New York Workers’ Compensation Injury Attorney
The workers’ compensation system creates obstacles that may prevent you from receiving the benefits you need to support your family during recovery. Insurance carriers often focus on their profits rather than on your health. You need a dedicated New York workers’ compensation attorney to review your case and protect your rights.
Lewis & Lewis, P.C. acts as your voice against powerful insurance companies and employers who try to minimize your injury. Call (716) 442-8885 today to discuss your options with our local legal team, or contact us online.
Why Choose Lewis & Lewis, P.C. for Your Workers’ Comp Case?
Lewis & Lewis, P.C. has stood with injured workers statewide across New York for more than eight decades. We know the local medical providers, the administrative law judges, and the specific tactics insurance carriers use in this region.
Deep Roots in Western New York
Our firm has five offices throughout Western New York. We understand the industries that drive the local economy, from manufacturing plants in Buffalo to the healthcare facilities in Niagara Falls. This local knowledge helps us build cases that reflect the reality of your work environment.
With Lewis & Lewis, P.C., you gain an advocate who knows the geography and the people of Western New York.
Decades of Legal Experience
Since 1944, our firm has handled thousands of cases involving workplace accidents and occupational diseases. We have seen how the laws change and how insurance companies adjust their strategies to deny payments. Our history gives us a perspective that newer firms may lack. We use this extensive background to anticipate challenges in your claim before they happen.
You’ll benefit from our New York workers’ compensation attorneys who have successfully managed complex files involving catastrophic injuries, repetitive stress claims, and toxic exposure cases.
Open Communication
You need answers when your paycheck stops arriving. We prioritize communication, so you always know the status of your case. Our team creates a supportive environment where you can ask questions without fear. We explain every form and every hearing notice in plain language.
New York Workers’ Compensation Law Explained
If you have been injured on the job, understanding the legal framework is the first step toward securing your recovery. A New York workers’ compensation attorney can help you navigate these rules to ensure you receive the maximum benefits allowed under the law.
New York operates under a no-fault workers’ compensation system. This means that you don’t need to prove that your employer’s negligence caused the accident to receive benefits.
Even if your own mistake led to the injury, you’re still eligible for coverage. In exchange for this guaranteed protection, employees generally forfeit the right to sue their employer in civil court for personal injury damages.
Who Is Covered in New York?
Coverage is mandatory for most employers in New York State. This includes full-time, part-time, and seasonal employees, as well as workers in for-profit and non-profit sectors. Whether you work in construction, healthcare, or an office setting, you’re typically covered from your very first day of employment.
The law applies statewide, ensuring that workers from Buffalo to New York City have access to the same fundamental protections.
What Benefits Are Available?
| Workers’ Compensation Topic | Key Information | Why It Matters for Injured Workers |
| Eligibility for Benefits | Most employees in New York are covered, including full-time, part-time, and seasonal workers. Coverage begins on the first day of employment. | Ensures workers know they may qualify for benefits immediately after a workplace injury. |
| Medical Treatment Coverage | All reasonable and necessary medical care related to a workplace injury is paid by the employer’s workers’ compensation insurance. | Prevents injured workers from paying out-of-pocket for treatment related to the injury. |
| Wage Replacement Benefits | Workers unable to work for more than 7 days may receive weekly payments equal to roughly two-thirds of their average weekly wage, subject to state limits. | Helps workers maintain financial stability while recovering from an injury. |
| Types of Disability | Disabilities are classified as Temporary Total, Temporary Partial, Permanent Partial, or Permanent Total depending on the severity and duration of the injury. | Determines the amount and duration of wage replacement benefits. |
| Schedule Loss of Use (SLU) Awards | Workers with permanent loss of use of a body part (such as an arm, leg, hand, or foot) may receive compensation based on a set number of benefit weeks. | Provides financial compensation even if the worker eventually returns to work. |
| Independent Medical Examination (IME) | Insurance carriers may require injured workers to attend an examination with a doctor selected by the insurer. | The IME report can influence whether benefits continue or are reduced. |
| Workers’ Compensation Board Hearings | Administrative law judges resolve disputes about benefits, treatment approvals, or claim validity. | Provides a legal forum for workers to challenge insurance company decisions. |
| Third-Party Claims | Injured workers may file a personal injury lawsuit against a negligent third party involved in the accident. | Allows recovery of damages not covered by workers’ compensation, such as pain and suffering. |
| Death Benefits | Surviving family members may receive weekly financial support and funeral expense coverage after a fatal workplace accident. | Helps families maintain financial support after losing a loved one. |
| Role of a Workers’ Compensation Attorney | A lawyer helps calculate wage benefits, challenge denied claims, prepare for hearings, and pursue additional compensation. | Protects workers from insurance tactics that attempt to reduce or deny benefits. |
The system provides several essential benefits to help injured workers maintain financial stability:
- Medical Treatment: All necessary medical care directly related to the work injury is paid for by the employer’s insurance carrier.
