Consequently, carriers often refuse to authorize medical treatment being requested by an injured worker’s doctor and carriers frequently attempt to pay an injured worker less than what they may be legally entitled to.
Abdo & O’Brien can help to make sure that an injured worker receives the maximum amount of compensation allowed by the New York State workers’ compensation law.
If a work-related injury or illness does not fully heal, the injured worker may be left with a permanent disability or impairment for which they are entitled to compensation either via Schedule Loss of Use (SLU) or Loss of Wage-Earning Capacity (LWEC). The insurance carrier has a financial interest in having permanency set as low as possible, so determining compensation for permanency via SLU or LWEC can be a very complicated and contentious process.
Abdo & O’Brien will explain the permanency process and review the medical permanency opinions to determine whether they are credibly based on a correct application of the NYS Workers’ Compensation Board’s Permanent Impairment Guidelines. It is often necessary for Abdo & O’Brien to litigate the issue of permanency, including developing the record with testimony, so that a decision can be made by a Workers’ Compensation Law Judge.
If the workers’ compensation carrier is not responding to your questions, Abdo & O’Brien will intervene on your behalf. If the issue can’t be resolved by agreement with the carrier, Abdo & O’Brien will request that a workers’ compensation hearing be scheduled to litigate the matter and have the issue ruled on by a Workers’ Compensation Law Judge.
Knowing you have a knowledgeable and experienced attorney on your side is reassuring and allows you to focus on your recovery and getting back to work as soon as possible. We’ll also answer any questions you have about the compensation process, which can reduce stress and anxiety.
The “Average Weekly Wage” or “AWW” is the foundation for all payments in a workers’ compensation case and is based on the injured workers’ gross (pre-tax) earnings in the 52-weeks leading up to the date of injury/ date of disablement. Abdo & O’Brien will confirm that the injured worker’s AWW is set correctly based on the correct payroll records and the applicable sections of the New York State workers’ compensation law.
Injured workers may be entitled to “indemnity benefits” (money payments) if they are out of work due to their injury or are earning less than their Average Weekly Wage while working “light duty”
because of restrictions from the injury that forms the basis for the workers’ compensation case. Indemnity payments in a NYS workers’ compensation case are largely based on the reports from the medical providers who have examined the injured worker and provided an opinion of the injured worker’s degree of disability/ impairment.
Injured workers may also be entitled to money payments called "Reduced Earnings". Reduced Earnings payments can be made if the injured worker is earning less than their Average Weekly Wage while working “light duty” because of restrictions from the injury that forms the basis for the workers’ compensation case.
Abdo & O’Brien will review the medical reports that have been filed with the Workers’ Compensation Board to determine the degree of disability which has been assessed by the medical providers and help ensure that that the indemnity payments are being calculated
properly. If your workers’ compensation payments have been suspended or reduced based on the opinion of the carrier’s doctor, Abdo & O’Brien can ensure that your doctor’s opinion is being taken into consideration. If the dispute cannot be resolved by negotiation with the carrier, Abdo & O’Brien can request that the Workers’ Compensation Board schedule a hearing, litigate the dispute, and receive a ruling from a Workers’ Compensation Law Judge.
Abdo & O’Brien can assist an injured worker in understanding the New York State Medical Treatment Guidelines which govern the authorization process for treatment and prescription medications under the NYS workers’ compensation law. In some instances, Abdo & O’Brien can litigate disputes over medical treatment, including with medical deposition testimony, and argue for authorization of medical treatment that’s been requested by the injured worker’s doctor and denied by the insurance carrier.
“Accidents” are the most common type of workplace injury and require very little explanation. A case can be established for workplace injuries that happen during a specific incident, such as while lifting, pushing, pulling, or during a fall.
Workers’ compensation benefits are available to active volunteer members of a fire company of a county, city, town, village, or fire district who are injured in the line of duty. Additionally, many New York State volunteer ambulance workers are entitled to workers’ compensation benefits. If you are an active volunteer member of an ambulance company and are injured in the line of duty, you likely have workers’ compensation coverage available to you.
Injuries don’t always happen all at once. Sometimes they happen over a longer period of time and are caused by the specific type of work that a person does. For example, a construction worker may develop a shoulder or a back problem caused by repetitively lifting or bending while at work. Alternatively, an electrician, mechanic, or office worker may develop problems with their arms, wrists or hands caused by repetitively using tools and/ or moving items. These types of injuries are referred to as “occupational diseases.”
Workers rights extend to the entire family.
As horrible as it is, some injured workers do not survive their workplace accident or
occupational disease. In these situations, a workers’ compensation case may be pursued on behalf of the surviving spouse, minor children, or on behalf of the injured worker’s estate.
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