What is Workers' Compensation?

Workers' Compensation is insurance, paid for by the employer, that provides cash benefits and medical care for workers who require medical care or become disabled because of a job-related injury, sickness or occupational disease. Some employers are self-insured.

Who is Eligible?

With few exceptions, nearly all workers in this State are covered. In addition, nearly all organized volunteers, such as members of volunteer fire and ambulance corps are covered.

How to File a Claim

• Report your injury to the employer promptly (must be within 30 days of accident).
• Obtain Board Form C-3, Employee's Claim for Compensation from the CSEA Workers' Compensation Legal Assistance Program, by calling CSEA Headquarters during normal business hours, 8 a.m. - 5 p.m., M - F, at 1-800-342-4146, and follow the menu instructions for the Workers' Compensation Legal Assistance Program.

What About Medical Care?

• You are free to choose any doctor authorized by the Workers' Compensation Board, unless your employer is participating in the New York State Managed Care for Workers' Compensation Pilot Program.
• You do not pay the doctor. The doctor is paid by your employer or his insurance carrier.

Will I Get Any Cash Compensation?

Yes. If you're totally or even partially disabled, you may receive as much as two-thirds of your average weekly wage. Under present tax laws these payments are tax free.

Injuries to certain parts of the body may entitle you to a substantial cash award, even without the loss of a single day from work. But failure by your treating physician to file a "C-4" (medical report) with the Workers' Compensation Board and your employer, or its insurance carrier, may delay payments.

What About Death Benefits?

If a worker dies from a compensable injury or illness, the surviving wife, husband or dependents are entitled to weekly cash benefits under the Law. Funeral expenses are payable, in whole or in part, depending on the amount of the bill.

Steps to Obtain Coverage

1. Obtain emergency medical treatment, if needed.
2. Note the location of the accident site and names of witnesses.
3. Report the accident to your supervisor. If required, file an accident or incident report.
4. Place yourself under the care of a medical practitioner who treats Workers' Compensation cases.
5. Contact the CSEA Workers' Compensation Legal Assistance Program at 1-800-342-4146 for help in preparing and filing your claim with the Workers' Compensation Board. When you call, be sure to have answers for the Intake Form as appears below:

CSEA Workers' Compensation Legal Assistance Program Intake Form

1. NAME
2. ADDRESS
3. HOME PHONE
4. WORK PHONE
5. SS #
6. BIRTH DATE
7. ACCIDENT DATE
8. DETAILS OF ACCIDENT
9. ADDRESS OF ACCIDENT (INCLUDING COUNTY)
10. PARTS OF BODY INJURED
11. NAME OF EMPLOYER (AGENCY/FACILITY/ETC)
12. EMPLOYER'S ADDRESS
13. CSEA LOCAL/UNIT #
14. WITNESSES TO ACCIDENT
15. TIME LOST FROM WORK
16. SALARY OR BENEFITS RECEIVED DURING ABSENCE
17. WEEKLY PRE-TAX SALARY
18. JOB TITLE
19. ADDITIONAL EMPLOYERS
20. W.C.B.# ON FILED CLAIM
21. INSURANCE COMPANY AND CASE #
22. NAME/ADDRESS OF REPRESENTATIVE, IF ANY
23. HEARINGS TO DATE IN THIS MATTER
    1. Initial Application:
       Call or visit your local Social Security Administration office. They will contact all doctors that have treated you. Your claim will probably be denied, but you don't need an attorney at this level. Be sure to file for "reconsideration" immediately after your initial application is denied.
    2. Reconsideration Level:
       You don't need an attorney at this level. A different Social Security Administration Examiner will review your file as well as any new medical reports you have submitted. Your claim will probably be denied again. Upon denial, you should promptly go to the Social Security Administration to request a hearing.
    3. Hearing Level:
       An Administrative Law Judge will review your file and ask you questions at the hearing. Claimants represented by counsel are more likely to be successful at this level than those who are not represented.
    • You must be unable to do any substantial gainful work due to a physical or mental impairment which has lasted or is expected to last for at least one year.
    • As a general rule if you are over age 31, you must have worked five out of the last ten years preceding the onset of disability.
    • You must have been subject to FICA deductions ("off-the-book" jobs and some government workers are not eligible.)

What is Social Security Disability?

Social Security Disability Insurance provides monthly benefits to workers who meet the Social Security Administration's definition of disabled. If qualified, you or your family are entitled to receive monthly benefits until age 65, if you continue to be considered disabled. At age 65, you will start to receive Old Age and Survivors Benefits.

Who is Eligible?

Every disability you suffer from, not just on-the-job accidents, is considered by the Social Security Administration in determining your eligibility for benefits. But there are certain requirements:

How to File a Claim

Though the Social Security Administration claims process can take longer than you would like, and at times may be frustrating to you, your financial security could be at stake. The tendency of the Social Security Administration has been to deny claims at the initial levels. Consequently, it is essential that you pursue your claim to the hearing level.

As a truly disabled person, however, it is vital that you make every effort to see that your claim application is granted. You can get assistance for doing this by contacting the CSEA Workers' Compensation Legal Assistance Program attorneys.

Steps to Obtain Coverage

The CSEA Workers' Compensation Legal Assistance Program attorneys can help prepare you for this process. They will conduct in-depth interviews with you, correspond directly with your doctors, obtain prior work histories, process all necessary forms, and represent you at the hearing. Be sure to contact the Program Attorneys at the same time that you request a hearing.

If you have a possible Workers' Compensation or Social Security Disability case, the CSEA Workers' Compensation Legal Assistance Program will provide you with honest, courteous and professional representation, at no out-of-pocket cost to you. The representation is provided by the firm of FINE, OLIN AND ANDERMAN, P.C., through its statewide network of offices staffed by attorneys who specialize in workers' compensation / social security law.