In New York, workers injured on the job are covered by their employer’s workers’ compensation insurance. Workers’ compensation covers medical treatment and a portion of lost wages. Once a workers’ compensation claim is formally established, medical treatment related to the established injury site can be covered for life. Doctors need to follow the law, rules, and regulations for treatment, but in general, if they believe the ongoing need for treatment relates to the original work injury, the treatment will be covered—even many years after the injury occurred. There are circumstances where workers’ compensation lost wage payments also last for life, but most claims result in a fixed period of payments.
How Long Can You Get Workers’ Compensation?
The length of time you can receive payments depends on the type and severity of your injury. You will qualify for lost wage payments if you are out of work for more than seven days and have medical evidence confirming you cannot work. The amount of your payment will be calculated based on your average earnings for the year before the injury and the level of disability reported by your doctor.
Once you start receiving payments, you will need medical evidence of ongoing disability every 90 days. If your doctor says you are totally disabled for an initial period after your injury, but then later says you can do light duty or work with restrictions, your benefit rate will go down. Eventually, and in general about one year from an injury or surgery, the Workers’ Compensation Board will want to know if you have reached a point of “maximum medical improvement.” This means there isn’t any additional treatment that will help you get better. Your doctor will then be asked to designate your injury status.
How Long Does Workers’ Compensation Last for a Permanent Injury?
If you have a permanent injury to an extremity, such as an arm, leg, hand, foot, fingers, or toes,
your payments may stop with a one-time permanency award. If you have a permanent injury to your spine or a chronic condition like complex regional pain syndrome, you may be entitled to ongoing payments for a range of one to 10 years. If you are permanently totally disabled, meaning you cannot return to any type of work, you may be entitled to payments for life.
Categories of permanent disability depend on medical evidence and your ability to return to different types of work. At the time of a permanent disability classification, the insurance company may have you examined by a doctor, and that doctor’s opinion may be different from your own. There will be hearings before a law judge who will render a decision on your level of permanent impairment. There are several factors considered in setting a permanent disability percentage and that percentage will determine how long you will be able to receive payments. It is a complicated process that the experienced lawyers at Lewis & Lewis know how to handle.
