FAQ: What Benefits am I Entitled to with Workers Compensation?

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Workers’ compensation is a benefits package offered to workers who are injured or made sick as a result of their occupational duties. The law also covers an illness that is deemed to be an “occupational disease”. In New York, all private-sector workers are eligible for workers’ compensation, regardless of whether they are full time, Gregg Marcus, a Long Island Insurance Executive, explains what benefits you may be entitled to in case of injury or illness on the job. Benefits offered to an injured worker in New York are broken into five categories: Cash benefits, Supplemental Benefits, Social Security Benefits, Medical Benefits and Death Benefits:

1. Cash Benefits
Claimants who are totally or partially disabled and unable to work for more than seven days can receive cash benefits. The amount that a worker receives is based on his/her average weekly wage for the previous year. The following formula is used to calculate benefits:

2/3 x average weekly wage x % of disability = weekly benefit

Necessary medical care is provided no matter how short or how long the length of the disability, however, cash benefits are not paid for the first seven days of the disability, unless it extends beyond fourteen days. In that case, the worker may receive cash benefits from the first workday off the job. If you can return to work but your injury prevents you from earning the same wages you once did, you may be entitled to a benefit that will make up two-thirds of the difference.

2. Social Security Benefits
A worker who becomes seriously disabled, either permanently or for a continuous period of more than 12 months, as a result of a medically determinable physical or mental impairment may be entitled to the payment of monthly Social Security benefits.

3. Medical Benefits
The injured or ill worker who is eligible for workers’ compensation will receive necessary medical care directly related to the original injury or illness and the recovery from his/her disability. With the exception of an emergency situation, the Workers’ Compensation Board must authorize the treating health care provider.

4. Death Benefits
If the worker dies from a compensable injury, the surviving spouse and/or minor children are entitled to weekly cash benefits. Funeral expenses may also be paid, up to $6,000 in Metropolitan New York counties; up to $5,000 in all others.

5. Supplemental Benefits
Claimants classified as permanently or totally disabled as the result of an injury that occurred prior to January 1, 1979, are eligible to collect supplemental benefits to make up for rising costs. Widows receiving death benefits as the result of the death of their spouse occurring prior to January 1, 1979 are also eligible for this category of benefits.

If you have been injured on the job and think you may be eligible for worker’s comp benefits, speak to a human resources representative at the place of your employment. If you are a small-business owner in Nassau or Suffolk County and need to purchase Workers’ Compensation insurance for your employees, contact Gregg S. Marcus today for a quote.

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