Should You Get a Workers’ Comp Attorney?

If you’ve been injured at work in New York, you are probably covered by workers’ compensation insurance that will compensate you for your medical costs and lost wages. Workers’ compensation operates on a no-fault system, meaning you can receive benefits regardless of who caused the workplace accident.

You may be wondering how long you can collect workers’ compensation benefits. Ideally, these benefits should start smoothly to provide you with the necessary time and medical care needed for recovery and to help you resume your normal life. However, obtaining the workers’ comp benefits you are entitled to can be challenging. It’s crucial to consult with a top-rated Queens workers’ compensation lawyer before making any decisions.

Contact K L Sanchez Law Office, P.C. at (646) 701-7990 to schedule a consultation.

Why Hire a Workers’ Comp Attorney in New York?

Not all workers’ compensation claims will need the assistance of an attorney. The system is meant to be simple so you can file on your own. Still, some situations call for backup. If you run into any of these, it’s smart to talk with a New York workers’ compensation lawyer.

• Your benefits are denied. Your claim was denied. Many people stop after a denial. You don’t have to. You can appeal or pursue other options to keep your case alive.
• Insurance is blaming a pre-existing condition for your issue. Unfortunately, workers’ compensation insurance will use previous health conditions as a reason to deny your benefits. They may argue that your pre-existing condition was the cause of your issue, not a workplace accident.
• Your employer denies that your injury happened at work. Your employer may deny that your injury or condition happened at the workplace or because of the nature of your work. An experienced workers’ compensation lawyer can establish the connection between your injury and your work.
• Your settlement doesn’t cover all your costs. Workers’ comp settlements aren’t always good ones. If you think that your offer is not sufficient to cover your costs and lost wages, it is advisable to get the assistance of a New York workers’ compensation attorney.
• You can’t work for an extended time, or you are permanently disabled. These scenarios can be costly for the insurance company, and they may try to avoid paying benefits or try to reduce benefits if you have a serious or permanent injury. An experienced workers’ compensation lawyer can help you maintain the benefits you deserve.
• You have rights to a third-party claim.  You may have a claim against another party in the workplace that isn’t covered by workers’ compensation. You have the right to hold that party accountable. A skilled workers’ comp attorney can help you hold the third party responsible for your injuries.
• Your employer is retaliating. If your employer cuts your hours or pay, harasses you, or fires you because you filed (or tried to file) a workers’ comp claim, that is unlawful under Workers’ Compensation Law §120. You can file a Discrimination/Retaliation Complaint (Form DC-120) with the Board within two years. Hiring a workers’ compensation attorney can help you hold them accountable for their actions.
• You disagree about your ability to work. If the insurance company or employer is claiming you can return to work if they modify your duties (all to reduce your benefits) and you disagree, it’s essential to get the advice of an experienced workers’ compensation attorney.
• You plan on applying for Social Security disability benefits. Workers’ compensation benefits can affect your Social Security disability benefits if not properly structured. You can hire a workers’ comp lawyer to make sure that your settlement is structured properly.

You can start your claim on your own. If any of these roadblocks show up, having a New York workers’ compensation lawyer in your corner can make a real difference.

Situation	What It Means	How a Workers’ Comp Attorney Helps
Your benefits are denied	Your claim was rejected and benefits won’t be paid.	An attorney can file appeals, gather evidence, and pursue other legal options.
Insurance blames a pre-existing condition	The insurer argues your health issue existed before your workplace accident.	A lawyer can prove the workplace incident aggravated or caused your condition.
Employer denies your injury happened at work	Your employer disputes that your injury was work-related.	An attorney can gather medical records, witness statements, and workplace evidence.
Settlement doesn’t cover costs	The offered settlement is too low to cover medical bills, lost wages, or future care.	A lawyer negotiates for a fair settlement and ensures you don’t accept less than what you deserve.
You can’t work for a long time or are permanently disabled	Extended or permanent disability cases are expensive, so insurers may try to reduce payouts.	Attorneys fight to secure long-term or lifetime benefits and prevent unfair reductions.
You may have a third-party claim	Another party may be liable for your injuries.	A lawyer can file both workers’ comp and third-party claims.
Employer retaliation	Your employer harasses, demotes, or fires you for filing a claim.	A lawyer can file a retaliation complaint and seek damages.
Disagreement about ability to work	Insurer or employer claims you can work with modified duties, reducing your benefits.	Attorneys can challenge premature return-to-work demands with medical evidence.
Applying for Social Security disability benefits	Workers’ comp benefits can reduce SSDI if not properly structured.	An attorney structures your settlement to protect your Social Security disability benefits.

How to Appeal a Denied Workers’ Comp Claim

If your New York workers’ comp claim was denied, you can appeal. Start by reading the decision closely and noting deadlines. You have 30 days from the filing date of the Workers’ Compensation Law Judge’s decision to file an Application for Board Review using Form RB-89. This is your chance to point out legal or factual errors and explain what the judge overlooked, supported by medical records and witness statements.

After you file, the insurance carrier can serve a rebuttal within 30 days. A three-member Board Panel reviews the case and issues a Memorandum of Board Panel Decision.

