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FAQs on Workers' Compensation

What Injuries Qualify for Workers’ Compensation in New York?

If you have been injured while at work, it is vital to understand what is and is not covered by New York’s workers’ compensation laws. These rules create strict guidelines concerning workers and their rights to pursue compensation. Just because you were at work when you were injured does not mean that you automatically qualify for benefits.

To be covered by New York compensation laws, your injury-causing incident must fall into the following categories:

You must work for a company and in a capacity that is mandated to have workers’ compensation coverage under New York law.
The injury, illness, or disability that you suffered occurred because of your job and while you were performing the duties involved in your employment.
Your employer has notice of the incident that caused your injury or illness within 30 days of when it happened.
A medical report states that your injury, disability, or illness was caused by an on-the-job accident or condition.

What are Workers’ Compensation Benefits in New York?

New York State law provides many different types of benefits for injured workers, with the goals of preventing financial hardship and helping victims return to work as soon as possible.

If you are found to qualify for workers’ compensation, you can receive benefits including:

Payments equal to 2/3 of your average weekly wage for total disability
Reduced earning compensation to make up for a decreased ability to work if you have suffered a partial disability
Medical treatment from doctors and chiropractors that is paid by the workers’ compensation provider
Compensation for extremity injuries, such as damage to arms, legs, hands, and feet or a facial scar, even when the damage does not keep you from working
Reimbursement for traveling to doctors or therapists and out-of-pocket expenses related to your injury, such as bandages and prescriptions

How Can A New York Workers’ Comp Attorney Help With My Claim?

These benefits are based on the nature of your injuries, the amount of time you will be unable to work, and what is needed for recovery. As such, it is vital that you collect evidence and testimony that proves the true extent of your losses so that you can gain fair and full compensation. Injured workers will have to be regularly evaluated by doctors and complete hearings with the Workers’ Compensation Board to prove that their injuries or disabilities are still present and preventing work.

Without workers’ compensation benefits, the cost of recovery and lost wages from being unable to work can fall squarely on your shoulders with no assistance from insurance providers. A dedicated NY workers’ compensation attorney can help you secure the settlement you need.

Does a Workers’ Comp Case Affect Job Security?

Many workers who have been injured at work may feel that they can’t bring a workers’ compensation claim out of fear of losing their job. New York workers often assume that pursuing a workers’ compensation claim will cost their employer money. This is not true. The vast majority of New York businesses carry workers’ compensation insurance so they don’t have to pay for worker injuries out of the company’s pocket. Your workers’ compensation claim should have no bearing on your job security.

What Medical Care Am I Entitled To?

Under Section 13 of New York Workers’ Compensation Law, injured workers are entitled to medical treatment that is directly related to their work injury. However, what counts as “causally related” is often disputed by employers and insurance companies, which can make obtaining timely care frustrating.

The Workers’ Compensation Board has established treatment guidelines for certain injuries—commonly involving the shoulder, neck, back, and knee—to help streamline care and reduce delays. Medical treatment can include doctor visits, hospital care, prescription medications, and therapies such as physical therapy or chiropractic care. Depending on your location or employer, you may be required to see specific providers or complete diagnostic tests, like MRIs, at facilities chosen by the insurance carrier.

Although the treatment guidelines are intended to speed up care, in practice they can sometimes be confusing. The prior authorization process set up by the Board has, in many cases, added complexity rather than clarity. At Oot & Associates, we help clients navigate these rules, advocate for the care they need, and work to minimize delays in receiving medical treatment.

How Do I Know If I Am Receiving the Lost Wages I'm Entitled To?

If your Workers’ Compensation claim is accepted and you’re unable to work, you should be receiving lost wage payments. But are they accurate? At Oot & Associates, we help ensure that your payments reflect the benefits you’re entitled to.

Generally, injured workers receive two-thirds of their average weekly wage (AWW), subject to certain limits that depend on the date of the accident or disability. If you have a temporary total disability, you typically receive the full two-thirds. If your disability is partial, your benefits are adjusted to reflect a percentage of the full rate.

It’s crucial to make sure your AWW is calculated correctly, as it determines your wage benefits for the duration of your claim. If you have more than one job, income from multiple jobs may be included in the calculation. The AWW is generally based on your earnings—or the earnings of a comparable worker—over the year prior to your injury or disability.

For workers under 25, there is an additional consideration called Minor’s Wage Expectancy, which can increase your AWW at the time permanency is determined. Properly calculating your wage benefits can significantly affect the compensation you receive, and our team at Oot & Associates is here to make sure your lost wages are handled correctly.

