When you are hurt or sick and unable to work, you’re worried about meeting your financial obligations. Even a couple of missed work days can spell trouble for many workers.
In New York State, financial and healthcare “safety nets” may be available if you become ill or injured while employed in a private sector job. NYS laws require employers to purchase disability insurance benefits plans and workers’ compensation benefits plans to assist employees when their health keeps them from earning a paycheck. Both types of coverage are similar in that they can help when you can’t work, but each provides coverage in very different circumstances.
Workers’ Compensation Benefits vs Disability Coverage
If your injury or illness is work-related, you’ll apply for workers’ compensation benefits. Alternatively, if your injury or illness occurs due to causes outside of work, you will instead apply for disability benefits.
Workers’ compensation benefits are calculated based on your average weekly earnings for the year prior to your injury date. You receive a percentage of your usual earnings based on your medical degree of disability. The current (2023) weekly maximum workers’ compensation rate is $1,145.43. Workers’ compensation benefits can be payable for many years, depending on medical evidence of ongoing disability. Workers’ compensation benefits are not taxable.
NYS Disability Benefits
Disability benefits are temporary payments for non-work injuries. The benefit rate is equal to 50% of the employee’s average weekly wage for the last 8 weeks of work, with a maximum benefit rate of $170.00 per week. Disability benefits are limited to 26 weeks. Disability benefits are taxable.
Under certain circumstances, you may be eligible for NYS disability benefits for a work-related injury. If a workers’ compensation claim is “controverted,” the injured worker may apply for NYS disability benefits in the interim period while they await workers’ compensation benefits. Controversion is the legal term used to indicate the claim has been denied by the insurance carrier and is being litigated before the Workers’ Compensation Board. In this case, the disability company would be reimbursed by the workers’ compensation company if the Board approves your claim. The injured worker is NOT responsible for ensuring the disability provider is reimbursed.
Some employers offer short-term and long-term disability coverage as employee benefits. These types of insurance policies may have higher payments than standard NYS disability minimums and may be available for both work-related and non-work-related conditions.
If a disability lasts, or is expected to last, more than 12 months, you may be eligible for Social Security Disability benefits whether the condition is work-related or not.
The attorneys at Lewis and Lewis will help you understand what type of benefits you are entitled to, so you can focus on what matters.