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Qualifying for workers’ compensation benefits

Although there are exceptions, most New York City employees are covered by insurance for occupational illnesses or accidents. Workers’ compensation insurance is employer-paid coverage for workers’ medical bills and wage losses. Some employees don’t give much thought to workers’ compensation benefits, until they become ill or injured in mishaps like construction workers’ accidents.

An employer files a claim with an insurer after being notified of a worker’s on-the-job injury. Workers’ comp insurers are under the direction of the state Workers’ Compensation Board. The state agency evaluates and processes claims.

Compensation is not dependent upon fault. Benefits are paid even for workers whose actions contribute to their own injuries, as long as the harm is not the result of intoxication or a self-inflicted injury. There is a trade-off for providing coverage — companies avoid legal claims by making workers’ compensation benefits available.

Benefits are paid only if a worker’s injury is job-related, as determined by an employer or the company’s insurer. When there is a dispute about an injury claim, benefits are withheld from the worker until the matter is resolved through the Workers’ Compensation Board. While the case is in suspension, an injured employee may qualify to receive disability benefits, which are deducted later from any approved workers’ comp benefits.

Workers’ compensation claims are viewed from the perspective of how an injury affects the employee’s ability to work. Benefits are paid, according to whether an injury is totally or partially disabling on a temporary or permanent basis.

Some employees go back to work but are forced by an injury to take a job that pays less than the one they had in the past. Workers’ comp benefits can help make up the shortfall by covering as much as two-thirds of the difference in pay. Paris & Chaikin attorneys help injured workers receive the maximum workers’ compensation benefits to which they are entitled.

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