What If I Am Earning Less Because of My Work Injury?

If you’ve returned to work but are earning less than your pre-injury wages due to your workplace injury or occupational illness, you may be entitled to reduced earnings benefits. These benefits typically cover up to two-thirds of the difference between your average weekly wage (AWW) before your injury and your current earnings.

Reduced earnings benefits are especially important in cases involving neck, back, or other serious injuries, as they help make up for lost income while you continue to work.

Don’t wait—schedule a free case evaluation with the Workers’ Compensation attorneys at Oot & Associates serving Syracuse, Watertown, and surrounding areas. We can help ensure you receive all the benefits you are entitled to.

How Do I Maintain My Connection to the Workforce?

Workers’ Compensation payments typically continue during your period of disability and recovery. However, if you have a partial disability and have not returned to work, it’s important to take certain steps to protect your right to ongoing benefits.

Showing that you remain attached to the workforce is critical. If you voluntarily leave your job—whether by resigning, retiring, or otherwise stepping away—the insurance company may argue that you are no longer eligible for lost wage payments. Because of this, it’s essential to carefully consider any decisions about leaving your employment after a work-related injury.

Once you reach Maximum Medical Improvement (MMI), your case may be ready for a permanency determination. The impact of a permanency finding depends on factors such as the part of your body that was injured, whether you’ve returned to work (with or without reduced earnings), and the date your injury occurred. At Oot & Associates, we guide clients through these decisions to ensure your rights and benefits are fully protected.

What Is an Accident Claim?

A Workers’ Compensation accident claim is one of the two main types of claims in New York. It applies when a sudden injury or illness occurs while performing your job or as a result of work tasks.

Examples of accident claims include:

Slipping, falling, or breaking a bone at work
Injuries from moving equipment or machinery
Healthcare workers hurt while assisting patients

These are just a few examples, and no matter the type of accident, our Oot & Associates Workers’ Compensation attorneys know how to guide you through the process.

What If I Think I Have an Accident Claim?

In New York, you have 30 days to notify your employer after discovering a work-related injury or illness. After that, you can file a Workers’ Compensation accident claim within two years of the incident.

Completing the required forms accurately, completely, and honestly is crucial for securing your benefits. Our team at Oot & Associates helps you handle the paperwork correctly from day one, protecting your rights and maximizing your chances of success.

For over 30 years, our award-winning lawyers near Syracuse, NY and Watertown, NY have helped injured workers navigate the system and fight for the compensation they deserve.

What Is an Occupational Disease Claim?

An occupational disease claim is the second type of Workers’ Compensation claim in New York. This applies when a disease or illness develops gradually due to your work environment or duties.

Examples include:

Carpal Tunnel Syndrome from repetitive typing or hand motions
Respiratory illnesses from long-term exposure to chemicals or hazardous materials

What If I Think I Have an Occupational Disease Claim?

New York law requires that workers notify their employer within 30 days of learning that their condition is work-related. You can then file a claim within two years of discovering the illness.

Just like accident claims, the initial forms must be completed accurately and completely. At Oot & Associates, we help you prepare and file these forms, ensuring your case starts strong and your rights are fully protected.

With over three decades of experience, our lawyers have helped injured workers all across Upstate, Central, and Western New York, successfully pursue benefits and safeguard their livelihoods.

Can I Receive Workers’ Compensation for Hearing Loss?

New York law recognizes two types of hearing loss claims:

Traumatic Hearing Loss – caused by a sudden, unexpected event, like an explosion
Occupational Hearing Loss – caused by prolonged exposure to loud noise over time

What’s Covered?

Medical treatment, including hearing aids
Schedule Loss of Use (SLU) awards based on the severity of the hearing loss

Statute of Limitations

Traumatic Hearing Loss: 2 years from the date of the event
Occupational Hearing Loss: 2 years and 90 days from the date you learn the condition is work-related

What Are the Steps to File a Hearing Loss Claim?

Wait 90 days after leaving the harmful noise exposure before having your hearing evaluated.
See a Board-approved otolaryngologist (ear, nose, and throat doctor).
Provide a detailed employment and noise exposure history. Include prior or concurrent noise exposure from other jobs or environments.
The doctor evaluates your hearing, completes the appropriate forms (C-4 or C-4NARR), and files them.
File a C-3 claim form within 2 years of the injury. This officially begins your claim with the Workers’ Compensation Board.
The insurance company will either accept or contest your claim. If contested, a hearing will determine which issues require resolution.
If successful, you may receive medical equipment (like hearing aids) and possibly a Schedule Loss of Use award.