If the panel does not rule in your favor, you have two options: (1) apply for Reconsideration/Full Board Review using Form RB-89.2 within 30 days after the notice of filing of the Memorandum of Board Panel Decision; and/or (2) file a judicial appeal to the Appellate Division, Third Department within 30 days after the panel decision has been served on the parties. Some parties do both to preserve rights because each path has different standards and timelines.

A Queens workers’ comp attorney can keep you on deadline, prepare the RB-89 with the exact issues preserved for appeal, and avoid procedural traps, like submitting materials the Board already has, which can get an application denied. Your lawyer can also line up treating doctors, request missing records, prepare you for testimony, and handle service and filing so your appeal is complete and timely.

Queens Workers’ Compensation Lawyer – K L Sanchez Law Office, P.C.

How Strong Evidence Can Boost Your Workers’ Compensation Case

For workers in New York seeking compensation after a workplace injury, the quality and completeness of the evidence presented can significantly influence the outcome of their case. The strength of a workers’ compensation claim largely depends on the ability to provide comprehensive medical records that not only detail the injury but also clearly link it to the workplace.

When claims are submitted with ambiguous or incomplete evidence, insurance companies often have grounds to deny them. To prevent this, it is crucial to present well-documented medical records that demonstrate a direct correlation between the workplace and the injury sustained. This includes detailed physician reports, diagnostic test results, and records of treatment that collectively paint a clear picture of how the injury occurred and the resulting medical needs.

The presentation of robust evidence does more than link the injury to the job; it establishes a solid foundation for your claim, helping to determine the compensation needed for recovery accurately. Through meticulous gathering and presenting of strong evidence, you improve your chances of securing adequate support to facilitate a smoother recovery process. While supporting your claim, this also emphasizes the legitimacy of your need for compensation following a workplace injury.

Engaging an experienced workers’ compensation attorney can be invaluable in this process. Besides assisting in compiling all necessary documentation, they can bring in additional forms of evidence, such as witness statements, to provide further insight into the circumstances surrounding the incident and reinforce the claim. Contact K L Sanchez Law Office, P.C. today to speak with a skilled Queens workers’ compensation lawyer.

• One-third of one week’s compensation when weekly temporary benefits are continued.
• 15% of increased retroactive temporary benefits.
• 15% of schedule loss or disfigurement awards above prior payments.
• For permanent partial or total disability and death benefits, 15% of compensation due above prior payments plus a sum equal to 15 weeks of compensation.
• For §32 settlements, 15% of the benefits are to be paid, excluding amounts allocated for future medical.

This fee structure helps to minimize any upfront financial burden on injured workers, allowing them to obtain skilled legal assistance without worrying about high initial costs. Familiarity with how these fees work can provide significant peace of mind to workers dealing with the specifics of workers’ compensation claims in New York.

Available Workers’ Comp Benefits for Injured Workers in NYC

Workers in New York City who are hurt while working and have workers’ compensation benefits can potentially receive compensation for their economic losses. 

• Medical benefits cover all the necessary medical expenses, such as hospitalization, surgery, medication, rehabilitation, and more. However, you must seek treatment from a pre-approved physician, except in an emergency. If your employer participates in a certified workers’ comp PPO, you must use a PPO provider for your initial visit (you may opt out after 30 days). Certain treatments require prior authorization submitted through the Board’s OnBoard Prior Authorization Request (PAR) system.
• Indemnity benefits or lost wages can be claimed if you are unable to work for more than seven days. You can receive wage replacement benefits, which amount to two-thirds of your average weekly wage before the injury, multiplied by the percentage of disability.
• Death benefits are also available in tragic circumstances where a work-related injury or illness results in an employee’s death. In this case, surviving family members can receive compensation to cover funeral expenses and financial support loss.

Workers’ compensation benefits don’t typically include non-economic damages like pain and suffering. It is critical to hire a skilled New York workers’ compensation lawyer to handle the complicated process of obtaining benefits, including gathering evidence and negotiating with insurance companies. At K L Sanchez Law Office, P.C., our team of experienced Queens workers compensation attorneys can help ensure that you receive the compensation you deserve.

Call us at (646) 701-7990 to schedule a consultation.

Securing Your Rights with a Skilled Legal Professional

Deciding whether to hire a workers’ comp attorney is a critical decision that can significantly impact the outcome of your claim. Learning the specifics of workers’ compensation law, knowing your rights as an employee, and fighting for the full benefits you deserve can be daunting tasks. With the right legal guidance, you can effectively handle disputes, manage paperwork, and negotiate with insurance companies. Remember, having a knowledgeable advocate on your side can make all the difference in securing your rightful compensation and benefits.

If you’re considering filing a workers’ compensation claim in Queens or have encountered challenges with your current claim, the K L Sanchez Law Office, P.C. can help. Our experienced Queens workers’ compensation lawyers can guide you through New York workers’ comp laws and are committed to advocating for your rights. Do not face this challenging process alone.

Contact us today at (646) 701-7990 to schedule a consultation and learn how we can assist you in achieving the compensation you rightfully deserve.