What Does it Mean to File a Workers’ Compensation Claim?
If you are injured at work, you need to notify your employer of the injury in writing. That notification needs to happen within 30 days of your workplace accident. However, to protect your rights, this is not the only report you need to make.
In New York, injured workers also need to file a claim with the New York State (NYS) Workers’ Compensation Board. In essence, filing a claim means giving the Workers’ Compensation Board information about your injury, so they can generate a record of the incident and monitor your claim.
If a claim is not filed with the Workers’ Compensation Board, or if the claim is filed too late, a judge might deny your Workers’ Compensation claim. This means you are not eligible for monetary benefits or medical coverage for your injury.
When Does an Injured Worker Need to File a Claim for Workers’ Compensation?
The general time limit for filing a claim is two years.
If the Workers’ Compensation claim is being filed due to an accident or injury while on the job (such as a fall, a motor vehicle accident, or equipment hazard) the law requires an injured worker to file their claim within two years of the date the accident occurred.
For accidental injuries, the time limit is clear. But for occupational diseases, which are physical or mental ailments wholly or partially received as the result of job responsibilities and functions, the time limit is less obvious. If you have an occupational disease (for example, a repetitive motion injury, exposure to a chemical, or other damage that occurred over time) the law requires an injured worker to file their claim within two years of the date they knew or should have known they have a work-related condition.
To say you “knew or should have known” about an occupational disease can mean many things. It can mean the first time you complained to a coworker or supervisor that you had aches and pains from your job. It can mean the first time a doctor or doctor’s staff discussed your work-related condition with you. It can also be the first time you left work early or took a day off due to your condition. If there are questions about whether a claim for Workers’ Compensation was filed within two years, the Workers’ Compensation Board will hold hearings, and a judge will decide.
Finally, if your claim is that a noisy workplace caused occupational hearing loss, your claim must be filed within two years and 90 days of the date you last worked in the noisy environment. If you retire from your employer, that clock starts to run on the day you last reported to the noisy workplace, not your official date of retirement.
How do I File a Claim for Workers’ Compensation in New York?
Sometimes a claim might be filed on behalf of an injured worker by someone else. A doctor’s report, for example, can constitute a claim for compensation. But injured workers should not rely on anyone else to file their claim! Doctor’s billing staff and employer HR representatives do not always know they need to file documents with the Workers’ Compensation Board. Also, other people might not know the correct circumstances of your injury. To make sure you do not lose important benefits that can only come with a properly-filed claim, you should file a claim yourself.
The only way to guarantee that your claim is filed is to complete and file the Workers’ Compensation Board Form C-3. The C-3 is a two-page form that, once in the Board’s hands, counts as having filed a claim for compensation. The C-3 can be found on the Board’s website, along with other forms for claimants, here.
In New York, workers who have informed their employers in person and through writing about the accident will be given a Claimant Information Packet. The packet contains a C-3 Employee Claim form. It can also be downloaded as a PDF or completed online. If you cannot complete the form on paper or online, claimants may call the Board at 877-632-4996.
The C-3 requires some basic personal information as well as information about your injury. Your name, address, and identifying information make up the first section. From there the questions become more specific. Some questions might not make sense in the context of your injury. If you are unsure as to whether any questions are required of you, contact your lawyer to determine the information that needs included in your C-3.
As a reminder, the C-3 is a legal document. If the information on this form does not match exactly with the information submitted in your injury report at work, or in your doctor’s reports, the insurance carrier could use the mismatch to deny your claim. Even worse, if a judge determines the information on this form is false or not credible, you could be permanently barred from receiving Workers’ Compensation benefits. Make sure to accurately list all the injuries you suffered, and all the body parts that were injured.
The information contained on the C-3 determines many aspects of your claim. Information about your salary may be used to determine your Average Weekly Wage, which is calculated into payments if you miss work. The section regarding treatment and doctors will inform the Workers’ Compensation Board and insurance carrier what medical reports need to be obtained.
Once your C-3 is complete, it needs to be filed with the Board. The Board accepts the C-3 by mail, email, or fax. During COVID, the Board is closed to in-person submissions. You should keep a copy of the form, along with proof it was submitted to the Board.
Do I Need a Lawyer to Help me File a Claim for Workers’ Compensation?
There are times where filing a claim for Workers’ Compensation might be a formality or an injured worker can complete their form C-3 without difficulty. In these situations, a lawyer’s help filing the claim might not be needed, but it is always a good idea to consult an attorney when filing a Workers’ Compensation claim.
We also recommend speaking with an attorney before submitting a C-3 form in any of these situations:
- If you are unsure of your exact injuries or an answer on the C-3 form.
- If there is any chance at all your C-3 is being filed late.
- If you get a letter from the Workers’ Compensation Board saying they need a C-3 to take action on your case.
- If you are contacted by the insurance carrier’s attorney or investigator.
- If the insurance carrier is denying your claim.
Lewis & Lewis, P.C., helps many people file their claim for Workers’ Compensation. Our dedicated team of professionals has decades of experience navigating these complex systems. We offer a free initial consultation with no obligation, and we never collect a fee unless we win you money.