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1 800 HURT 511

Workers’ Compensation Claim Guidelines


Often times the first thought that employees have after suffering an on the job injury is whether their injury will cause them to be looked upon negatively by their employer.  It is common knowledge that an injury that requires medical treatment and lost time from work will cost the employer money, both by way of lost productivity and increased workers’ compensation premiums. 

When an employee is injured on the job and requires more than six calendar days of disability from work, or requires medical treatment, shall be entitled to workers’ compensation benefits that compensate the injured worker for the lost time and medical treatment. These benefits are typically paid for by the employer’s workers’ compensation insurer, but may be paid directly by the employer themselves if they qualify for “self- insured” status. 

Once an employer’s workers’ compensation insurer has paid benefits to worker injured in New York, that insurer will then subject the employer to an insurance premium adjustment based on cost incurred by the insurance company.  This adjustment typically passes some or all of the cost of the injured workers’ compensation claim from the insurance company back down to the employer.  Because workplace injuries can cause an employer to incur a substantial cost, often times injured workers may be reluctant to report injuries or seek medical treatment out of fear that they may alienate their employer or be terminated.

Although New York workers’ compensation benefits are limited in that they only provide a partial wage replacement benefits to the injured worker (and does not provide any compensation for pain and suffering), they may be costly to the employer and have an impact on the employer’s ability to conduct business. 

There is a possible way for the injured worker to receive a significant increase in his financial recovery due to the work injury, while at the same time having his employer’s workers’ compensation insurance premium adjusted (which therefore pays back the employer a significant amount of the money that they had to pay after their insurance company modified their premiums due to the workers’ compensation benefits being paid). 

New York General Laws, Chapter 152, Section 15 allows an injured worker to bring a lawsuit against a third party whose negligence caused the workplace injury (and the resulting disability from work and need for medical treatment).  Third party negligence claims allow an injured worker to pursue compensation for 100% of their wage loss (both past and future), 100% cost of medical treatment, and compensation for pain and suffering. 

The possible financial recovery for an injured worker in a third party negligence claim is typically far greater than the recovery allowed in a straight workers’ compensation claim.  In the event that the injured worker is able to receive compensation from a negligent third party, the injured workers’ employers’ workers’ compensation insurer shall be paid back a percentage of any money they paid in workers’ compensation benefits to the injured worker. This is typically referred to as the “workers’ compensation lien” on the personal injury lawsuit filed against the negligent third party.  

New York state law also mandates that a workers’ compensation insurer who recovers previously paid workers’ compensation benefits from a negligent third party must file a revised report to the insurance bureau within 60 days of its recovery, the purpose of which is so that the Commissioner of Insurance can review and adjust the employer’s insurance premium accordingly.

In summary, if a negligent third party can be identified, the filing of and settlement of a third party negligence lawsuit arising out of a work injury can benefit both the injured worker and the employer.  The laws that apply to third party lawsuits, the worker’s compensation insurer’s ability to recover its lien on the third party lawsuit, and the employer’s right to premium modification are very tricky and should only be navigated by an experienced workers’ compensation and personal injury lawyers.  Our firm has extensive experience in this complicated area of the law, and is able to coordinate all benefits that are available to injured workers in a way that maximizes the compensation received by the injured worker and their family members.

At HURT-511, our personal injury lawyers help injured workers recover the benefits to which they are entitled by law. For a free consultation with an experienced workers’ compensation lawyer, call us toll-free at 800-4878-511 or complete our online form. Our firm handles accident and injury claims throughout all five boroughs of New York.

HURT-511 operates in all boroughs of New York including all Bronx neighborhoods, namely: Bedford Park, Belmont, Fordham, Highbridge, Hunts Point, Jerome Park, Kingsbridge, Morris Park, Morrisania, Mott Haven, Parkchester, Riverdale, Spuyten Duyvil, Throgs Neck, University Heights and Woodlawn.

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Stephanie De La Cruz

I was an UBER passenger and the car got rear-ended by a utility van. I called 1-800-HURT-511 since a friend dealt with them before and I was glad I did. My attorney was extremely professional and aggressive when necessary. He was transparent from the start and didn’t complicate things unnecessarily.

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Serious team effort from the entire staff to get my work injury case resolved quickly. They built a strong case and kept me in the loop for the duration. This team also delivered on two previous occasions and did it in a very cost-effective way. A faithful customer for life thank you!

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I highly recommend HURT-511! When the insurance companies turned me away after a scary scooter accident that nearly killed me, a lawyer at HURT-511 stayed and fought for me and recovered the entire policy! Their staff is well-informed and always available to answer my questions. They treated me like one of their own and I made the right decision to stick with them. Thank you so much!

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