- Cash Benefits: Workers who are unable to work for more than seven days receive weekly payments to compensate for lost wages, usually calculated as two-thirds of their average weekly wage.
- Permanent Disability: If an injury results in a permanent physical impairment or the loss of use of a body part, the worker may be entitled to a Schedule Loss of Use award.
- Death Benefits: If a workplace accident results in a fatality, surviving family members may receive weekly financial support and funeral expenses.
Role of the NY Workers’ Compensation Board
The New York State Workers’ Compensation Board is the regulatory agency that oversees all claims. The Board does not pay the benefits—the insurance companies do—but it ensures that claims are processed according to the law.
If an insurance company denies a claim or disputes the severity of an injury, the Board provides a system of administrative hearings where judges resolve the conflict and issue binding decisions on benefit payments.
Wage Replacement Benefits Under New York Workers’ Compensation Law
The workers’ compensation system provides cash benefits to replace a portion of your lost wages. The amount depends on your average weekly wage for the year prior to the accident and your level of disability. The law sets a maximum weekly benefit rate that changes each year.
Calculating the average weekly wage requires precision. Your New York workers’ compensation attorney reviews your payroll records to verify your earnings. This includes overtime, bonuses, and second jobs if you had concurrent employment.
Carriers often make mistakes in this calculation that result in lower weekly checks. We audit these figures to demand the full amount you may receive.
Your level of disability may also fluctuate. Your doctor assigns a percentage of temporary impairment. A 100% disability rating yields the maximum benefit rate for your wages. As you heal, this percentage may decrease.
If the carrier often tries to lower this percentage prematurely, we’ll present medical evidence to support your doctor’s assessment of your ongoing limitations.
Partial Disability and Reduced Earnings
You might return to work in a limited capacity while still recovering. This often means working fewer hours or taking a lower-paying light-duty position. You may qualify for reduced earnings benefits in this situation.
These benefits make up two-thirds of the difference between your pre-injury wages and your wage-earning capacity. This financial support helps you transition back to the workforce without suffering a drastic drop in income.
We help you calculate the correct reduced earnings rate. We also address situations where an employer cannot accommodate your restrictions. If your doctor clears you for light duty but your employer has no work available, we must show that you’re looking for work elsewhere to maintain your benefits. We explain exactly what steps you need to take to satisfy the legal standards.
Classes of disability include:
- Temporary Total Disability: Your medical condition prevents you from performing any work duties for a limited period.
- Temporary Partial Disability: You can perform some work duties, but with specific physical restrictions while you recover.
- Permanent Partial Disability: Your injury reaches maximum medical improvement but leaves you with lasting impairments that affect your earning capacity.
- Permanent Total Disability: You suffered a catastrophic injury that permanently eliminates your ability to perform any gainful employment.
Third-Party Liability Claims in New York
The workers’ compensation system generally prevents you from suing your employer for a workplace accident. You receive guaranteed benefits regardless of fault, but you lose the right to file a personal injury lawsuit against the company that signs your paycheck.
However, many workplace accidents involve negligence by a third party. If a party other than your employer injured you while you were working, Lewis & Lewis, P.C. can help you file a workers’ comp claim and a personal injury lawsuit.
Potential defendants in a third-party claim include:
- Negligent Driver: A delivery driver or other motorist caused the crash that injured you while you were working.
- General Contractor: A general contractor created an unsafe job site condition that led to your injury.
- Property Owner: A building owner failed to maintain safe conditions, and that failure caused your injury.
- Subcontractor: Another subcontractor on your worksite created a hazard that caused your injury.
- Equipment Rental Company: A rental company provided unsafe or poorly maintained equipment that caused your injury.
Third-party claims allow you to seek damages that workers’ compensation doesn’t cover, such as pain and suffering. We coordinate these claims to maximize your potential recovery.
Your New York workers’ compensation attorney will investigate the accident to identify all liable parties. We manage the complex interaction between the two claims, including the workers’ compensation lien that the carrier asserts against your personal injury settlement.
What Are Schedule Loss of Use Awards?
You may receive a specific financial award if your injury involves a body part like an arm, leg, hand, or foot. This is a Schedule Loss of Use (SLU) award. The law assigns a value to each body part measured in weeks of benefits.
If you lose 25% of the use of your arm, you receive benefits for a set number of weeks based on that percentage. You receive this payment even if you didn’t lose time from work.
Doctors determine the percentage of loss after you reach maximum medical improvement. This usually happens one year or more after the accident or surgery. Your doctor measures your range of motion and uses the Workers’ Compensation Board guidelines. The insurance company’s doctor also measures your loss.
Your attorney negotiates with the carrier to agree on a fair percentage. If we cannot agree, we litigate the issue before a law judge. We present medical testimony to justify a higher percentage. We review the medical guidelines to verify that the doctors applied the correct formulas.
