How to File a Workers' Compensation Claim in New York
If you've been injured on the job in New York, workers' compensation benefits can cover your medical expenses and replace lost wages. This guide walks you through the entire process of filing a claim, from reporting the injury to receiving benefits.
Understanding Workers' Compensation in NY
Workers' compensation is a no-fault system that provides benefits to employees injured on the job, regardless of who was at fault. In New York, most employers are required to carry workers' compensation insurance.
1What's Covered
Medical treatment for work-related injuries or illnesses, wage replacement (usually 2/3 of your average weekly wage), disability benefits, and vocational rehabilitation if you can't return to your previous job.
2What's NOT Covered
Injuries caused by intoxication, intentional self-infliction, fights you started, or injuries occurring while committing a serious crime.
Step 1: Report Your Injury Immediately
Time is critical in workers' compensation cases. New York law requires you to notify your employer of a work-related injury within 30 days.
1Notify Your Supervisor
Tell your supervisor, manager, or HR department about your injury as soon as possible, preferably in writing. Include the date, time, location, and how the injury occurred.
2Get Written Confirmation
Ask for written acknowledgment that you reported the injury. Keep a copy for your records.
3Document the Incident
Write down details about the accident while they're fresh in your mind. Take photos of the injury and the accident scene if possible.
Important Warnings
- ⚠Missing the 30-day reporting deadline can jeopardize your claim
- ⚠Even if your injury seems minor, report it—some injuries worsen over time
- ⚠Your employer cannot retaliate against you for filing a workers' comp claim
Step 2: Seek Medical Treatment
Getting proper medical care is crucial for your health and your claim.
1Emergency Treatment
For serious injuries, go to the emergency room immediately. For non-emergency injuries, your employer may direct you to a specific medical provider for the first 30 days.
2Follow All Medical Advice
Attend all appointments, complete prescribed treatments, and keep detailed records. Gaps in treatment can be used to deny or reduce benefits.
3Choose Your Own Doctor After 30 Days
After the first 30 days, you have the right to choose your own doctor. Make sure they're authorized by the Workers' Compensation Board.
Helpful Tips
- •Always tell doctors that your injury is work-related
- •Keep copies of all medical records and bills
- •If your employer's doctor says you can return to work but you don't feel ready, get a second opinion
Step 3: File Form C-3 (Employee Claim)
You must file Form C-3 with the New York Workers' Compensation Board within 2 years of the injury date (or 2 years from when you knew the injury was work-related).
1Complete Form C-3
This form officially starts your workers' compensation claim. Include all details about your injury, medical treatment, and lost wages.
2Submit the Form
File electronically through the Workers' Compensation Board website, or mail it to: NYS Workers' Compensation Board, PO Box 5205, Binghamton, NY 13902-5205.
3Your Employer Must File Too
Your employer must file Form C-2 (Employer's Report) within 10 days of learning about your injury. If they don't, contact the Workers' Compensation Board.
Step 4: Attend Hearings and IMEs
The Workers' Compensation Board may schedule hearings and independent medical examinations (IMEs) to evaluate your claim.
1Attend All Scheduled Hearings
Missing a hearing can result in your case being dismissed. These hearings determine the extent of your injury and the benefits you'll receive.
2Cooperate with IMEs
Insurance companies may request you attend an Independent Medical Examination. While these doctors work for the insurance company, refusing to attend can result in suspension of benefits.
Important Warnings
- ⚠IME doctors are hired by the insurance company—their reports often downplay injuries
- ⚠You can have your own medical evidence to counter IME findings
- ⚠Consider having a lawyer present at hearings, especially if your claim is disputed
Receiving Benefits
If your claim is approved, you'll receive various types of benefits depending on your situation.
1Medical Benefits
All necessary and reasonable medical treatment related to your injury should be covered, including doctor visits, hospital stays, prescriptions, physical therapy, and medical equipment.
2Wage Replacement
If you miss more than 7 days of work, you'll receive temporary disability benefits equal to 2/3 of your average weekly wage (subject to state maximums). Benefits start on the 8th day of disability.
3Permanent Disability
If you have a permanent impairment, you may receive additional compensation based on the Workers' Compensation Board's schedule of awards.
Conclusion
Filing a workers' compensation claim can be complex, but following these steps increases your chances of a successful claim. Remember to report injuries promptly, seek proper medical care, file all required forms on time, and don't hesitate to consult a workers' compensation attorney if your claim is denied or you encounter problems.
Frequently Asked Questions
Can I be fired for filing a workers' comp claim?
No. It's illegal for your employer to fire you in retaliation for filing a workers' compensation claim. If you believe you've been wrongfully terminated, contact a lawyer immediately.
What if my employer doesn't have workers' comp insurance?
If your employer failed to carry required workers' compensation insurance, they can face serious penalties. You can still file a claim with the Workers' Compensation Board, and you may also be able to sue your employer directly.
Can I sue my employer for my injury?
Generally no—workers' compensation is your exclusive remedy. However, you may be able to sue a third party (like a contractor or equipment manufacturer) if they contributed to your injury.
How long do workers' comp benefits last?
Medical benefits continue as long as treatment is necessary. Wage replacement benefits depend on your disability status and can continue for years in cases of permanent disability.
Content provided by: NY Legal Resource Center
Disclaimer: This guide provides general information only and does not constitute legal advice. Individual circumstances vary, and you should consult with a qualified attorney for advice specific to your situation.