Why Do I Have to Wait For Benefits?

Erin McCabe, Esq.

If you are injured on the job in New York the workers compensation insurance carrier is required to pay for lost earnings that are related to the disability, but you may not receive benefits immediately.   No compensation is payable to the injured worker for the first seven calendar days when they are disabled.  After the seventh day, the carrier is responsible for payment.  If the injury keeps the injured worker out of work for fourteen days or more, then the injured worker will be entitled to receive payments back to the first day out of work due to the disability.  The law requires that the first payment to the injured worker due to the disability is to be mailed on or before the 18th day of disability or within ten days after the employer has knowledge of the accident, whichever is later.

Why the delay in payments?  To eliminate the carrier having to make payment on cases with little lost time and potentially minor injuries.

It is possible that your employer may pay you when you begin to lose time from work regardless of the waiting period.  However, that is at the employer’s discretion, or per your contract with the employer.  You may be able to use your own paid time off if it is permitted by your employer or by contract.  However, if you use any accumulated sick or paid time off you may not receive it back.  The employer would have to request reimbursement from the insurance carrier for any money paid to you.  If the employer does not request reimbursement, you will not recover your time.

If a claim is controverted by the insurance carrier no payments may be made until the issues are decided by the Law Judge after testimony of lay witnesses and possibly as well from the doctors.  An injured worker may wait for months if a claim is controverted for indemnity benefits for lost wages while at the same time the treating physician also is not receiving payment making for a difficult and stressful time.

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