In New York, businesses are required to provide workers’ compensation insurance coverage for their employees, which allows injured workers to receive benefits by filing a claim for workplace injuries. However, due to the exclusive remedy rule outlined in the Workers’ Compensation Code, employees are typically unable to sue their employers for negligence.
Under New York Workers’ Compensation Law §29(6), workers’ compensation benefits serve as the exclusive remedy for workplace injuries and accidents. This means that if an employee is injured while working, their only option is to file a workers’ compensation claim. The employee does not need to prove their employer’s negligence to receive benefits. However, it’s important to note that workers’ compensation benefits might not cover all financial losses and damages resulting from workplace injury.
Speaking to an experienced NYC workers’ compensation lawyer is important if you’ve been injured in a workplace accident. A workers’ comp attorney is crucial because they can explain how long you can collect workers’ compensation and help you file a personal injury lawsuit, if necessary. Our skilled team at K L Sanchez Law Office, P.C. can assist you. Contact us today at (646) 701-7990 to schedule a free consultation.
Can I Sue My Employer for Negligence?
If you have been injured at work due to your employer’s negligence, you might be wondering if you can pursue legal action against them. It’s important to understand that in most situations, you cannot sue your employer for negligence if the injury occurred while you were on the job. Instead, the appropriate course of action is to file a workers’ compensation claim.
Workers’ compensation is a type of insurance that most employers are required to have. It is designed to provide compensation for medical bills, rehabilitation expenses, and lost wages resulting from work-related injuries. This system aims to streamline the process of recovering damages from workplace injuries, ensuring that employees receive support without the need for lengthy and costly litigation.
The primary benefit of workers’ compensation is that it allows you to receive help regardless of who was at fault for your injury. However, it also means you forfeit the right to sue your employer directly under most circumstances. This arrangement is designed to safeguard both employees and employers, reducing the risk for both parties.
However, there are exceptions where a lawsuit might be possible, such as cases involving intentional harm or the involvement of a third party in your injury. To fully understand the specific legal options available in your case, it is recommended to consult with an experienced NYC workers’ compensation lawyer who can offer tailored guidance based on your circumstances.
Exceptions to the Exclusive Remedy Rule in New York
The exclusive remedy rule in New York for workplace injuries allows an injured employee to sue their employer for negligence only under very limited exceptions. An employee may be able to sue their employer if the employer lacks the required workers’ compensation insurance coverage, intentionally injured the employee, or if the employee works for an employer that is not mandated to have workers’ compensation coverage.
If your workplace injury does not fall under any of these exceptions, you are unable to sue your employer for negligence. The exclusive remedy rule typically covers workplace injuries that result from a co-worker’s negligence. However, if an independent contractor is classified as a “special employee,” the exclusive remedy rule may apply to them as well.
What Is the Grave Injury Exception in New York?
New York’s Workers’ Compensation Law generally prohibits employees from suing their employers for injuries sustained on the job, offering instead a system of benefits regardless of fault. However, a significant exception exists under Section 11 of the Workers’ Compensation Law, known as the “grave injury” exception. This provision is essential for workers and third parties involved in workplace accidents to understand.
Under Section 11, an employer’s liability is typically limited to the workers’ compensation system, shielding them from direct injury-related lawsuits by employees. However, if an injured employee files a lawsuit against a third party, such as a general contractor, property owner, or equipment manufacturer, that third party may seek indemnification or contribution from the employer if the injury qualifies as “grave.” This means that while the worker cannot sue their employer directly, the employer may still become financially responsible if a third party successfully brings them into the case.
The law strictly defines “grave injury” to include conditions such as death, permanent and total loss or amputation of an arm, leg, hand, or foot, loss of multiple fingers or toes, paraplegia or quadriplegia, total and permanent blindness or deafness, loss of a nose or ear, permanent severe facial disfigurement, loss of an index finger, or an acquired brain injury causing permanent total disability. These injuries are explicitly listed in the statute, and courts interpret them narrowly. For example, partial loss of use of a limb or other serious but non-qualifying injuries does not meet the statutory threshold.
Since this exception primarily affects third-party claims, it is crucial for injured workers to recognize how it may impact potential legal actions. Understanding the “grave injury” exception is important for all parties involved in workplace injury cases, as it influences liability distribution and potential compensation beyond standard workers’ compensation benefits.
Third-Party Actions in Personal Injury Law
While an injured employee cannot sue their employer or co-worker for work-related injuries, they can pursue legal action against a third party or another entity if their negligence caused the injury. Such legal actions are referred to as “Third-Party Actions.” These claims commonly arise in cases involving negligent drivers, defective equipment, unsafe premises, or construction site accidents.
