Workers’ Compensation

Why You Need an Attorney

Hello my name is Dave Pilippone. I’m a partner with Oot and Associates, I’ve been with the firm for over two decades. We handle workers’ compensation matters, social security disability claims, and personal injury matters. I’ve handled over 10,000 workers’ compensation hearings and our firm has handled over 40,000 workers’ compensation hearings.

The first question I often receive is “Do I really need a lawyer in my workers’ compensation claim?” The simple answer to that question is absolutely yes. Whether you retain our firm or another firm it is important to have an individual with you at workers’ compensation hearings that is truly skilled in the area of the workers’ compensation law. The insurance company certainly will send a skilled representative to work against you in your claim so it’s important that you obtain representation.

The next question I receive is “How do workers compensation attorneys receive payment?” It’s important to understand that unlike other attorney-client relationships, a workers’ compensation attorney cannot collect money from you directly. That attorney has to submit a few requests to the workers’ compensation law judge and the judge determines whether or not that fee request is reasonable. If the judge determines the request is reasonable the fee will be awarded on the benefits the insurance company has yet to pay. Again, the payment for attorney fees comes out of money that is moving and there is no situation where an individual reaches into their own pocket and sends a check to an attorney for workers’ compensation representation.

Given those facts I think it is very important to retain counsel and also to understand that you really aren’t at risk of running into a situation where you run up a legal bill that you can’t pay. The only way the lawyer gets paid as if they produce a result for you and the fee comes out of that result in an amount that the judge sets as being reasonable and fair.

Based on the information I just shared with you, I think you’ll agree that it is important to obtain representation for workers’ compensation matters and I would encourage you to contact our firm for assistance, thank you.

Voluntary Removal from the Workplace

I’d like to talk to you a little bit about defense in the workers’ compensation form used by insurance carriers called Voluntary Removal from the Labor Market. In recent years, our firm has been retained more often by individuals who are receiving a partial disability rated workers’ compensation, but went to a hearing and the judge suspended their benefits.

This defense of voluntary removal from the labor market is something that’s generally easy to overcome if you follow a few simple steps that are established in case law. Those steps include registering with Access VR, which is the vocational entity of New York State, registering with a New York State one-stop Career Center such as CNY Works or Jobs Plus or Labor Ready and performing an independent job search log that is within the restrictions imposed by your treating physician.

If you have a situation where the carrier has filed a request to suspend your benefits because they don’t believe you’re providing documentation of labor market attachment, I encourage you to contact our office because that is certainly something we can assist you with.

How to Start a Workers' Compensation Claim

Hi my name is Jim McGevna, I’m a partner here with Oot and Associates and I just want to speak for a couple minutes about the initial start of your claim. At this point hopefully you’ve filed the C3, which protects your right to prosecute your claim. However, it does not mean that any action will be taken or that ultimately your claim will be established.

To get the ball rolling initially it’s the responsibility of the injured worker to provide what is called Prima Facie medical evidence. The board will not proceed any further until such a statement exist. It’s incumbent upon the worker or your attorney to obtain and provide such a statement to the board. This is just a fancy statement for a threshold opinion by a qualified medical professional that your condition is related to work and is disabling in some fashion.

After finding a Prima Facie medical evidence is deemed to exist by the workers’ compensation board, the burden then shifts to the insurance carrier. The insurance carrier is entitled certain procedural rights and the claim will continue as they prosecute or defend their claim. The first thing that most insurance carriers do after such a finding, or even before, is to retain qualified counsel attorneys to assist them in prosecuting the claim.

At this point we would suggest that you, as an injured worker, do exactly the same thing and get qualified legal counsel to support your claim and hopefully that will be Oot and Associates.

What is Workers' Compensation?

What is workers’ compensation? Workers’ Compensation is a collection of laws enacted in the state of New York that are designed to protect people hurt in the workplace. If you file a Workers’ Compensation claim you’re entitled to lost wages and medical coverage consistent with the benefits afforded you in the statute.

Understand that the insurance company for your employer will have a skilled individual whose job is to make sure you don’t receive all those benefits, that’s how those people measure their success in the workplace. It’s important if you do file a claim that you’re well aware that you have the right to be represented by an attorney or licensed representative so that you can advocate on your behalf to receive all those benefits.

Please contact our office if you’d like a no-cost plan review we’d be happy to speak with you.

How to file a Workers' Compensation Claim

Employers, injured workers, and medical providers all have obligations and responsibilities at the outset of workers compensation claim. Many times at the outset of a claim that person will appear at my office and indicate that they filed a claim or of course they know its compensation. Unfortunately, they are not responsible for whether you receive benefits or worse do not receive benefits.

Ultimately you as the injured worker are required to provide written notice to the Workers’ Compensation Board within two years of the date of injury, as well as provide notice to your employer within a statutory time period.

There are many more details as to what actually provides statutory notice and filing a claim within the statutory time period. To assist you with this you should consult with a qualified attorney like Oot & Associates as soon as possible.