At Oot & Associates, we’ve developed a streamlined process that gives hearing loss claims the strongest chance for success. Don’t wait—schedule a consultation to review your case with our experienced Workers’ Compensation attorneys.

What Are the Important Deadlines for Workers’ Compensation Claims in New York?

In New York State, Workers’ Compensation law requires that injured workers notify their employer in writing within 30 days of a workplace injury or illness. Missing this deadline can put your claim at risk of being denied.

Additionally, injured workers generally have up to two years from the date of the injury or illness to file a Workers’ Compensation claim. Following these timelines helps ensure you can receive the benefits you’re entitled to.

Informational Videos

Miscellaneous Medical & Transportation Reimbursement Charges in a Workers' Comp Case

My name is Dave Philippone. I’m here today to talk about miscellaneous medical and transportation reimbursement expenses. Oftentimes people think that they’re receiving a worker’s compensation check, their medical bills are being paid, but they fail to realize that the travel to and from the doctor’s office, to and from physical therapy, attending even the insurance carrier’s independent medical exam, is something they can receive reimbursement for.

So if you haven’t done that already, you should look for a form C-257 and submit your request for travel expenses. However, be advised that if you attempt to inflate your reimbursement request, there are penalties under the law. So be very careful about what you submit for and make certain that it’s accurate.

Accuracy With Your Past Medical History in a Workers' Comp Case

My name is Dave Philippone, and I’m here today to talk to you about accuracy with your past medical history. In a workers’ compensation matter, if you fail to properly disclose your past medical history, the insurance company could, and most likely will, raise fraud, a violation of section 114 of the workers’ compensation law. So you should never guess as to whether or not you’ve treated in the past for a body part or condition being claimed in a workers’ compensation matter, and you should always, always be truthful.

The fact that you may have had a pre-existing condition doesn’t necessarily preclude you from having an established workers’ compensation claim, but if you fail to disclose it and they find out, you will have a much larger problem.

Settlements in a Workers' Comp Case

My name is Dave Philippone. I’ve been with the firm Oot & Associates for over 30 years. Today I’m here to talk with you about settlements.

There are many kinds of settlements in a workers’ compensation matter. You can attend a hearing and reach an agreement with the insurance carrier over an issue. You can sign a written stipulation with the insurance carrier identifying resolved issues or an agreement of the parties. And lastly, you can enter into what’s called a Section 32 settlement, where you agree in return for a sum of money to waive on a permanent basis some or all rights under the workers’ compensation law, including lost wages, medical benefits. And these agreements are binding once they’re approved by the board. So you need to be aware that the insurance company will always have a skilled individual negotiating those agreements on their side of the table. And it is my firm belief that an injured worker should always have a skilled representative on their side of the table, making certain that the agreements reached are fair and equitable and that you’re not taken advantage of because you don’t know what your rights are.

Aspects of a Workers' Comp Claim

My name is Dave Philippone. I’m a partner here at Oot & Associates. I’ve been with the firm for over 30 years. And I’m here today to talk to you about the different aspects of a worker’s compensation claim.

There are essentially two phases to a worker’s compensation claim. The first phase is the temporary disability phase, which is usually from the date of injury up until a finding of permanency. Permanency is also referred to as maximum medical improvement. The worker’s compensation board has adopted treatment guidelines and impairment guidelines that help a treating physician determine when an individual has reached the second phase of the injury, which is the permanency phase. That permanency phase goes from the date of the finding of permanency by the judge until you’re passing, until you’re dead. Unless you choose to settle your rights in the worker’s compensation claim for a waiver of those benefits. Given the fact that there are two phases to the injury, it’s important that in each phase you seek out the benefits you’re entitled to under the law, and not every individual fully understands what those rights are, so it’s always important to consult with an attorney, for assistance in this matter, because the insurance company certainly will be trying to limit the benefits paid in the temporary phase, or the finding of permanency, to limit what they owe you into the future.

You should be aware that there’s been significant changes in the worker’s compensation law over the years. Prior to 2007 an injured worker who was found to have a permanent partial disability could potentially collect payments from the date of permanency, until they’re dead. The law changed in 2007, and in return for injured workers receiving a yearly increase in the maximum benefit allowed by law for injuries, the trade-off was that a cap was set for benefits into the future for permanently partially disabled individuals. So it’s important that you try to maximize those permanency benefits with the assistance of a skilled attorney.

Statues of Limitations in Workers' Comp Cases

My name is Dave Philippone. I’m a partner here at Oot & Associates. I’ve been with the firm for over 30 years. And today I’m here to talk to you about statutes of limitations in workers’ compensation matters.

