Occupational Injury Laws

In New York, an occupational injury or illness is a disability or death caused by an occupational disease listed in the law. The New York Workers' Compensation Law applies broadly to nearly all employers. The law covers a wide range of injuries that arise out of and in the course of employment, including accidental injuries and occupational diseases. Occupational diseases are defined as a condition that arises out of and in the course of employment and is caused by the nature of that employment. This broad definition is designed to ensure comprehensive coverage for workers.

Upon a workplace injury, the employer must file a report with the New York State Workers' Compensation Board (WCB). This is required for any injury that causes the employee to miss work beyond their regular shift or requires more than first aid. The report must be submitted promptly, typically within 10 days of the employer receiving notice of the injury or death.

Employers are required to secure compensation for their employees through one of three methods: by insuring with the State Insurance Fund, with a private insurance carrier, or by becoming a self-insurer. After a claim is filed, the insurer or self-insured employer investigates and determines whether to accept or contest the claim. The Workers' Compensation Board (WCB) will then review the claim and evidence, and may schedule a hearing if there is a dispute. The WCB's decision is final unless appealed, and compensation benefits are paid accordingly.

Injured employees in New York are entitled to all necessary medical treatment, including hospital care, physician services, and prescription drugs. In addition to medical benefits, an employee who is temporarily or permanently disabled from earning full wages is entitled to disability benefits. The New York Disability Benefits Law defines "disability" as the inability to perform the duties of employment due to a non-occupational illness or injury. However, workers' compensation specifically covers occupational injuries and diseases.

The New York Workers' Compensation Law provides different types of wage replacement benefits, including:

• Temporary Total Disability: For an employee who is completely unable to work for a temporary period.
• Temporary Partial Disability: For an employee who can perform some work but not their full duties, or must work fewer hours, resulting in a loss of wages.
• Permanent Partial Disability: For an employee who has a permanent impairment as a result of the injury but is still able to work in some capacity.
• Permanent Total Disability: For an employee who is permanently and completely unable to work due to the injury.

The amount of compensation is based on a percentage of the employee's average weekly wage.

In cases where an occupational injury results in the death of an employee, the law provides death benefits to the surviving dependents, such as a spouse or children. These benefits are paid to help the family manage financially after the loss of the employee's income. The benefit amount is calculated based on a percentage of the deceased employee's average weekly wage at the time of the accident or disablement. The law outlines specific allocation rules for different categories of dependents.

The following provides a simplified overview of how death benefits may be distributed among surviving dependents under certain provisions of the law:

• Surviving Spouse and No Children: A portion of the deceased's average weekly wage is paid to the spouse for life or until remarriage.
• Surviving Spouse and Children: A percentage of the deceased's average weekly wage is allocated between the spouse and children. The portion for the children is paid to their guardian until they reach age 18 or 23 if they are a full-time student.
• Only Surviving Children: A percentage of the deceased's average weekly wage is divided equally among the children.

When a workers' compensation claim is contested by an employer or insurer, the New York WCB will schedule a hearing before a Workers' Compensation Law Judge (WCLJ). The WCLJ will review all evidence, including medical reports, witness testimonies, and employer records, to make a determination. Both parties have the right to present their case and cross-examine witnesses. The WCLJ's decision can be appealed to the WCB Board, and further to the state's appellate courts.

Employers who fail to secure workers' compensation insurance or violate the law face severe penalties. Failure to provide coverage is a felony in New York and can result in significant fines and potential imprisonment. Employers may also be subject to civil lawsuits from injured employees for damages that would have been covered by workers' compensation. This can include compensatory damages for pain and suffering, which are not covered by workers' compensation benefits.