If the third-party action results in monetary compensation, either through a settlement or a verdict, the workers’ compensation carrier has the right to reimbursement for any lost wages and medical benefits paid to the injured worker. This is called a “Third-Party Lien.” Determining the lien and other expenses can be challenging, and it is recommended to seek legal advice to navigate the process.
Moreover, the workers’ compensation carrier must give consent for the injured worker to settle a third-party action. Failing to obtain consent may prevent the employee from receiving future workers’ compensation benefits, including ongoing medical coverage and wage replacement. If the carrier unreasonably refuses consent, the worker may seek court approval to finalize the settlement.
Motor vehicle accidents are a common basis for third-party claims, especially when a worker is injured due to another driver’s negligence. In New York, workers’ compensation is the primary source of benefits for work-related injuries, with no-fault insurance only covering damages not included in workers’ compensation. Other frequent third-party actions include construction accidents, particularly claims under New York Labor Law Sections 200, 240(1), and 241(6), which allow workers to sue property owners and general contractors for unsafe working conditions.
Navigating third-party claims and workers’ compensation liens can be challenging. Consulting a New York City workers’ compensation lawyer may help injured employees maximize their recovery while ensuring compliance with New York law.
Appealing a Denied Workers’ Compensation Benefits Claim
If your workers’ compensation claim has been denied in New York City, you have the right to appeal the decision. While workers’ compensation laws generally prevent employees from suing their employers for workplace injuries, exceptions exist, such as cases involving intentional harm or lack of required insurance coverage. Our lawyers can guide you through the appeals process to help secure the benefits you may be entitled to receive.
Common reasons for denied claims include:
- Disputes over the location of your injury
- Claims that the injury was pre-existing and unrelated to work
- Questions about your employment status
- Errors in wage replacement benefits
- Disputes over medical evidence supporting the claim
The appeals process works similarly to the court system, starting with an appeal to the workers’ compensation board. If the board maintains its decision, a workers’ compensation judge can hear the case and evaluate evidence such as:
- Medical records
- Testimony
- Wage information
- And other relevant evidence
If necessary, we can appeal the judge’s decision to a panel of board members or the entire board. Lastly, we have the option to appeal to the formal New York courts for a review. Each stage of the appeal process has strict deadlines and procedural requirements. Our legal team can assist in preparing a strong case, gathering medical and wage evidence, and representing you in hearings and court proceedings to help challenge the denial of your claim.
| Reason for Denied Claims | Details |
|---|---|
| Disputes over the location of your injury | Insurance companies may deny claims if they dispute whether the injury occurred at work or during work-related activities. |
| Claims that the injury was pre-existing | Insurers might argue that the injury existed before the work-related incident, thus denying compensation. |
| Questions about your employment status | Denials may occur if there are uncertainties about your employment status at the time of the injury, such as contractor vs. employee status. |
| Errors in wage replacement benefits | Mistakes in calculating wage replacement benefits can lead to denials or reduced compensation amounts. |
Differences Between Personal Injury Lawsuits and Workers’ Compensation
The contrast between workers’ compensation and personal injury claims can be unclear to some, and they may be mistaken for one another. However, these two have significant differences from each other.
When an employee sustains an injury while on the job, they can file a workers’ compensation claim. New York follows a no-fault system, meaning the injured worker is typically entitled to benefits regardless of who was at fault for the injury. These benefits may cover medical expenses, a portion of lost wages, and rehabilitation costs. However, workers’ compensation does not provide damages for pain and suffering. Under New York State law, employers are obligated to carry workers’ compensation insurance for their full-time and part-time employees, which covers the costs of an employee’s injury.
Workers’ compensation is generally the exclusive remedy for workplace injuries, meaning employees cannot sue their employer for negligence. However, a personal injury lawsuit may be an option if a third party (such as a property owner, contractor, or manufacturer of defective equipment) contributed to the injury. These types of lawsuits are less predictable and can take over a year to resolve in court. Personal injury claims also take into account factors such as pain, emotional trauma, and suffering caused by the injury, which are not covered under workers’ compensation.
If you have suffered a workplace injury, It is important to speak with an experienced personal injury attorney who may be able to help you seek the compensation you deserve.
Seeking the Help of an Experienced Workers’ Compensation Attorney in Queens
It is crucial to know your rights as an employee and understand your legal entitlements. In the event of a work-related injury, it is essential to take immediate action and seek the advice of competent legal counsel.
If your employer is legally responsible for your injury or your injuries were sustained in the workplace, and you are still employed, our team of adept workers’ compensation lawyers can evaluate your medical records, examine your situation, and support you in constructing a robust claim.
At K L Sanchez Law Office, P.C., personal injury lawyer Keetick L. Sanchez and her team of workers’ compensation lawyers may be able to help you seek the compensation you deserve. Contact us today at (646) 701-7990 to schedule a free consultation.
