases that develop in the future or result from exposure in the future, including cancer, COPD, asbestos-related diseases, heavy metal poisoning, musculoskeletal disease and chronic psychological disease.

These changes are in Workers’ Compensation Law § 161(3).


The Board is committed to ensuring all World Trade Center workers receive the benefits and protections they are accorded under the law. To help achieve this, the Board is in the process of expanding our communication and outreach to World Trade Center workers. Our initiatives include:

  • Translating Form WTC-12 into the seven common languages other than English, designated by the Board’s Language Access Plan;
  • Reopening a dedicated phone line for World Trade Center workers, 1-855-WTC-2014 (1-855-982-2014);
  • Adding a dedicated page to the Board website for World Trade Center workers, www.wcb.ny.gov/WTC-12;
  • Using traditional and social media to reach World Trade Center workers;
  • Planning outreach to workers and groups representing World Trade Center workers; and
  • Mailing letters to previous untimely filers.

The Board’s dedicated World Trade Center work groups and hearing parts have functioned continuously since September, 2001

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