What Is an Independent Medical Examination?
The insurance carrier has the right to send you to a doctor of their choosing. This is the Independent Medical Examination (IME). The term “independent” misleads many injured workers; the insurance company pays this doctor to evaluate your condition.
These doctors sometimes minimize the severity of injuries or claim that a disability is temporary rather than permanent. The IME report carries significant weight with the Workers’ Compensation Board.
Preparing for the IME
You must prepare thoroughly for this appointment; it’s safe to assume that the IME doctor watches you from the moment you arrive in the parking lot. They note if you have trouble getting out of your car or opening the heavy waiting room door.
The doctor may even track how long you can sit in the waiting area. During the exam, they may perform tests that seem unrelated to your injury to check for consistency in your pain response. A negative IME report can lead to a suspension of your benefits.
If the IME doctor says you can return to work, the carrier may stop your wage replacement checks immediately. Your New York workers’ compensation lawyer challenges these reports and cross-examines the IME doctor to expose bias or errors in their evaluation. We compare their findings with the detailed reports from your treating physician.
Workers’ Compensation Hearings Before the New York Workers’ Compensation Board
Many disputes in a workers’ compensation claim require a formal hearing. A Law Judge presides over these hearings at the Workers’ Compensation Board. The hearings resolve issues like unpaid medical bills, correct benefit rates, and the degree of permanent disability.
You don’t have to face the judge alone. Your New York workers’ comp lawyer represents you at every hearing. Our team prepares you for testimony so you know what questions the judge or the insurance attorney might ask. Our presence signals to the carrier that you take your claim seriously.
Appeals occur when a party disagrees with the judge’s decision. We handle appeals to the Board Panel and, if necessary, to higher courts. We review the hearing transcript to identify legal errors. Your attorney writes detailed briefs that explain why the law supports your position.
Common hearing topics include:
- Claim Status: The judge decides if your claim is valid after the insurance company issues a denial.
- Average Weekly Wage: The parties present payroll evidence to establish the baseline for your benefit calculations.
- Treatment: The judge reviews medical necessity when the carrier denies surgery or therapy.
- Fraud Allegations: We defend you against accusations that you misrepresented your injury or work status.
FAQ for New York Workers’ Compensation Attorney
Can I Choose My Own Doctor?
New York law allows you to select any doctor who is authorized by the Workers’ Compensation Board to treat your injury. You don’t have to use a doctor the employer recommends. We can help you find a provider near you.
However, if your employer participates in a Preferred Provider Organization (PPO), you may need to treat with their network providers for the first 30 days if you received proper notice of the PPO requirement. After that period, you may switch to a doctor of your choice.
Does My Employer Have To Hold My Job for Me?
The law doesn’t require an employer to keep your position open while you recover. However, the Family and Medical Leave Act (FMLA) may provide job protection for up to 12 weeks for qualified employees. Additionally, your employer cannot fire you strictly because you filed a claim.
If you recover and your employer has an opening, they must consider you for the role, but they don’t have to create a job for you.
What if My Pre-Existing Condition Got Worse?
You may still qualify for benefits if a work accident aggravates or worsens a prior injury. The law covers the worsening of a condition just as it covers a new injury. The medical evidence must show that your work duties caused a measurable change in your health.
The insurance carrier may fight these claims vigorously. You need a New York workers’ compensation attorney to help differentiate the new damage from the old condition.
How Does a Workers’ Compensation Settlement Affect Social Security?
A workers’ compensation settlement can reduce your Social Security Disability Insurance (SSDI) benefits due to an offset rule. The Social Security Administration limits the combined total of your workers’ compensation and SSDI benefits to 80% of your average current earnings.
Lawyers put special wording in settlement agreements to minimize or eliminate this reduction. You have to set up the settlement carefully so that the total amount is spread out over how long you are expected to live, for Social Security rules.
When Should I Contact a New York Workers’ Compensation Attorney?
You can hire a legal team at any stage of the process. Early involvement helps streamline the collection of evidence and the filing of forms. However, even if your case is years old, an attorney can review the file to look for additional benefits like a Schedule Loss of Use award.
Protect Your Rights Today
Insurance carriers use their resources to find ways to limit what they pay you. You don’t have to accept their decisions as final. Lewis & Lewis, P.C. fights to secure the medical care and financial support you need to move forward. Call us at (716) 442-8885 for a free consultation, or contact us online.
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Satisfied Client Stories
”I liked Lewis & Lewis from the beginning when they helped me sort through all the paperwork-related to my injury. They really helped me get organized. But what really impressed me was when my Lewis & Lewis personal injury lawyer obtained thousands of dollars in workers’ compensation benefits that I didn’t even know I was entitled to. My attorney worked hard to get me paid.
Fred T.Kenmore, NY - Steam Fitter
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