There are very important deadlines that must be met when you’re filing a claim. First and foremost, Section 18 of the comp law requires that you give notice to your employer in writing of a work injury within 30 days.

If you fail to give notice to the employer timely, the law judge, despite how clearly you were injured at work, has the discretion to disallow the claim for failure to meet the 30-day deadline.

There are certain exceptions to the rule that requires 30-day notice, and the judge can excuse late notice in the event it is apparent that the employer has not been prejudiced. That is a standard that you do not want to get into argument with with the insurance company because the percentages of winning those cases are very small. And so it’s always important to timely give notice to your employer within 30 days of any accident.

The second statute of limitations is Section 28 of the comp law. You are required to file a claim with a comp work within two years of when you knew or should have known your injury occurred at work.

The Section 28 defense is raised routinely by insurance carriers in situations where an injured worker gave notice to their employer of a work injury, but did not seek medical treatment or file a claim within two years of that accident. And then after the two-year anniversary of an injury, went to get their first treatment because they could no longer deal with the pain. That is a claim that will likely get disallowed by the Workers’ Compensation Board.

So it’s important that you not only give notice to your employer within 30 days, but within two years of any accident, you file a claim form with the Workers’ Compensation Board. That form is called a C-3. That C-3 form has very, very difficult questions that you must answer correctly and truthfully. If you don’t complete your C-3 form accurately, you will have significant problems with your claim.

It’s important to consult with an attorney that’s skilled in representing injured workers and workers’ compensation matters to make certain that your C-3 is not only timely, but also the contents of the C-3 don’t give rise to a basis to disallow or rule against you in the claim.

Attorney Fees in a Workers' Comp Case

My name is Dave Philippone. I’m a partner here at Oot & Associates. I’ve been with the firm for over 30 years, and I’m here today to talk to you about attorney’s fees and workers’ compensation matters.

First and foremost, you need to be aware that you should never pay a workers’ compensation attorney directly. All fees are awarded by the workers’ compensation board with the approval of a workers’ compensation law judge and any fee awarded has to be consistent with Section 24 of the workers’ compensation law. Fees are paid directly by the insurance carrier to the attorney out of money that is moving, that is money they’ve yet to pay you that they owe, a fee can be awarded out of that, and that fee is limited to the provisions of Section 24 of the workers’ compensation law.

So if you’re concerned about getting an attorney in a workers’ compensation matter because you think you might end up paying money more than you should, there are safeguards in the system to make certain, number one, you never pay your attorney directly, number two, you never overpay your attorney because the law judge and the board make certain that any fee awarded is consistent with the statute.

Fees are generally limited to no more than 15 percent of what is owed for retroactive lost wage benefits. Fees can be one-third of an ongoing payment, that is the very next check, not one-third of each check.

And again, Section 24 of the comp law is something that you can google to read for yourself. Any firm like ours, when an attorney is engaged, will provide their client with a copy of Section 24 of that law. We do that at every initial visit to make certain up front you understand how fees are calculated and what is necessary for a fee to be awarded.

Selecting a Workers' Compensation Attorney

My name is Dave Philippone. I’m an attorney here with Oot & Associates. I’ve been with the firm for over 30 years. I’m here today to talk to you about selecting a workers’ compensation attorney.

You’re probably seeing a lot of advertisements on TV from different firms saying that they handle workers’ compensation or personal injury or social security disability. It’s my belief that you should pick a firm that’s local, that has familiarity with the geographic area, the doctors, the employers.

Certain firms advertise here, but their main offices are nowhere near here. Our firm has been on the corner of Washington and Townsend Street for over 60 years. We represent injured workers in the central New York area, and in northern New York, we’ve been on Main Street in Canton, New York, for the last 30 years.

Jim McGevna, my partner, born and raised in Syracuse. I’m a transplant, I grew up in Rochester, New York, but I’ve been in Syracuse since 1989. Connor Hamilton, our newest associate, born and raised in Baldwinsville, New York, living in the city of Syracuse right now after attending Syracuse University College of Law. And Leah Oot, the daughter of the founder of our firm, born and raised in Solvay, New York, lives in Liverpool. Our attorneys here are familiar with your doctors, your employers, and we feel that we are best suited to help you with your workers’ compensation, social security, and personal injury needs.

Please give us a call.

Contact Us: FREE Consultation

If you or a loved one has been seriously injured, it is important to seek legal representation as soon as possible. Contact the New York attorneys at Oot & Associates, PLLC for a FREE consultation toll-free at 800.435.8457, or in the immediate area at 315.471.6687, and in the north country at 315.379.1466.

Workers’ Compensation